Complete remission from intralesional talimogene laherparepvec for regionally advanced Merkel cell carcinoma in an immunocompromised solid organ transplant patient

Abstract

ICI: immune checkpoint inhibitor MCC: Merkel cell carcinoma T-VEC: talimogene laherparepvec INTRODUCTION Merkel cell carcinoma (MCC) is a rare aggressive cutaneous neuroendocrine tumor with a high risk of locoregional recurrence and distant metastasis. Immune checkpoint inhibitors (ICIs), avelumab and pembrolizumab, have been approved by the US Food and Drug Administration for the treatment of advanced MCC. Talimogene laherparepvec (T-VEC) is a genetically modified type 1 oncolytic herpes simplex virus encoding granulocyte-macrophage colonystimulating factor. It has been approved by the US Food andDrug Administration for the local treatment of unresectable cutaneous, subcutaneous, and nodal melanoma lesions; however, the clinical benefits of T-VEC in immunosuppressed patients with MCC, including solid organ transplant recipients, are not yet known. We report a case of surgically unresectable stage IIIB MCC in a patient with a history of heart transplantation and prior radiation, who had a complete response to intralesional T-VEC.