Abstract Number: 17

Topical and intralesional therapies for locoregional metastasis of cutaneous melanoma

D.J Deshpande, D.L. Damian, M Carlino

Meeting: 2015 Dermcoll

Session Information

Date: -

Session Title: Melanoma Symposium

Session Time: -

Melanoma is well known to be an immunogenic tumour
and locoregional melanoma provides a unique opportunity to use topical and intralesional immunotherapy in an
attempt to induce tumour specific immune responses. We
review the management options for this scenario. Treatment
modalities for these patients are determined by the
site and volume of local-regional disease and the presence
of distant metastatic disease. Topical immunotherapeutic
agents such as diphencyprone and imiquimod may be
indicated for superficial lesions unsuitable for or resistant
to surgery or radiation therapy. Intralesional therapies
such as Rose Bengal and Talimogene laherparepvec (T-Vec)
are an option for thicker cutaneous or subcutaneous
metastases, and the observation that untreated bystander
lesions often resolve after Rose Bengal suggests an
immune contribution to its mechanism of action. The role
of these local therapies remains to be determined particularly
given the activity of BRAF/MEK inhibitors and the
newer immunologically active systemic agents such as
ipilimumab and anti-PD1 agents. Possible future
approaches may involve combination topical and systemic
therapy in order to maximise rates of durable tumour
response in this patient group.