Advances in the management of regionally metastatic melanoma

Despite numerous developments in systemic therapy, the prognosis for patients with locoregionally advanced melanoma remains poor. By delivering therapy directly to the targeted area via intralesional injections or intra-arterial isolated infusions, systemic side effects are minimized and oncolytic agents are delivered more directly and effectively to the melanoma. There has been significant progress in recent years with intralesional agents such as Talimogene laherparepvec (T-VEC), PV-10 and TAVOkinase/electrocorporation as well as advances in infusional therapies such as percutaneous hepatic perfusion (PHP) for hepatic metastasis of ocular melanoma. This review evaluates advances in intralesional and infusional therapies for melanoma while limiting discussion to those therapies currently approved and on trial.