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Tumor-infiltrating lymphocyte (TIL)ٳis aԱ,sophisticatedform of cellular immunotherapy designed to target cancer cells byleveragingthe body’s immune system using specialized cells called T-lymphocytes.T-lymphocyteshelp destroy tumor cells and control immune responsesby preventing the immune system from attacking the body’s healthy cells.
Certain cancertreatmentsleverage T-lymphocytesfrom a patient’s own body to infiltrate the tumor and attack the cancerous cells.By amplifying these cells intothe billionsand delivering them back to the patient, these cells are able to target cancer cells.
Lifileucel(AMTAGVI) is the first cellular therapy for solid tumorsusing T-lymphocytes that has been approved by the U.S. Food and Drug Administration (FDA).Currently AMTAGVITIL therapyis approved for use inpatients withmetastatic melanoma,anditisalsobeing investigated for use in other solid tumors such as lung cancer, head and neck cancers, sarcoma, and cervical cancer.
ĢƵ andNewYork-Presbyterian Hospital offer this innovativeTILtreatmentoptionto patients. Additionally, researchers at Weill Cornell areleading efforts tohelp expand TIL therapy and other cellular immunotherapies to improve outcomesfor patients with melanomasanddifferent forms ofcancers.
“TIL is a practice changing treatment that is a new standard of care for patients who have progressed on prior immunotherapy,” said Dr. Barbara Ma, a medical oncologist caring for patients with skin cancers at ĢƵ/NewYork-Presbyterian Hospital. “We are proud to offer this novel treatment to our patients.”
TILsare formed fromlymphocytecells,a form ofimmunecellthathelps the body fight infections and diseases.There are two main types of lymphocytescalledB lymphocytes and T lymphocytes.B lymphocytesproduceantibodiesand T lymphocytes, also known as T cells,are responsible forhelping the immune systemtofight off germs and protect the body from diseases, such as cancer.
When cancer is detected, the body naturally creates TIL cells to try and fight off the cancer, but as cancerprogresses, the body’s natural cells can no longerkeep up with the rapidly dividing cancer cells. TIL therapy helpsbuild on this natural process occurring in the bodybycollecting unique cells from the patient’s tumor and enhancing and expanding them in the laboratory, creating many more multiples of these TIL cells beyond what the body can naturally produce.Because theseTILcells are naturally found in the body, they already have the ability to recognize cancer cells, making this form of treatment effective at attacking the cancer.
TIL therapy is a one-time treatmentconsisting of several steps.After the tumor is removedfrom the patient, ittakes approximately 1 month to makethe specialized cells, followed byamulti-stepprocessto prepare the body for thetreatment, receive the TIL infusion, and receive post-infusion treatment and monitoring. The entire process cantakeseveral weeks from start to finish.
In order tocreatethecopiesofthese tumorfightingTILcells, asmall piece of a patient’s tumor is removedby a surgeon. These surgeries can often be done as outpatient procedures.
The tissue from the tumor is used to collect the t-lymphocyte cells that will then be used to create individualized TIL therapy – unique to each individual patient and their specific tumor.
The tissue is then sent to a specialized manufacturing facility where the T cells are separated from other cells. These cells are then rejuvenated, grown and multiplied before being sent back to the care team to be administered to the patient via an intravenous (IV) infusion.
Prior to the TIL therapy infusion, patients will be admitted to the hospital to receive a short course of chemotherapy (starting 7 days beforehand). This helps to create space in the body for the TILs and prepares the body to receive the treatment more effectively. Because chemotherapy can affect the immune system, receiving it prior to the TIL therapy improves the likelihood that the TILs will survive when they are infused into the body.
Patients will stay in the hospital after completing chemotherapy. Twenty-four hours later, patients will receive the TIL therapy via IV infusion, which typically takes less than 90 minutes.
Following the TIL treatment infusion, patients will receive a short course of interleukin-2 (IL-2) therapy to support T cell activity in the body. IL-2 is a medicine that helps expand and activate the number of TILs in the body. Because a large number of TILs enter the body during the TIL therapy infusion, IL-2 is an important step in boosting response. This process can take up to 3 days.
Patients are closely monitored throughout this process for any side effects or reactions to the medication. Common side effects can include chills, fever, fatigue, and shortness of breath. This is due to the nature of the way the treatment activates and “jump starts” the immune system.
A variety of care team members are involved in the TIL therapy process. An oncologist, surgeon, cell therapy coordinator, nurse navigator, and social worker may all be part of the team assisting patients as they undergo this treatment. Ask your care team any questions you may have about the process or the team members who will involved in your care.
