However, in 2022, a phase 3 (NCT02263508) randomized controlled, double-blinded trial evaluating intralesional T-VEC with systemic pembrolizumab versus an intralesional placebo with systemic pembrolizumab in 692 patients with Stage IIIB-IVM1c unresectable, anti-PD-1-naïve melanoma found no significant difference in overall survival (OS) or progression-free survival (PFS) and similar rates of grade 3 or greater treatment-related AEs between the two groups [59]. This evidence concerns the gene PDCD1 and melanoma.