Surgical Resection After Talimogene Laherparepvec for Melanoma: Persistent Fuorodeoxyglucose Avidity on Positron Emission Tomography Despite No Viable Disease
Autor: | Taleen A. MacArthur, Aodhnait S. Fahy, James W. Jakub |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Skin Neoplasms Minnesota Herpesvirus 1 Human Injections Intralesional Article 030207 dermatology & venereal diseases 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Fluorodeoxyglucose F18 Surgical oncology medicine Humans Melanoma Pathological Aged Retrospective Studies Ultrasonography Fluorodeoxyglucose Biological Products medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Institutional review board Combined Modality Therapy Oncolytic virus Positron emission tomography Positron-Emission Tomography 030220 oncology & carcinogenesis Radiology Radiopharmaceuticals business Talimogene laherparepvec medicine.drug |
Zdroj: | Am Surg |
ISSN: | 1555-9823 0003-1348 |
Popis: | Background Talimogene laherparepvec (TVEC) is an injectable attenuated oncolytic herpes simplex virus (HSV-1) used in the treatment of loco regionally metastatic melanoma. Lesions managed by TVEC are generally considered unresectable at time of initiation of intralesional therapy; however, a subset of patients go on to have surgical resection of loco regionally controlled disease. We sought to review our experience with surgical excision of treated lesions to offer an insight into the radiologic correlate, treatment effect, and pathological findings of intralesional TVEC therapy. Methods This is a retrospective descriptive case series of patients who underwent TVEC injection at Mayo Clinic, Rochester, MN, between October 2016 and July 2020. Institutional Institutional Review Board approval was obtained. Results Twenty-one patients underwent intralesional TVEC, met inclusion criteria, and were included in this series. Seven went on to surgical excision of the injected lesions after an initial course of TVEC. Of those 7 patients, 4 had residual melanoma in the specimen on final pathology, while 3 had a complete pathologic response. All 3 patients who had no residual disease on pathology continued to have fluorodeoxyglucose (FDG) avidity on preoperative positron emission tomography scan of the excised lesions. Discussion Despite ongoing FDG avidity on PET scan, patients who have well-controlled disease and stability over time of the injected lesions may benefit from surgical excision following a course of TVEC. This may render the patient clinically disease free and/or allow them a reprieve from TVEC treatment. |
Databáze: | OpenAIRE |
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