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Care During Chemotherapy and Beyond

Talimogene Laherparepvec

tal-IM-oh-jeen la-her-pa-REP-vek)

Trade Name: Imlygic®

Other Name: T-VEC

Talimogene Laherparepvec is the generic name for the trade name drug Imlygic. In some cases, health care professionals may use the trade name, Imlygic® or T-VEC when referring to the generic drug name talimogene laherparepvec.

Drug type: Talimogene Laherparepvec is a genetically modified viral therapy, it is a weakened form of live herpes simplex virus. (For more detail, see "How Talimogene Laherparepvec Works" below).

What Talimogene Laherparepvec Is Used For:

  • Treatment of skin lesions unable to be removed by surgery, subcutaneous (just under the skin surface) lesions, and/or lymph node lesions in patients with melanoma that has surfaced after initial surgery.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Talimogene Laherparepvec Is Given

  • Talimogene Laherparepvec is directly injected into a skin lesion that is unable to be removed by surgery, subcutaneous (just under the skin surface) lesion, and/or lymph node that are visible, able to be felt, or detectable by ultrasound guidance.
  • Your health care provider will decide which tumor(s) to inject and may not inject every one.
  • Your health care provider will determine your dose and schedule.
  • You will receive the second treatment 3 weeks after the first treatment. After that, you will receive treatments every 2 weeks for at least 6 months unless other treatment is required or until there are no injectable lesions to treat.
  • You will have dressing on the treatment site after injection. (See self-care tips below).

Side Effects

Important things to remember about the side effects of Talimogene Laherparepvec:

  • Most people will not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset, duration, and severity.
  • Side effects will improve after therapy is complete.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking Talimogene Laherparepvec:

Most side effects reported were mild or moderate in severity and generally resolved within 72 hours.

These are less common side effects (occurring in 10-29%) for patients receiving Talimogene Laherparepvec:

Not all side effects are listed above. Side effects that are very rare (occurring in less than about 10 percent of patients) are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Pain, burning, or tingling in a blister around the mouth or genitals or on the fingers or ears
  • Weakness in arms or legs
  • Extreme drowsiness
  • Mental confusion

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Herpes like lesions (itchy or painful red spots that become small blisters)
  • Mouth pain
  • Signs of inflammation (pain, redness, warm to touch) at the injection site
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Extreme fatigue (unable to carry of self-care activities)

Always inform your health care provider if you experience any unusual symptoms.

Precautions

Before receiving this drug, tell your health care provider if you:

  • Are taking medications that suppress your immune system
  • Are taking antiviral medications to treat or prevent herpes (such as acylovir)
  • Have or ever had medical conditions such as HIV infection, AIDS, leukemia, lymphoma, autoimmune disease, or immune deficiency
  • Are pregnant or plan to become pregnant.
  • Are breastfeeding or plan to breastfeed
  • Have close contact with someone who has weakened immune system, is pregnant, or is breastfeeding (see self-care tips below)

Self-Care Tips

To prevent viral transmission to other areas of your body or to your close contacts (household members, caregivers, sexual partners, or person sharing the same bed)

  • Wash your hands before or after you change the dressing.
  • Avoid direct contact between your treatment sites, dressings, or body fluids or close contact.
  • Wear gloves while putting on or changing your dressings.
  • Keep treatment sites covered with airtight and watertight dressings for at least 1 week after each treatment or longer if the treatment site is weeping or oozing.
  • If the dressing comes loose or falls off, replace it right away with a clean dressing.
  • Place all used dressings and cleaning materials in a sealed plastic bag and throw them away in the garbage.
  • Do not touch or scratch the treatment sites.

Other general tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • Wash your hands often.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

How Talimogene Laherparepvec Works

Talimogene Laherparepvec is a type of immunotherapy that used an oncolytic virus (a virus that infects and breaks down cancer cells but not normal cells). The virus used is a genetically modified herpes virus. It is genetically modified so that it can replicate within tumors and produce a protein called granulocyte-macrophage colony-stimulating factor (GM-CSF). When talimogene laherparepvec is injected into the tumor it causes a breakdown of tumor cells followed by a release of tumor-derived antigens which together with the virally derived GM-CSF may promote an immune response against the tumor.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Reference:

  • Talimogene Laherparepvec Lexicomp Online® [updated 2016 August 3; cited 2016 August 30]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; July 12, 2015.
  • IMLYGIC (Talimogene Laherparepvec) [package insert]. Thousand Oaks, CA: Bio Vex, Inc., a subsidiary of Amgen Inc.; 2015.

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