Abstract
Melanoma, characterized by its aggressive nature and tendency for metastasis, presents a significant challenge in clinical management. While surgical excision remains the gold standard for localized disease, therapeutic advancements for advanced stages are crucial. Oncolytic virotherapy, exemplified by Talimogene laherparepvec (T-VEC), offers a potential approach. Here, we present a 79-year-old male with advanced melanoma on the left distal thumb who opted for T-VEC therapy over surgical excision. Over 18 sessions, T-VEC demonstrated efficacy, resulting in lesion regression and no evidence of recurrence upon long-term monitoring. This case emphasizes the potential of T-VEC in advanced melanoma management, leveraging its dual mechanism targeting primary and metastatic lesions while harnessing immune response. Safety considerations and further investigations into potential interactions with other immunotherapies are warranted to optimize treatment strategies and ensure patient well-being. As oncolytic virotherapy continues to evolve, T-VEC stands as a potential option for the treatment of advanced melanoma.