Metastatic melanoma with diffuse melanosis histologically after stable response to talimogene laherparepvec therapy

Talimogene laherparepvec (T-VEC) is the first oncolytic viral immunotherapy approved for treatment of unresectable recurrent melanoma metastases involving skin, subcutaneous fat, or lymph nodes after initial surgery. T-VEC has a favorable safety profile; however, use has been limited to specialized centers because of a select eligible patient population and logistical concerns.1 A randomized phase 3 study comparing T-VEC with subcutaneous granulocyte-macrophage colony-stimulating factor in unresectable stage IIIC-IV melanoma (limited visceral disease) showed an improved durable response rate (complete and partial response ≥6 months) of 16.3% versus 2.1%.