title: Developments in Intralesional Therapy for Metastatic Melanoma.
abstract: BACKGROUND
  Locoregional advanced melanoma poses a complex clinical challenge that requires a multidisciplinary, patient-centered approach. Numerous agents have been studied for their suitability as intralesional therapy in the past decades, but few have successfully completed phase 3 clinical trial testing.
  
  
  METHODS
  The relevant medical literature was searched for articles regarding use of intralesional therapies in metastatic melanoma. Therapies with data from phase 2 or higher studies were selected for review. This review also summarizes the mechanisms of action, adverse-event profiles, and clinical data for these agents.
  
  
  RESULTS
  Intralesional therapies demonstrate promising effects in select patients with advanced melanoma. The optimal approach should be individually tailored and consist of a combination of intralesional therapies, regional perfusions, systemic immunotherapies, targeted therapies, and surgery, if necessary.
  
  
  CONCLUSIONS
  Due to its relatively good local response rates and tolerable adverse-event profile, intralesional therapy may be a treatment option for select patients with unresectable, locally advanced or metastatic melanoma.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sloot
authors.forename: Omar M
authors.initials: OM
authors.lastname: Rashid
authors.forename: Arnod A
authors.initials: AA
authors.lastname: Sarnaik
authors.affiliation: Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Jonathan.Zager@Moffitt.org.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
mesh_terms: D000279:Administration, Cutaneous; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004274:DNA, Recombinant / Q000008:administration & dosage / Q000627:therapeutic use; D053672:Electrochemotherapy / Q000379:methods; D005456:Fluorescent Dyes / Q000008:administration & dosage / Q000627:therapeutic use; D015316:Genetic Therapy; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use; D015793:HLA-B7 Antigen / Q000235:genetics; D018259:Herpesvirus 1, Human; D006801:Humans; D007167:Immunotherapy; D015552:Injections, Intralesional / Q000379:methods*; D007376:Interleukin-2 / Q000008:administration & dosage / Q000627:therapeutic use; D008055:Lipids / Q000008:administration & dosage / Q000627:therapeutic use; D008545:Melanoma / Q000235:genetics / Q000628:therapy*; D050504:Oncolytic Viruses; D012395:Rose Bengal / Q000008:administration & dosage / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000235:genetics / Q000628:therapy*
chemical_list: C096492:Allovectin-7; D001500:BCG Vaccine; D004274:DNA, Recombinant; D005456:Fluorescent Dyes; D015793:HLA-B7 Antigen; D007376:Interleukin-2; D008055:Lipids; D012395:Rose Bengal; D016178:Granulocyte-Macrophage Colony-Stimulating Factor