Phase 1 Study Shows Promise for Targeted Immunotherapy to Treat Advanced-Stage Liver Tumors

March 21, 2018—The Society of Interventional Radiology (SIR) announced the presentation of findings showing that advanced-stage liver tumors may be safely treated through image-guided injections of an immunotherapy approved for melanoma.

According to SIR, the investigators found that talimogene laherparepvec (T-VEC, Amgen)—a genetically modified version of the herpes virus—can be safely administered into active cancer in the liver and stimulate the immune system to destroy cancer cells throughout the body. The early findings from the phase 1, multicenter, open-label study by Steven S. Raman, MD, et al, were presented as abstract 375 at the SIR 2018 annual scientific meeting held March 17–22 in Los Angeles, California.

As summarized in the SIR announcement, investigators at centers in the United States, Switzerland, and Spain used image-guided needle injections to treat 14 advanced-stage cancer patients with liver metastases, including those with cirrhosis. Patients were given escalating doses of T-VEC, up to the maximum dosage for melanoma approved by the US Food and Drug Administration. Injection volume was based on lesion size.

The investigators found that the patients tolerated the treatment well with expected side effects, including temporary flu-like symptoms.

As part of the study, investigators will follow patients for up to 2 years. Additionally, new trials to investigate the effectiveness of the drug in treating advanced cancer in the liver are being planned. Further investigation is also planned to test the therapy in combination with a checkpoint inhibitor to activate a stronger immune response.

The investigators noted several limitations of the current study, including the preliminary nature of the results and the number of patients tested. Amgen, the pharmaceutical company that makes T-VEC, was a sponsor of the trial, advised SIR.

In the SIR announcement, Dr. Raman commented, “Advanced-stage liver tumors, including ones that have spread from other locations, have limited treatment options because the patients can be in poor health; further, the complex structure of the organ can make it difficult to target with standard approaches. This minimally invasive treatment offers patients a novel way to, directly and indirectly, attack the cancer cells.”

Dr. Raman added, “Image-guided treatments have expanded the options available for patients with liver cancer from innovative approaches to biopsies to resections to chemo. This is an exciting way to look to the future, but patients living with advanced liver cancer should understand that this treatment will not be available for several years, except through clinical trials.” Dr. Raman is Professor of Radiology, Surgery, and Urology at the David Geffen School of Medicine at UCLA in Los Angeles, California.