Tumor Infiltrating Lymphocyte Therapy (TIL) has Shown Promise in Melanoma Treatment
In the past decade, immunotherapies have utilized the patient’s own immune system to fight cancer. Several different types of immune checkpoint inhibitors have been approved for melanoma immunotherapy over the past 10 years. These drugs target a specific protein, such as PD-1 or CTLA-4, that prevents the immune system from recognizing and attacking cancer cells. Whether given alone or as a combination treatment, this therapy can lead to durable responses for nearly half of melanoma patients with advanced disease.
But what about the other half of patients whose melanoma progresses despite this kind of immunotherapy?
Moffitt Cancer Center has been at the forefront of a new type of immunotherapy called cellular immunotherapy. This therapy involves using immune cells instead of drugs to fight cancer. Tumor infiltrating lymphocyte therapy (TIL) is a specific form of cellular therapy that has shown promise in melanoma and other solid tumors.
"TIL therapy has been used in an investigational setting for more than three decades, mostly for melanoma patients who have not received prior immunotherapies," said Amod Sarnaik, MD, a physician in Moffitt's Cutaneous Oncology Program. "However, we know the potential of this therapy, which is why we are evaluating TIL as an option for melanoma patients with advanced disease who may have seen initial responses to immunotherapies, such as immune checkpoint inhibitor therapy, but relapsed or had disease progression."
Sarnaik is principal investigator of a phase 2 multi-center trial of TIL, performed under the sponsorship of Iovance Biotherapeutics. It is considered the largest cell therapy study in advanced melanoma patients who have received previous immune checkpoint inhibitor therapy. Dr. Sarnaik presented results from cohorts 2 and 4 of this study at the 2022 Society for Immunotherapy of Cancer Annual Meeting.
Cohorts 2 and 4 included 153 melanoma patients who, on average, had three or more prior therapies for their metastatic melanoma. Each patient underwent surgery to remove a portion of one of their tumors, which was then shipped to Iovance for centralized TIL manufacturing. Patients were given chemotherapy before receiving their TIL infusion and the immune stimulating cytokine interleukin-2 (IL-2) after their infusion, in order to augment the survival of the administered tumor-infiltrating lymphocytes. The overall response rate was 31.4%. 41.7% of those who responded had a durable response two years or more after receiving the single TIL infusion therapy.
"Our results show that TIL, a therapy that only requires one single infusion of cells, is a viable option for heavily pretreated melanoma patients with advanced disease," says Sarnaik. "We look forward to being able to offer this therapy to more patients in the future."
Iovance is currently in the process of submitting its TIL therapy product, lifiluecel, for FDA approval. A decision is expected sometime this year. Moffitt is further developing a refined strategy of TIL therapy in partnership with Turnstone Biologics, Corp. This strategy involves selecting TIL that are reactive to specific tumor targets that are personalized to the patient. Two clinical trials are actively recruiting patients (NCT05628883 and NCT05576077).
If you’d like to refer a patient to Moffitt Cancer Center, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are typically responded to within 24 - 48 hours.
