skip to main content

In-transit Melanoma — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMelanoma & SkinIn-transit MelanomaSCE Medical Oncology

A 55-year-old man with unresectable stage IIIC melanoma on nivolumab + ipilimumab develops painful in-transit metastases (subcutaneous nodules between the primary site and regional nodes) in his right leg. What locoregional treatment option specifically targets in-transit melanoma?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Talimogene laherparepvec (T-VEC) intralesional injection

T-VEC (talimogene laherparepvec) is an oncolytic herpes simplex virus type 1 approved for intralesional injection of unresectable melanoma (including in-transit metastases) per NICE TA410. The OPTiM trial demonstrated durable response rates and potential abscopal (bystander) effects on uninjected lesions. It can be used alongside systemic immunotherapy. Isolated limb perfusion/infusion with melphalan is an alternative for limb-confined in-transit disease.

Reference: NICE TA410 T-VEC for unresectable melanoma; OPTiM Andtbacka et al JCO 2015; ESMO 2024 Melanoma Guidelines