Imagine if your body had superpowers to fight cancer! Well, that’s exactly what a new treatment called Intratumoral therapy does. By giving your body the tools it needs to attack cancer cells, this treatment is changing the game for patients with unresectable or metastatic melanoma. Some of the treatments are directly killing cancer cells itself or more often it is just recruiting the marines of your body to attack the cancer cells directly. It’s like having a superhero team inside your body, working to defeat the bad guys (the cancer cells) and save the day. But it’s not just a wild idea, it’s a real treatment that has shown promising results in clinical trials. Keep reading to learn more about how it works and how it could help you or a loved one win the fight against melanoma.
One example of intratumoral therapy is called TVEC or basically a live modified herpes virus. That’s a herpes virus that can infect the melanoma cells without really hurting normal cells nearby for the vast majority of patients who were treated. Also, the virus has been modified with a gene insertion called GM-CSF. So when the virus enters the cancer cell, it hijacks the cancer cells molecular machinery to make more of itself and infect nearby cancer cells and it also release this potent protein called GM-CSF. This GM-CSF is like sounding the alarm to all your immunes specifically the dendritic cells which act like scouts to recognize the melanoma specific dead parts and present these “targets” to recruit the marines of your body called the cytotoxic T cells. These T cells can go on a killing spree for other live melanoma cells not injected elsewhere in the body. The best use of the treatment is specifically for patients with skin or nodal disease and it is already approved for general use in melanoma patients. I would not recommend this form of treatment for patients with organ involvement such as the brain, liver or lung. Also, in the small risk of developing a herpetic infection, this virus is very sensitive to treatments that we have that target herpetic infections such as valtrex or acylovir.
Another example of intratumoral therapy that has shown promising results in melanoma is called tavokinogene telseplasmid (also known as pIL-12). This treatment is like a super strength medicine that is delivered directly to the cancer cells in the melanoma. It helps the body’s immune system to fight the cancer cells and can lead to a high control rate of the disease. This is a piece of DNA that injection along with a bit focal electricity to allow the DNA to enter the cancer cell, make the actual protein IL-12, which is also a very potent immuno-stimulant that sounds the alarms to your immune system to recruit the cells to the problem area. Studies in patients who have progressed on standard treatment options are looking promising with some patients having durable responses. More studies are needed to validate the early signal and are ongoing currently.
Intratumoural immunotherapies for unresectable and metastatic melanoma: current status and future perspective
Like any treatment, there can be side effects. Some people may experience pain or swelling at the injection site, fever or flu-like symptoms. However, these side effects are usually mild and temporary.
To decide if intratumoral therapy is right for you, your doctor will look at your overall health and the specific type and stage of your cancer. It’s important to have a team of doctors who specialize in different areas of cancer care work together to make the best decision for you. There are many ongoing trials looking at several different cytokines, interferons, viral vectors, and/or other immune-modulating agents or simply mechanical destructive agents alone or in combination with systemic intravenous therapies.
Overall, intratumoral therapy is a promising treatment option for melanoma and other types of cancer that may have progressed on systemic immunotherapy, chemotherapy, or targeted therapy. It targets the cancer cells directly and helps the body’s immune system fight the cancer. If you or a loved one has been diagnosed with unresectable or metastatic melanoma, it’s important to talk to your doctor about all treatment options, including clinical trials for intratumoral therapy and cellular therapy (separate article to come).
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.