TIL Immunotherapy Offers Promising Results in Metastatic Non-Small Cell Lung Cancer
"Here at Moffitt Cancer Center we are pioneering TIL transfer trials in lung cancer, which are producing impressive clinical responses and, to the best of my knowledge, have not been implemented at this scale anywhere else yet. Spearheaded by Dr. Eric Haura and Dr. Ben Creelan, these efforts involve basic scientists and physician-scientists dissecting mechanisms associated with therapeutic effectiveness and resistance."
Many of the immunotherapies that work well in melanoma can also benefit lung cancer patients. Tumor infiltrating lymphocytes (TIL) in melanoma show the potential for a complete response which can last for decades and this long-term effect is attributed to persistence of memory T cells. Moffitt Cancer Center presented on a phase I trial with to determine if non-small cell lung cancer patients could have a similar response to TIL therapy after evidence of progression on nivolumab.
Moffitt recruited 20 patients with metastatic NSCLC with at least 1 RECIST measurable lesion and also 1 lesion safely accessible for excisional biopsy, usually a supraclavicular lymph node or pleural nodule. This histologically confirmed metastasis was resected and the T cells inside were cultured. These cells, which are able to detect and invade the tumor, are multiplied by the billions — a process that takes at least one month — and then infused back into the patient.
Initial tumor regression occurred in most patients at their first post-TIL CT scan. Two patients achieved durable clinical responses which are still ongoing almost 1 year post-TIL. Three additional patients were able to maintain a clinical remission by local ablative therapy of an isolated new lesion performed 6 to 17 months post-TIL and several other patients on the trial showed partial response to TIL therapy making the overall response rate from the study at least 25%.
Because TIL has manageable toxicity and the capacity to achieve durable remission in metastatic NSCLC after nivolumab treatment, TIL could be a promising option for fit metastatic NSCLC patients.
A summary of these interventions was presented at the American Association for Cancer Research Annual Meeting this year by Dr. Ben Creelan, principal investigator of the phase 1 trial and associate member of the Department of Thoracic Oncology at Moffitt.
Moffitt Cancer Center is a world-leader in the application of CAR T therapy trials in solid tumors, and continues to lead in treatments that utilize tumor infiltrating lymphocytes. Moffitt is also opening Iovance Biotherapeutics’ clinical trial, which combines pembrolizumab with TIL for stage 4 lung cancer.
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