Over the last decade, melanoma survival rates have improved significantly due to ongoing research and the development of immunotherapy. Lifileucel, also known by its brand name AMTAGVI, is a new form of immunotherapy approved by the U.S. Food and Drug Administration (FDA) for patients with metastatic melanoma whose cancer has stopped responding to immune checkpoint inhibitors. The Barbara Ann Karmanos Cancer Institute is the first and only cancer center in Michigan to treat a patient with this new immunotherapy.
“I am truly excited for our patients. We have a new promising treatment, giving them hope in their melanoma treatment journey,” said Yusra Shao, M.D., medical oncologist and leader of the Melanoma Multidisciplinary Team (MDT).
What is TIL Therapy?
Tumor-infiltrating lymphocyte (TIL) therapy is a one-time treatment for adults who have melanoma that cannot be treated with surgery, and the disease has progressed following previous therapy, including an immune checkpoint inhibitor and BRAF-targeted therapy (if BRAF-mutated). The treatment is most successful when given to patients early in their care plan.
The TIL Treatment Process
The treatment is unique for each patient because no two patients have the same cell makeup. The process begins with the removal of a small portion of the tumor, which is sent to a laboratory for extraction and expansion of T-cells (immune cells) obtained from the tumor.
“You can look at it as if we’re giving you a treatment made by you. We take the patient’s immune cells and grow them in the lab, where they become stronger and smarter,” Dr. Shao said. “After the extraction, the patient is given chemotherapy for a week to empty out the bone marrow for new immune cells to take home.”
After chemotherapy, the prepared TILs, now with stronger immune cells that were grown in the lab, are infused back into the patient intravenously (IV).
“After the patient receives the TIL therapy, they are given a medication called IL-2. IL-2 is a chemical that our body naturally makes,” said Dr. Shao. “This chemical tells the new immune cells that it’s now time to get to work.”
TIL therapy involves a two-week process from chemotherapy to TILs infusion, followed by IL-2 administration, all of which are performed in the hospital. Patients are monitored closely throughout the process and after they have completed the treatment.
This treatment was approved based on a clinical trial that included 73 patients whose cancer had progressed on multiple prior therapies. After receiving TIL therapy, 31% of patients experienced tumor shrinkage, and in another 46% the cancer stopped growing. Half of the responses were seen after six weeks of receiving the treatment. In patients whose cancer shrank, the cancer remained under control on average for three years.
“For patients with progressive disease after checkpoint inhibitors and targeted therapy, these results represent a major advancement and a new life,” said Dr. Shao.
TIL therapy requires a multidisciplinary approach, involving multiple teams at Karmanos: the Melanoma and Bone Marrow and Stem Cell Transplant MDTs, surgical oncology, and pharmacy team members. Patients also have access to a patient navigator and social worker.
Learn more about TIL therapy at Karmanos here.