Treatment with the oncolytic virus talimogene laherparepvec may be effective in patients with basal cell carcinoma, according to a novel study published by Ressler et al in Nature Cancer.
Background
Although basal cell carcinoma—which typically occurs in chronically sun-exposed areas such as the face—is the most common type of skin cancer, locally advanced tumors can be difficult to treat surgically.
Talimogene laherparepvec is a genetically modified herpes simplex virus designed to target tumor cells and simultaneously activate the immune system. The virus has been approved for the treatment of superficial melanoma metastases.
Study Methods and Results
In the study, researchers aimed to reduce the size of basal cell carcinoma tumors prior to planned procedures in order to reduce the risk of patients experiencing functional or cosmetic restrictions postsurgery. They assigned 18 patients who would have required a flap or skin graft because of the size and localization of their basal cell carcinoma to receive six intralesional injections of talimogene laherparepvec over a period of 13 weeks prior to surgical resection.
The researchers discovered that talimogene laherparepvec therapy led to a reduction in the size of the basal cell carcinoma tumors among all of the study participants—allowing for the improvement of surgical resection and resulting in complete regression of the tumor in some patients.
“This enabled the tumor to be reduced in size in half of the patients to such an extent that surgery with direct wound closure was possible. In [one]-third of the cases, the subsequent histologic examination even showed no more living tumor cells. All treated tumors at least became smaller, and no tumor grew further under the therapy. The treatment was well tolerated by the patients,” emphasized senior study author Christoph Höller, MD, PhD, Head of the Skin Tumour Centre in the Department of Dermatology at the Medical University of Vienna.
The researchers further carried out comprehensive analyses that showed that the immune defense in the tumor tissue was strengthened in the course of therapy with talimogene laherparepvec.
Conclusions
The findings indicated that talimogene laherparepvec could serve as a novel treatment option for the neoadjuvant treatment of basal cell carcinoma, particularly in patients who should avoid major surgery.
“The new treatment option for basal cell carcinoma can not only simplify surgery, but also help to avoid disfiguring operations and functional limitations,” underscored lead study author Julia Ressler, MSc, BSc, of the Department of Dermatology at the Medical University of Vienna.
Future studies may be needed to confirm the benefits of talimogene laherparepvec in a larger patient population.
Disclosure: For full disclosures of the study authors, visit nature.com.
