Dr. Andtbacka on T-VEC Plus Ipilimumab in Unresected Melanoma

Robert H. I. Andtbacka, MD, CM, a surgeon and investigator with Intermountain Healthcare and Huntsman Cancer Institute, discusses the safety and efficacy of talimogene laherparepvec (T-VEC) in combination with ipilimumab in patients with previously untreated, unresected stage IIIB-IV melanoma.

In a phase Ib study, 18 patients received treatment with the combination of T-VEC and the CTLA-4 inhibitor ipilimumab. Overall, this study demonstrated promising efficacy without inducing dose-limiting toxicity, with most of the toxicity experienced by patients associated with ipilimumab rather than T-VEC, Andtbacka explains. Overall, grade 3/4 adverse events occurred in 32% of patients, with the most common T-VEC-related event being pyrexia.

The overall response rate for ipilimumab plus T-VEC was 56%, with 33% of patients experiencing a complete response. The disease control rate was 72%. The ongoing phase Ib study is moving into a phase II component that will randomize patients to ipilimumab alone or in combination with T-VEC, explains Andtbacka. This study is currently recruiting patients (NCT01740297).