Herpes simplex virus oncolytic vaccine therapy in melanoma

IMPORTANCE OF THE FIELD: Advanced melanoma is a devastating disease with a five year survival for Stage IV disease of 10 - 20% and a median survival of 6 - 18 months depending on sub-stage. Current FDA approved therapies demonstrate limited response rates, few complete remissions and no proven survival benefit. New therapies are clearly needed. JSI/34.5-/47-/GM-CSF is a herpes simplex virus-1 (OncoVEX(GM-CSF)) oncolytic vaccine therapy designed to induce local and systemic anti-tumor immune responses. AREAS COVERED IN THIS REVIEW: Evolution of current herpes simplex virus oncolytic vaccines from preclinical to clinical studies from 1994 to 2010. WHAT THE READER WILL GAIN: Preclinical studies have shown that herpes simplex virus-1 oncolytic vaccines generate local tumor destruction through the lytic action of the virus and local and systemic immune responses. Phase I studies demonstrated limited toxicities with no neurotoxicty. Phase II studies demonstrated durable regressions in patients with metastatic melanoma. A Phase III trial in melanoma is ongoing to determine clinical effectiveness, and a Phase III trial in head and neck cancer will initiate during 2010. TAKE HOME MESSAGE: JSI/34.5-/47-/GM-CSF is a new generation herpes simplex virus-1 oncolytic vaccine that demonstrates direct tumor lysis and systemic immune responses. Early clinical studies have yielded preliminary evidence of activity.