Treatment of Unresectable Melanoma with Injectable Lesions When Systemic Therapy Is Not an Option

Clinical Scenario

This protocol addresses patients with unresectable melanoma presenting as injectable cutaneous, subcutaneous, or nodal lesions who are either ineligible for or who decline the recommended systemic therapies. This situation calls for an evidence-based primary therapy approach tailored to the constraints of systemic treatment avoidance.

Patient Population

Patients have injectable unresectable melanoma — involving cutaneous, subcutaneous, or regional nodal sites — and are not candidates for, or are not willing to undergo, standard recommended systemic treatment. This subset requires a primary therapy strategy that can be delivered directly to accessible tumour sites.

Treatment Approach

An oncolytic viral immunotherapy is used as the primary treatment in this setting — administered directly to the injectable lesions. The full regimen details, eligibility criteria, and structured evidence summary are available in the complete protocol.

Full regimen, sequencing, and clinical detail available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

For patients with injectable (cutaneous or subcutaneous or nodal) unresectable lesions who are not eligible or do not desire the recommended systemic therapies, talimogene laherparepvec may be offered as primary therapy (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak).

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