What is Tamliogene Latherparepvec (TVEC)?
Tamliogene latherparepvec (TVEC) is a weakened form of the herpes simplex virus type-1 (HSV-1) which is commonly called the cold sore virus.
When is TVEC used?
TVEC is used when a melanoma has spread to the skin or lymph nodes, either near to the original tumour or more distantly, where surgery is not an option. The TVEC virus is modified so that when it is injected into tumours it multiples. This leads to the destruction of tumour cells.
The treatment aims to shrink, control and in some cases completely destroy the melanoma tumour/s. There is some evidence it may help your immune system to fight more distant tumours.
Follow this link for further information about T-Vec
What does treatment with TVEC involve?
You will be reviewed by your Consultant Dermatologist and if TVEC is the right treatment for you they will:
- Ask you to sign a consent form for the treatment
- Mark the lesions to be treated
- Send you to the Medical Illustration for baseline photography
- Give you a blood test request form for baseline blood tests
- Refer you the Clinical Nurse Specialists (CNS) Clinic to receive treatment. The CNS will telephone you with a start date for your treatment
TVEC treatment has to be administered 2 weekly and is often administered for several months to be effective. If you cannot make a treatment then we have to omit that dose of TVEC, it cannot be given late.
Treatment with TVEC
On the day of treatment you will need to allow 2-3 hours of time for your hospital visit.
At each visit the Clinical Nurse Specialist:
- Will check your blood test results
- Ask you about how you were after your last treatment (not at first visit)
- Check you are well enough for treatment
- Call the Consultant Dermatologist to come and mark the areas which require treating and indicate the amount of TVEC to be given
You will then have some time to wait (around 1 hour) whilst the TVEC treatment is prepared. Once the TVEC is ready to be administered the Clinical Nurse Specialist will ask you to come back into the clinic room.
The Clinical Nurse Specialist will then inject the TVEC directly into the melanoma metastases as indicated by the Consultant Dermatologist earlier in the visit.
You will be given an alert card and your alert card will be completed to record the TVEC administration. You will be given a blood form. This will enable you to have a blood test to be taken before to your next visit. The Clinical Nurse specialist will explain how to arrange the blood test. You will be given you next outpatient appointment.
TVEC is administered for the following schedule-
- Treatment 1- first visit
- Treatment 2- 3 weeks after treatment 1
- Treatment 3 onwards – 2 weeks after treatment 2
Treatment can last for several months, and it may be some time before you see an improvement. We will assess this at each visit and keep you informed throughout.
During treatment we are likely to want you to have Medical Illustration photography every 12 weeks and may ask for repeat staging scans depending on how you are and any new symptoms you may report to us.
A watertight dressing will be placed over the injection sites.
- You should keep this in place for 8 days or whilst there is any open wound.
- If you need to change your dressing you should wear clean medical gloves to do this (your nurse can give you these). You should place any used dressings into a sealed plastic bag and place in your household waste.
- You will need to avoid direct contact with your injection sites.
- You should avoid direct contact with bodily fluids and use latex condoms if engaging in sexual activity whilst being treated with TVEC and for 30 days after your last dose.
If your close contacts are accidently exposed to TVEC they should clean the affected area on their body with soap and water and/or a disinfectant. If they develop signs of symptoms of herpes infection, you should ask them to contact their health care professional.
Possible Herpes infection from TVEC
Herpes infection- It is possible to get reactivation of the cold sore virus from the treatment.
This may include;
- Pain, burning or tingling in a blister around the mouth or genitals, or fingers or ears
- Eye pain, light sensitivity, discharge from the eyes, or blurry vision
- Weakness in the arms, legs, extreme drowsiness and mental confusion.
- Infection at the injection site- symptoms include swelling, pain redness, warmth, discharge, fever or chills.
- Autoimmune reactions- This is an overreaction of the body’s immune system. Some people receiving TVEC have developed inflammation of the kidneys, narrowing of blood vessels, swelling of the lungs, skin scaling, and areas without any pigment in the skin. Your Doctor will monitor you for signs of this during the course of your treatment. If you do notice any of these symptoms please contact your clinical Nurse Specialist.
- Patients with no prior herpes infection- If you have never had herpes infection in the past, you may be more likely to get fever, chills, and flu-like symptoms within the period of the first 6 treatments with TVEC.
If you have any of these symptoms please let your Consultant know
Side effects of treatment
Like all medications, this medicine can cause side effects, although not everybody gets them.
Very common side effects include:
- Tissue Swelling
- Vomiting, diarrhoea, constipation, nausea
- Muscle pain, painful swollen joints, limb pain
- Flu like illness, fever, chills, fatigue, pain
If you have any further questions please call either;
Consultant Secretary: 01603 288210 Mon-Fri 8-5
Clinical Nurse Specialists: 01603 288365 Mon-Fri 8-