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T-VEC Mechanism — SCE Medical Oncology MCQ

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HardMelanoma & SkinT-VEC MechanismSCE Medical Oncology

A 68-year-old man with melanoma presents with subcutaneous melanoma metastases amenable to injection. He is offered T-VEC (talimogene laherparepvec). What is the mechanism of T-VEC?

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Correct answer: C — Tumour-selective HSV-1 replication combined with local GM-CSF expression

T-VEC is an engineered HSV-1 that replicates selectively within tumour and expresses GM-CSF to promote antitumour immunity. Tumour-selective adenovirus replication combined with local interferon-alpha expression: T-VEC is derived from HSV-1 and encodes GM-CSF rather than interferon-alpha. Replication-deficient HSV-1 delivery combined with local interleukin-two expression: T-VEC is replication competent in tumour and does not encode interleukin-2. Tumour-selective vaccinia replication combined with local GM-CSF expression: the GM-CSF concept is close, but the vector is HSV-1 rather than vaccinia. Replication-deficient adenovirus delivery combined with local GM-CSF expression: the platform has the wrong virus and omits tumour-selective viral replication.

Reference: Imlygic UK summary of product characteristics (Current UK SmPC, accessed July 2026): https://www.medicines.org.uk/emc/product/5117/smpc