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Soo Park, MD
Soo Park, MD
Posted: Monday, February 10, 2025
According to Julia Maria Ressler, MD, of Medical University of Vienna, and colleagues, neoadjuvant treatment with talimogene laherparepvec (T-VEC) was well tolerated, showed activity, and resulted in reprogramming of the tumor microenvironment in patients with difficult-to-resect cutaneous basal cell carcinoma. Their findings from the single-arm phase II NeoBCC trial, which were published in the journal Nature Cancer, advocate for the use of oncolytic viruses as a therapeutic strategy in this clinical context.
“The new treatment option for basal cell carcinoma cannot only simplify surgery but also help to avoid disfiguring operations and functional limitations,” commented Dr. Ressler in an institutional press release.
A total of 18 patients with difficult-to-resect disease (defined as a surgical necessity for either a skin flap or skin transplant for wound closure) were enrolled. The primary endpoint, which was identified as the proportion of patients whose disease became resectable after six cycles of T-VEC (13 weeks) without requiring plastic reconstructive surgery, was met after stage I (50%); the study was thus discontinued for early success. The objective response and complete pathologic response rates were 55.6% and 33.3%, respectively. Safety, relapse-free survival, overall survival, time to occurrence of new basal cell carcinomas, and biologic readouts were evaluated as secondary endpoints.
Mild adverse events alone were reported. Both the 6-month relapse-free and overall survival rates were 100%. A new basal cell carcinoma was diagnosed in two patients. Treatment with T-VEC was found to result in a significant increase in cytotoxic T cells (P = .0092), B cells (P = 0004), and myeloid cells (P = .0042), as well as a decrease in regulatory T cells (P = .0290), within the tumor microenvironment.
Disclosure: For full disclosures of the study authors, visit nature.com.
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