Talimogene laherparepvec
Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)High alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: contraindicated
Pregnancy is avoided during treatment, because the live virus could harm the fetus; breastfeeding is discussed with the team.
A modified herpes simplex virus injected into melanoma lesions: it bursts tumour cells and makes GM-CSF to stir an immune response.
Also called: T-VEC, oncolytic herpes simplex virus type 1
Quick facts
- Group
- Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
- Target
- Melanoma cells (infected and lysed by an engineered herpes simplex virus type 1)
- Used for
- Local treatment
- Key effects
- Flu-like symptoms · Pain at the injection site
- Monitor
- Injected lesions for infection · Breathing symptoms
- ATC
- L01XL02
No doses: the clinician sets them by the current guideline.
Mechanism of action
T-VEC is a weakened, genetically modified herpes simplex virus type 1 that replicates within tumour cells and carries the gene for GM-CSF. Infected tumour cells break open; tumour antigens released after this virus-induced cell death, together with GM-CSF, can promote an antitumour immune response.
- The virus is injected directly into melanoma lesions
- It replicates inside tumour cells and bursts them
- Tumour antigens and GM-CSF are released
- An antitumour immune response is promoted
Indications
- Local treatment of unresectable cutaneous, subcutaneous and nodal melanoma lesions that recur after initial surgery. Melanoma →
Adverse effects
Common
- Flu-like symptoms: fever, chills, fatigue
- Pain at the injection site
- Nausea, vomiting, diarrhoea or constipation
- Headache, muscle and joint pain
- Slow wound healing
Contraindications
- Pregnancy (avoided during treatment)
- Severely weakened immune system (leukaemia, lymphoma, HIV/AIDS, immunosuppressive treatment): reported beforehand, as the live virus could spread
Key interactions
- Medicines that weaken the immune system (e.g. corticosteroids, chemotherapy)
- A weakened immune system raises the risk that the vaccine virus spreads; they are reported before treatment.
What is monitored
- Injected lesions for infection or necrosis
- Signs of herpes infection in the patient (and contacts)
- Skin and eye colour changes
- Breathing symptoms
Administration and safety
- Injected directly into lesions (intralesional) by a trained health professional.
- Live virus: preparation, injection and waste follow the centre's biosafety precautions.
- The injection sites are covered with a dressing after each treatment.
Pregnancy and breastfeeding
Pregnancy is avoided during treatment, because the live virus could harm the fetus; breastfeeding is discussed with the team.
Nursing care
- Check injected lesions for redness, pus or dead tissue.
- Ask about cold sores or blisters in the patient and household contacts.
- Teaching: keep sites covered and do not touch or scratch them; household members, especially if pregnant or immunocompromised, avoid contact with the sites, dressings or body fluids; dispose of dressings as instructed.
Pharmacokinetics
- Distribution
- Acts locally in and around the injected lesions; the virus can be present at the injection sites and on dressings.
Test yourself
Think of the answer, then tap the question to see it.
What kind of agent is talimogene laherparepvec?
An oncolytic, genetically modified herpes simplex virus type 1.
Which immune-stimulating gene does T-VEC carry?
The gene for GM-CSF.
How is T-VEC given?
By injection directly into melanoma lesions (intralesional).
Why are injection sites kept covered?
Because the live virus can spread to other people through contact with the sites or dressings.
Connections
← Back to the class: Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Talimogene Laherparepvec Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Talimogene Laherparepvec - NCI (National Cancer Institute, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.