Evidence map›Paper›PMID 39522025›Full record

ArticleCancer2025

A comparison of isolated limb infusion/perfusion, immune checkpoint inhibitors, and intralesional therapy as first-line treatment for patients with melanoma in-transit metastases.

Danielle K DePalo, Michelle M Dugan, Syeda Mahrukh Hussnain Naqvi, David W Ollila, Tina J Hieken, Matthew S Block, Winan J van Houdt, Michel W J M Wouters, Sophie J M Reijers, Nethanel Asher and 20 more

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Danielle K DePaloDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Michelle M DuganDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.ORCID https://orcid.org/0000-0001-8121-7559
Syeda Mahrukh Hussnain NaqviDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
David W OllilaUniversity of North Carolina, Chapel Hill, North Carolina, USA.
Tina J HiekenMayo Clinic Comprehensive Cancer Center, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-4277-8692
Matthew S BlockMayo Clinic Comprehensive Cancer Center, Rochester, Minnesota, USA.
Winan J van HoudtNetherlands Cancer Institute, Amsterdam, Netherlands.ORCID https://orcid.org/0000-0002-2303-3468
Michel W J M WoutersNetherlands Cancer Institute, Amsterdam, Netherlands.
Sophie J M ReijersNetherlands Cancer Institute, Amsterdam, Netherlands.
Nethanel AsherSkin Cancer and Melanoma Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.ORCID https://orcid.org/0000-0002-4094-8045
Kristy K BromanUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.
Zoey DuncanUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.
Matilda AndersonDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
David E GyorkiDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Hayden SnowDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Jenny HeldFox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Jeffrey M FarmaFox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
John T VettoOregon Health and Science University, Portland, Oregon, USA.
Jane Y C HuiUniversity of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-2628-0720
Madison KolbowUniversity of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-7739-6547
Robyn P M SawMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Serigne N LoMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-5092-5544
Georgina V LongMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-2816-2496
Youngchul KimDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Lilit KarapetyanDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Lars NySahlgrenska University Hospital, Gothenburg, Sweden.
Alexander C J van AkkooiNetherlands Cancer Institute, Amsterdam, Netherlands.
Roger Olofsson BaggeSahlgrenska University Hospital, Gothenburg, Sweden.
Jonathan S ZagerDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA.ORCID https://orcid.org/0000-0002-6886-4468

Funding

TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI KENNETH Lynn WRIGHT · 1998 to 2026
$93.5M
Leveraging Health Systems to Increase Implementation of Evidence-Based Surgical Cancer CareK08CA283001 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BROMAN, KRISTY KUMMEROW · 2023 to 2025
$592k
NCI NIH HHS K08 CA283001NCI NIH HHS P30 CA076292
6 · The paper itself

Abstract

backgroundIsolated limb infusion and perfusion (ILI/ILP) has been a mainstay treatment for unresectable melanoma in-transit metastases (ITM), but increased use of immune checkpoint inhibitors (ICI) and intralesional therapy (talimogene laherparepvec [TVEC]) introduced several different management options. This study compares first-line ILI/ILP, ICI, and TVEC.

methodsRetrospective review from 12 international institutions included patients treated from 1990 to 2022 with first-line ILI/ILP, ICI, or TVEC for unresectable melanoma ITM.

resultsA total of 551 patients were treated, with ILI/ILP (n = 356), ICI (n = 125), and TVEC (n = 70) with median follow-up of 5.5 years. Tumor burden was highest with ILI/ILP and lowest with TVEC (p = .002). Breslow thickness was lowest with TVEC (p = .007). TVEC was mostly used in stage IIIB disease versus IIIC for ILI/ILP and ICI (p = .01). Using ICI as the reference category, TVEC had the highest odds of a complete response (CR) (odds ratio, 1.96; p = .029) and a longer local progression-free survival (PFS) (hazard ratio [HR], 0.40; p = .003). ILI/ILP had shorter local PFS (HR, 1.72; p = .012), PFS (HR, 1.79; p < .001), distant metastasis-free survival (DMFS) (HR, 1.75; p = .014), overall survival (HR, 1.82; p = .009), and melanoma-specific survival (HR, 2.29; p = .004). Stage IIIB disease had longer DMFS (HR, 0.24; p < .001) compared to IIIC/D.

conclusionsTVEC as first-line therapy for unresectable melanoma ITM was associated with superior CR rates and local PFS. Notably, TVEC was used in patients with a lower Breslow thickness, disease stage, and tumor burden. Therefore, when compared to ILI/ILP and ICI, TVEC should be considered as first-line therapy for unresectable stage IIIB melanoma ITM with minimal tumor burden and lower Breslow thickness.

Indexed as

Immune Checkpoint InhibitorsMelanomaAdultAgedAged, 80 and overBiological ProductsChemotherapy, Cancer, Regional PerfusionExtremitiesFemaleHerpesvirus 1, HumanHumansMaleMiddle AgedNeoplasm MetastasisRetrospective StudiesSkin NeoplasmsBiological ProductsImmune Checkpoint Inhibitorstalimogene laherparepvecimmune checkpoint inhibitorsintralesional therapyin‐transit metastasisisolated limb infusionisolated limb perfusionmetastatic melanomaregional chemotherapytalimogene laherparepvec

Identifiers

PMID39522025
PMCPMC12310295

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.