Safe and Effective Standards of Care: Supporting the Administration of T-VEC for Patients With Advanced Melanoma in the Outpatient Oncology Setting

Lisa M. Wall, PhD, RN, CNS, AOCNS®; Abigail Baldwin-Medsker, MSN, RN, OCN®
CJON
10.1188/17.CJON.E260-E266

Description

Background: Talimogene laherparepvec (T-VEC) is the first oncolytic virus (OV) to demonstrate therapeutic benefit for the treatment of advanced melanoma. As a live virus, the use of T-VEC in medical and surgical outpatient clinics posed challenges. 


Objectives: The purpose of this article is to describe the challenges faced when introducing an OV treatment into outpatient clinics and the processes implemented to ensure safety for patients, caregivers, and staff across the care continuum. 


Methods: An interdisciplinary team of experts developed and implemented new practices and workflows to support the administration of T-VEC in the outpatient setting. Clinical staff were educated on this new treatment, its indications and side effects, and the practice standards created to support its use. 


Findings: T-VEC posed safety and logistical challenges that were successfully addressed and implemented. To date, 16 patients with locoregionally advanced melanoma have been treated with T-VEC. No adverse events occurred related to preparation or administration, which opens the door for similar therapies in the future.

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