Clinical Challenges with Talimogene Laherparepvec: CuredLymph Nodes Masquerading as Active Melanoma

Talimogene laherparepvec is a novel, genetically engineered, oncolytic herpes virus approved for local treatment of unresectablecutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery. It is administered as anintralesional injection. However, if the lesion continues to persist, it presents with a clinical challenge as when to stop treatment.Herein, we present two cases from our institution wherein the disease appeared to be persistent radiologically; however, onpathological excision, there was no evidence of disease and patients continue to be in durable remission after stopping treatment.