Reacción a "Reaction: clinical trial tests oncolytic viruses against breast cancer"

The study is generally of good quality, although it suffers from two weaknesses. The first is that the chemotherapy selected does not include carboplatin, a drug now considered crucial in triple-negative breast cancer. A second weakness is the study design: by not including a control arm without T-VEC [a type of oncolytic virus], the results are difficult to interpret. Most of the included patients are stage II, so it is not excluded that chemotherapy alone could show similar efficacy without the need for T-VEC.  

The main conclusion of the study is that T-VEC can be applied in combination with chemotherapy without serious toxicities, while paying attention to the risk of thrombosis, which nowadays can be easily prevented in patients at higher risk of these events. I believe that the results do not exclude further evaluation of the combination in a randomised study. The main problem for this is that, today, the standard pre-surgical therapy of triple negative breast cancer is no longer chemotherapy alone, but chemotherapy plus the immunotherapy pembrolizumab.  

Limitations of the study are the small sample size, the selection of a carboplatin-free chemotherapy and the absence of a randomised control arm without T-VEC.