Talimogene laherparepvec resulting in near-complete response in a patient with treatment-refractory Merkel cell carcinoma

Abstract

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous tumour of neuroendocrine cell origin, which can grow rapidly and metastasise early. Localised disease is treated with surgery and radiotherapy. Disease that reaches a more advanced stage can be treated with a variety of different treatment modalities including surgery, radiotherapy, chemotherapy, radionuclide therapy, immunotherapy, and intralesional therapy. We report a case of a patient who had exhausted all local and systemic treatment options and who subsequently had an exceptional response to intralesional injection of Talimogene laherparepvec (TVEC).

Keywords: cancer intervention; chemotherapy

FIGURE 1

Photograph of left upper limb showing large, ulcerated mass in the dorsal forearm and a smaller localised tumour recurrence on the hand.

FIGURE 2

(a) Left upper limb forearm response to TVEC. (b) Left hand dorsal aspect response to TVEC.

FIGURE 3

Visual schematic of patient's treatment history. Abbreviations: RT, radiotherapy; PRRT, peptide receptor radionuclide therapy; TVEC, Talimogene laherparepvec.