AUTHOR=Ingason Arnar B. , Muruganandam Venkatesa P. , Chidobem Ikechukwu , Cintolo-Gonzalez Jessica , Rehman Hibba tul TITLE=Talimogene Laherparepvec treatment for mucosal melanoma with metastatic lymph node metastasis: case report JOURNAL=Frontiers in Oncology VOLUME=Volume 15 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1647603 DOI=10.3389/fonc.2025.1647603 ISSN=2234-943X ABSTRACT=Mucosal melanoma is a rare and aggressive subtype of melanoma, accounting for approximately 1% of all melanoma cases. Of those, only 4% occur primarily in the vagina. Talimogene Laherparepvec (T-VEC) is a biopharmaceutical medication that is used to treat unresectable malignant melanoma. However, the clinical trials for this treatment option excluded patients with mucosal melanomas. Here we report a case of an 85-year-old female with vaginal melanoma with regional lymph node metastasis that had complete durable response to combined T-VEC and immune checkpoint inhibition treatment. This is, to our best knowledge, the first reported case of T-VEC treatment for vaginal melanoma. It supports findings from case reports demonstrating good response to T-VEC in mucosal melanomas of the urethra, maxillary sinus, and the soft and hard palate. Prospective studies assessing the efficacy of T-VEC in treating mucosal melanoma are needed to confirm these findings.