Administration and Handling of Talimogene Laherparepvec: An Intralesional Oncolytic Immunotherapy for Melanoma.

PURPOSE/OBJECTIVES: To describe the administration and handling requirements of oncolytic viruses in the context of talimogene laherparepvec (Imlygic™), a first-in-class oncolytic immunotherapy.
. DATA SOURCES: Study procedures employed in clinical trials, in particular the OPTiM study.
. DATA SYNTHESIS: Evaluation of nursing considerations for administration of talimogene laherparepvec.
. CONCLUSIONS: Talimogene laherparepvec is administered through a series of intralesional injections into cutaneous, subcutaneous, or nodal tumors (with ultrasound guidance as needed) during an outpatient clinic visit. A single insertion point is recommended; however, multiple insertion points are acceptable if the tumor radius exceeds the needle's radial reach. Talimogene laherparepvec must be evenly distributed throughout the tumor through each insertion site. Talimogene laherparepvec requires storage at -90°C to -70°C and, once thawed, should be administered immediately or stored in its original vial and carton and protected from light in a refrigerator (2°C to 8°C). 
. IMPLICATIONS FOR NURSING: Because talimogene laherparepvec can be administered in the outpatient setting, nurses will be pivotal for appropriate integration and administration of this unique and effective therapy.