Here are a couple of previous posts on TIL:
From April: TILs (tumor infiltrating lymphocytes) - advancing as melanoma immunotherapy and new trial
From May: TIL - Tumor infiltrating lymphocytes (a bit of a primer)
This was published in March:
Long-lasting complete responses in patients with
metastatic melanoma after adoptive cell therapy with tumor-infiltrating
lymphocytes and an attenuated IL-2 regimen. Andersen, Donia, Ellebæk, et
al. Clin Cancer Res. 2016 Mar 22.
Adoptive cell transfer
therapy (ACT) based on autologous tumor infiltrating lymphocytes (TILs) has
achieved impressive clinical results in several phase I and II trials performed
outside of Europe. Although transient, the toxicities associated with high-dose
(HD) bolus interleukin-2 (IL-2) classically administered together with TILs are
severe. To further scrutinize whether similar results can be achieved with
lower doses of IL-2, we have carried out a phase I/II trial of TIL transfer
after classical lymphodepleting chemotherapy followed by an attenuated IL-2
regimen.
25 patients with progressive
treatment-refractory metastatic melanoma, good clinical performance, age <
70 and at least one resectable metastasis were eligible. TIL infusion was preceded
by standard lymphodepleting chemotherapy and followed by attenuated doses of
IL-2 administered in an intravenous, continuous decrescendo regimen
(ClinicalTrials.gov Identifier:NCT00937625).
Classical IL-2 related
toxicities were observed but patients were manageable in a general oncology
ward without the need for intervention from the intensive care unit. RECIST 1.0
evaluation displayed three complete responses and seven partial responses (ORR
42%). Median overall survival was 21.8 months. Tumor regression was associated
with a higher absolute number of infused tumor reactive T cells. Moreover,
induction and persistence of anti-melanoma T cell responses in the peripheral
blood was strongly correlated to clinical response to treatment. TIL-ACT with a reduced IL-2 decrescendo regimen
results in long-lasting complete responses in patients with
treatment-refractory melanoma. Larger randomized trials are needed to elucidate
whether clinical efficacy is comparable to TIL-ACT followed by HD bolus IL-2.
Basically, this study looked at doing pretty much the old-fashioned version of TIL: Harvest cells from a tumor, grow cells, give old-time chemo to deplete the patient's existing t cells, infuse t cells that have been grown, then follow with IL-2 as usual...BUT in this case - with a decreasing dose in hopes of retaining the benefit and minimizing the suffering IL-2 can produce. Of 25 patients, there were 3 complete response and 7 partial ones. Median overall survival was almost 22 months. Not surprisingly, tumor regression and clinical responses were related to the greater number of t cells infused and the persistence of the anti-melanoma t cell responses in the patient's blood.
For what it's worth. - c