Ep. 622 Intratumoral Immunotherapy Injections for Melanoma with Dr. Jennifer McQuade and Dr. Rahul Sheth

Mar 6, 2026

Dr. Jennifer McQuade, a melanoma medical oncologist researching oncolytic therapies, and Dr. Rahul Sheth, an interventional radiologist skilled in image-guided tumor treatments, discuss intratumoral oncolytic injections like RP1. They cover how these agents work, trial evidence for refractory metastatic melanoma, practical delivery to visceral lesions, technique tips, imaging follow-up, and multidisciplinary implementation challenges and opportunities.

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INSIGHT

RP1 Works After Checkpoint Failure In Melanoma

RP1 (Replimune) showed meaningful responses in patients refractory to anti-PD-1 ± anti-CTLA-4, raising overall response rates above single-agent rechallenge.
McQuade referenced the IGNYTE program enrolling PD-1–refractory patients, many also post PD-1+CTLA-4.

ADVICE

Prioritize Fast Communication To Build An IR Oncolytic Program

Build close IR–oncology collaboration and respond quickly to referrals to integrate intratumoral therapy.
Rahul Sheth emphasized rapid communication, biohazard workflow setup, and scaling beyond a single physician for program growth.

ANECDOTE

Spilled TVEC Taught Us To Improve Logistics

Rahul recalled mishandling thawing TVEC on the table and spilling virus, illustrating TVEC logistical hassles.
He contrasted TVEC's long thaw and messy handling with RP1's simpler handling as a practical improvement.

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When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice.

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SYNPOSIS

The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment.

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TIMESTAMPS

00:00 - Introduction
02:28 - Immunotherapy Basics
06:51 - How Oncolytic Viruses Work
11:01 - IGNYTE Trials and Why IR Matters
18:14 - T-VEC vs RP1 Indications and Logistics
21:57 - Physician Communication and Multidisciplinary Treatment
23:06 - RP1 Protocol and Administration Techniques
30:28 - RP1 Safety Profile
32:46 - Follow-Up Imaging and Response Assessment
35:44 - Future Applications Beyond Melanoma
41:42 - Final Thoughts and Closing Remarks

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RESOURCES
Wong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.
https://doi.org/10.1200/jco-25-01346

IGNYTE-3 Trial
https://clinicaltrials.gov/study/NCT06264180