Introduction: Melanoma brain metastases remain a devastating disease process with poor prognosis. Recently, there has been a surge in studies demonstrating the efficacy of oncolytic virotherapy for brain tumor treatment. Given their specificity and amenability to genetic modification, the authors explore the possible role of oncolytic virotherapy as a potential treatment option for patients with melanoma brain metastases. Methods: A comprehensive literature review including both preclinical and clinical evidence of oncolytic virotherapy for the treatment of melanoma brain metastasis was performed. Results: Oncolytic virotherapy, specifically T-VEC (Imlygic™), was approved for the treatment of melanoma in 2015. Recent clinical trials demonstrate promising anti-tumor changes in patients who have received T-VEC; however, there is little evidence for its use in metastatic brain disease based on the existing literature. To date, only two single cases utilizing virotherapy in patients with metastatic brain melanoma have been reported, specifically in patients with treatment refractory disease. Currently, there is not sufficient data to support the use of T-VEC or other viruses for intracranial metastatic melanoma. In developing a virotherapy treatment paradigm for melanoma brain metastases, several factors must be considered, including route of administration, need to bypass the blood–brain barrier, viral tumor infectivity, and risk of adverse events. Conclusions: Evidence for oncolytic virotherapy treatment of melanoma is limited primarily to T-VEC, with a noticeable paucity of data in the literature with respect to brain tumor metastasis. Given the promising findings of virotherapy for other brain tumor types, oncolytic virotherapy has great potential to offer benefits to patients afflicted with melanoma brain metastases and warrants further investigation.

中文翻译：

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黑色素瘤脑转移瘤的溶瘤病毒疗法，一种潜在的新治疗范式？

简介：黑色素瘤脑转移仍然是一种预后不良的破坏性疾病过程。最近，大量研究证明了溶瘤病毒疗法对脑肿瘤治疗的疗效。鉴于其对基因改造的特异性和适应性，作者探索了溶瘤病毒疗法作为黑色素瘤脑转移患者潜在治疗选择的可能作用。方法：进行了全面的文献回顾，包括溶瘤病毒疗法治疗黑色素瘤脑转移的临床前和临床证据。结果：溶瘤病毒疗法，特别是 T-VEC (Imlygic™)，于 2015 年被批准用于治疗黑色素瘤。然而，根据现有文献，几乎没有证据表明其用于转移性脑病。迄今为止，仅报道了两例在转移性脑黑色素瘤患者中使用病毒疗法的病例，特别是在治疗难治性疾病的患者中。目前，没有足够的数据支持使用 T-VEC 或其他病毒治疗颅内转移性黑色素瘤。在开发黑色素瘤脑转移的病毒疗法治疗范式时，必须考虑几个因素，包括给药途径、绕过血脑屏障的需要、病毒肿瘤的传染性和不良事件的风险。结论：溶瘤病毒疗法治疗黑色素瘤的证据主要限于 T-VEC，文献中关于脑肿瘤转移的数据明显缺乏。鉴于病毒疗法对其他脑肿瘤类型的有希望的发现，溶瘤病毒疗法具有为患有黑色素瘤脑转移的患者带来益处的巨大潜力，并值得进一步研究。