Neoadjuvant Combination Immunotherapy for Stage III Melanoma

Inclusion Criteria:

• 18 years of age, any race or sex, who have pathologically confirmed cutaneous melanoma
• ECOG performance status of 0 or 1
• Adequate hematologic, hepatic, renal and coagulation function
• Must have measurable disease and have an injectable target lymph node forintralesional therapy administration
• Primary melanoma has been resected
• Pathologically confirmed resectable stage III disease, clinically apparent.Resectability is at the discretion of the treating surgeon who is a melanomaspecialist.
• Stage III disease can be at time of diagnosis of primary melanoma or a recurrenceafter initial treatment of stage I-II disease.
• BRAF mutant or wild type allowed (mutations status not necessary for enrollment)
• Signed, written informed consent

Exclusion Criteria:

• Cannot have metastatic (AJCC M1) disease
• No primary mucosal or uveal melanoma
• No evidence of melanoma associated with immunodeficiency state or history or othermalignancies (other than non-melanoma skin cancer) within the past 3 years
• May not have been previously treated with T-VEC, any other oncolytic virus,pembrolizumab, or any other PD-1, PD-L1, or PD-L2 inhibitor
• Must not have a history or evidence of symptomatic autoimmune pneumonitis,glomerulonephritis, vasculitis, or other symptomatic autoimmune disease, documenthistory of autoimmune disease or syndrome requiring systemic treatment in the past twoyears (i.e. use of disease modifying agents, steroids, or immunosuppressive agents)except vitiligo or resolved childhood asthma/atopy, or evidence of clinicallysignificant immunosuppression
• Must not have active herpetic skin lesions or prior complications of herpeticinfection and must not require intermittent or chronic treatment with an anti-herpeticdrug (e.g. acyclovir) other than intermittent topical use