Understanding the Significance of TIL Therapy for Metastatic Melanoma

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Topics include: Treatments and Understanding

Dr. Sylvia Lee, medical oncologist at Seattle Cancer Care Alliance, discusses a Phase II trial underway focusing on TIL therapy or tumor infiltrating lymphocytes for metastatic melanoma patients. Dr. Lee helps us understand what the therapy is, how it works, and why patients with advanced disease should be excited about it. She also discusses the successes seen in clinical trials so far and the hope for continued expansion of research at other cancer centers.

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Transcript

Andrew Schorr:

Hello and welcome to Patient Power, sponsored by the Seattle Cancer Care Alliance. I’m Andrew Schorr. Many of us know that the scariest form of skin cancer, if you will, is malignant melanoma. If it’s caught early, it can often be cured. But, unfortunately, too often, it spreads, and it can be fatal. There are new medicines to treat malignant melanoma, and they work for many people. And we hope they’ll work for a long time, but some people are not helped. Can we marshal the power of our own immune systems to fight the melanoma that was missed the first time around? Well, work is going on like that in Seattle. And joining us now is one of the leading researchers. That’s Dr. Sylvia Lee from the Seattle Cancer Care Alliance, University of Washington, and the Fred Hutchinson Cancer Research Center. Dr. Lee, thank you so much for being with us on Patient Power.

Dr. Lee:

Thanks.

Andrew Schorr:

Dr. Lee, you’re helping lead a Phase II trial for something called TIL therapy for metastatic melanoma. Tell us, what is TIL therapy?

Dr. Lee:

TIL stands for tumor infiltrating lymphocytes. What we’re trying to do is take advantage of the patient’s immune system’s natural ability to recognize the melanoma and fight it and build on that and augment that. So in TIL therapy, a melanoma patient undergoes surgery, and we resect part of their tumor. Then we take it to the lab, and we isolate the T cells, the lymphocytes or white blood cells, that are growing in between the tumor cells so their natural white blood cells that have been drawn out of their bloodstream and have been attracted to the tumor and are trying to fight it, but they aren’t quite doing the job. And we grow those out, we isolate them, and then we throw in a ton of IL-2, which is food for the T cells and causes them to start growing. And then we test them, and we see which cells recognize the tumor the best, and we grow those out some more to re-infuse into the patient.

Andrew Schorr:

So, Dr. Lee, if I have this right, a patient’s own immune system is trying to fight the malignant melanoma but there just are not enough immune system cells to fight back. You also need to make them stronger. So you take them out of the body, you feed them, you kind of bulk them up, and then you re-infuse them.  Who’s a candidate for this clinical trial?

Dr. Lee:

We’re selecting patients who are mostly stage IV so metastatic melanoma and patients who are fit enough for the procedure so people who can undergo surgery who have a clinical reason to need surgery, for example, a spot of melanoma that’s causing them pain that they would benefit from removing it, so we could use it, and people who are strong enough to receive the TIL therapy. So they have to be pretty fit.

Andrew Schorr:

And there is some chemotherapy that’s part of this clinical trial as well, so a patient has to be fit and also fit as they get these cells re-infused back into them.

Dr. Lee:

Yes, it’s also followed by high-dose IL-2, not as intensively as sort of the standard high-dose IL-2 that melanoma patients have heard about that’s very aggressive, but a few doses of high-dose IL-2 is given after the TIL because it’s thought that that will help the TIL grow in the patient’s body.

Andrew Schorr:

What are you hoping to accomplish with this trial?

Dr. Lee:

TIL therapy, it’s been shown in clinical trials to have a higher response rate and to have more lasting responses than any FDA-approved therapy and so more lasting responses than vemurafenib (Zelboraf) for BRAF mutations, higher response rates than ipilimumab (Yervoy), which everyone is excited about. So it also works for patients who have failed other FDA-approved therapies, including ipilimumab, vemurafenib, and IL-2, so it really has the ability to help melanoma patients in a very meaningful way. And the challenge is that it is so technically difficult to grow these cells that it’s only offered at a few sites around the country. So our goal is to try to expand the numbers of patients who would be able to receive TIL. We’re the only site on the West Coast right now. Before we opened in July, patients would have to travel to Maryland at the NIH or MD Anderson or Florida to get this therapy, and we’re hoping to expand this to therapy to people on the West Coast.

Andrew Schorr:

Dr. Sylvia Lee from the Seattle Cancer Care Alliance, thanks for all you do. We wish you all the best with this clinical trial, and certainly it may well help people in the trial and so many more people with malignant melanoma. Thanks for being with us on Patient Power.

Dr. Lee:

Thanks!

Andrew Schorr:

This is what we do on Patient Power is connect you with leading experts like Dr. Sylvia Lee in melanoma at the Seattle Cancer Care Alliance. I’m Andrew Schorr. Remember, knowledge can be the best medicine of all!

Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer Care Alliance, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on May 1, 2015