Immuno-Oncolytic Virotherapy for Melanoma

Oncolytic virotherapy is a targeted immunotherapeutic approach to induce tumor cell lysis in vivo, with efficacy in a wide range of cancers, including melanoma. Viruses are carefully selected based on their ability to demonstrate selective tumor cell replication, and viral genomic modifications are used to enhance such replication and create a heightened immune response. Current use of oncolytic viruses (OVs) in melanoma ranges from discovery in the experimental phase to proof of efficacy in clinical trials. With the 2015 approval of Talimogene laherparepvec for the treatment of advanced melanoma, we have added yet another tool to effectively treat those with locally unresectable or in-transit disease. Recently, combination therapy trials with OVs and immune checkpoint inhibitors have shown to have some very promising results in patients with advanced, often metastatic, melanoma. This chapter includes an overview of the history of and making of OVs as well as a detailed summary of current clinical trials in melanoma patients. With new experimental data on oncolytic virotherapy published in ever-increasing numbers, the future of OVs for the treatment of melanoma seems to hold promise as a major component of treatment for melanoma.