Intratumoral Targeted Hyperthermia Therapy (THT) for Stage 3C/3D/4M1 Cutaneous Metastatic Melanoma

Inclusion criteria

• 16 years of age or older
• Participants with histologically or cytologically confirmed stage 3C/3D/4M1 advanced or cutaneous metastatic melanoma, with measurable disease by iRECIST including any number of cutaneous lesions
• Present a visible and accessible primary tumor or metastatic deposit (any site) that has not been surgically removed
• Present target tumors of 0.5 -2.5 cm in diameter
• Participants must have received and failed systemic and local intra-tumoral therapy at least one prior standard therapy, including immune checkpoint inhibitors (e.g., anti- PD1 or anti-CTLA-4), and failed local intra-tumoral IL-2 treatment. Failed response to treatment will be categorized according to iRECIST guidelines.
• Participants who have:

• Immune partial response (iPR): At least a 30% decrease in the sum of diameters of target lesions compared to baseline, no progression of non-target lesions, No new lesions
• Immune Stable Disease (iSD): Neither sufficient reduction to qualify for iPR nor sufficient increase to qualify for iCPD (immune confirmed progressive disease), no new lesions
• Immune Unconfirmed Progressive Disease (iUPD); At least a 20% increase in the sum of diameters of target lesions, taking the smallest sum on study as the reference, appearance of new lesions, iUPD needs confirmation after at least 4 weeks; if confirmed, it becomes iCPD
• Immune Confirmed Progressive Disease (iCPD): iUPD must be confirmed in a follow-up assessment (minimum of 4 weeks after initial iUPD), if progressive disease (increase in lesion size or additional new lesions) is still evident upon re-evaluation, iCPD is confirmed.
• Participants must agree to discontinue treatment with local intralesional immunotherapies during the study, with resumption after completion of the trial
• ECOG Performance Status:
• Life expectancy: ≥6 months
• Participants able and willing to provide written informed consent and comply with the trial protocol. 10. Either BRAF positive (BRAF+) or BRAF negative (BRAF-)

Exclusion criteria

• Women who are pregnant, breastfeeding, or planning to become pregnant during the study.
• Women of childbearing potential must have a negative pregnancy test within 72 hours prior to enrollment and agree to use adequate contraception throughout the study
• Any infection requiring systemic therapy or other concurrent medical conditions (e.g., hepatitis B, hepatitis C, HIV) that would interfere with the study
• Myocardial infarction or stroke within the past 6 months, uncontrolled angina, or significant arrhythmia
• Participants receiving blood thinners as part of therapeutic anticoagulation therapy
• Any severe or uncontrolled comorbid condition that, in the investigator's opinion, would pose excessive risk to the participants (e.g., immunodeficiencies, severe hypertension, uncontrolled diabetes, liver failure)
• Participation in another clinical trial involving an investigational product/device within 30 days prior to screening
• Any condition that would impede compliance with study procedures
• Participants with a known allergy to gold of any kind
• Participants who are unable to tolerate cutaneous injections for any reason will not be eligible
• Participants with a known allergy to injectable local analgesics
• Participants with ocular melanoma or melanoma involving periorbital skin.