Combined use of talimogene laherparepvec and cisplatin (T-VEC + Cisplatin)

The combined use of talimogene laherparepvec (T-VEC) and cisplatin is a multimodal therapeutic strategy rather than a single molecular target. T-VEC is a genetically modified herpes simplex virus type 1 (HSV-1) designed to selectively infect and lyse tumor cells while expressing human GM-CSF to recruit and activate antigen-presenting cells (NIH, 2023). Cisplatin is a potent platinum-based chemotherapeutic agent that induces DNA cross-linking, leading to programmed cell death in rapidly dividing malignant cells (StatPearls, 2023). This combination is primarily investigated in advanced solid malignancies, such as head and neck squamous cell carcinoma (HNSCC), where the agents are hypothesized to work synergistically to enhance local tumor control and stimulate a systemic immune response against tumor neoantigens (PubMed, 2021). By combining direct viral oncolysis with chemotherapy-induced DNA damage, the regimen aims to overcome the immunosuppressive tumor microenvironment. Clinical management of this combination requires monitoring for cumulative toxicities, including the renal and auditory risks associated with cisplatin and the viral-related inflammatory symptoms associated with T-VEC administration.

Other names

Talimogene laherparepvec and cisplatin combination therapyT-VEC plus cisplatinImlygic and cisplatin regimenOncolytic immunotherapy and platinum chemotherapy

Talimogene laherparepvec (T-VEC) is an oncolytic immunotherapy derived from herpes simplex virus type 1 (HSV-1) that selectively replicates within tumor cells, causing direct cell lysis and releasing granulocyte-macrophage colony-stimulating factor (GM-CSF) to stimulate a systemic anti-tumor immune response (NIH, 2023). Cisplatin is a platinum-based cytotoxic agent that forms covalent DNA adducts and intra-strand cross-links, which inhibit DNA replication and transcription, leading to cell cycle arrest and apoptosis (PubChem, 2024). The combination is designed to achieve synergy by using cisplatin to induce immunogenic cell death and DNA damage, which may sensitize tumors to the oncolytic and immune-priming effects of T-VEC (PubMed, 2021).