000K utf8 1100 $c2023 1500 eng 2050 urn:nbn:de:gbv:8:3-2023-00312-8 2051 10.1136/jitc-2022-006270 3000 Chesney, Jason A 3010 Collichio, Frances A 3010 Friedlander, Philip 3010 Garbe, Claus 3010 Glaspy, John 3010 Hamid, Omid 3010 Hauschild, Axel 3010 Joshi, Harshada 3010 Lebbé, Celeste 3010 Logan, Theodore 3010 Mehnert, Janice M 3010 Milhem, Mohammed M 3010 Puzanov, Igor 3010 Ross, Merrick 3010 Singh, Parminder 3010 Snyder, Wendy 4000 Talimogene laherparepvec in combination with ipilimumab versus ipilimumab alone for advanced melanoma: 5-year final analysis of a multicenter, randomized, open-label, phase II trial [Chesney, Jason A] 4209 Talimogene laherparepvec (T-VEC) plus ipilimumab has demonstrated greater antitumor activity versus ipilimumab alone, without additional toxicity, in patients with advanced melanoma. Here, we report the 5-year outcomes from a randomized phase II study. These data provide the longest efficacy and safety follow-up for patients with melanoma treated with a combination of an oncolytic virus and a checkpoint inhibitor.Eligible patients with unresectable stage IIIB‒IV melanoma were randomized 1:1 to receive T-VEC plus ipilimumab or ipilimumab alone. T-VEC was administered intralesionally at 106 plaque-forming units (PFU)/mL in week 1, followed by 108 PFU/mL in week 4 and every 2 weeks thereafter. Ipilimumab (3 mg/kg every 3 weeks; ≤4 doses) was administered intravenously starting at week 1 in the ipilimumab arm and week 6 in the combination arm. The primary end point was investigator-assessed objective response rate (ORR) per immune-related response criteria; key secondary end points included durable response rate (DRR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety.Overall, 198 patients were randomized to receive the combination (n=98) or ipilimumab (n=100). The combination improved the ORR versus ipilimumab (35.7% vs 16.0%; OR 2.9; 95% CI 1.5 to 5.7; p=0.003). DRR was 33.7% and 13.0% (unadjusted OR 3.4; 95% CI 1.7 to 7.0; descriptive p=0.001), respectively. Among the objective responders, the median DOR was 69.2 months (95% CI 38.5 to not estimable) with the combination and was not reached with ipilimumab. Median PFS was 13.5 months with the combination and 6.4 months with ipilimumab (HR 0.78; 95% CI 0.55 to 1.09; descriptive p=0.14). This is the first randomized controlled study of the combination of an oncolytic virus and a checkpoint inhibitor that meets its primary end point.Trial registration number: NCT01740297. 4950 https://doi.org/10.1136/jitc-2022-006270$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:gbv:8:3-2023-00312-8$xR$3Volltext$534 4961 https://macau.uni-kiel.de/receive/macau_mods_00003631 5051 610 5550 Herpesvirus 1, Human 5550 Humans 5550 Immunotherapy 5550 Ipilimumab 5550 Melanoma 5550 Melanoma 5550 Oncolytic Virotherapy 5550 Oncolytic Virotherapy 5550 Oncolytic viruses 5550 Oncolytic Viruses