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Almost half of people with metastatic melanoma—a type of skin cancer that has spread beyond the skin—can become resistant to standard treatments. A new immunotherapy available at MedStar Georgetown Cancer Institute at MedStar Georgetown University Hospital is giving hope to patients with metastatic melanoma whose previous treatments didn’t work.
Tumor-infiltrating lymphocyte (TIL) therapy is a breakthrough treatment that uses a patient’s own immune cells to attack and eliminate cancer. This new type of immunotherapy is approved by the Food and Drug Administration (FDA) to treat metastatic melanoma that does not respond to or progresses with anti-PD-1 based immunotherapy and BRAF targeted therapy (if the tumor harbors a BRAF mutation).
MedStar Georgetown University Hospital is the first and only center in the Washington, D.C., region to offer this exciting treatment.
The National Cancer Institute estimates more than 100,000 cases of melanoma will be diagnosed in the U.S. in 2025, and more than 8,000 people will die of the disease.
Melanoma is the most aggressive form of skin cancer. Risk factors include having light skin and getting older. White people have about a 1 in 33 risk of developing melanoma during their lifetime. Hispanic people’s risk is 1 in 200, and Black people’s risk is 1 in 1,000. About 4% of people with melanoma are diagnosed with metastatic disease at the initial presentation. Others can have metastatic recurrence after treatment of localized disease.
Research to develop this exciting new treatment has been conducted at Georgetown Lombardi Comprehensive Cancer Center and other cancer centers across the U.S. Georgetown Lombardi is the Institute’s research engine and the only National Cancer Institute-designated comprehensive cancer center in the region.
Studies showed that the single TIL treatment course led to tumors shrinking or disappearing in 31% of patients. In another 46% of patients, TIL treatment led to stable control of the disease. Many responses were very durable, with half of the responses or more ongoing after 2 years of follow up without further treatment.
How does TIL therapy work?
TIL, also known as tumor-derived autologous T-cell immunotherapy, is an advanced therapy that uses the patient’s own immune system to attack the cancer.
TIL are a specialized immune cells or lymphocytes found in tumor that have the ability to recognize and selectively kill the cancer cells. Unfortunately, there are ways the tumor can inactivate these cells where they lie dormant in a non-active state.
To harness TIL as a therapy, a surgeon first removes a patient’s melanoma tumor for the manufacturing steps. In the lab, the tumor is processed and the TIL cells are stimulated and expanded in culture. The TIL are grown to 7.5 billion cells or more as the FDA approved Lifileucel (Amtagvi) product. The treatment course in the hospital typically involves chemotherapy followed by TIL infusion and then interleukin-2 to stimulate the TIL.
TIL therapy is a one-time course of treatment that can be completed in two to three weeks. In the study that led to FDA approval, TIL therapy was shown to be effective with a manageable side effect profile in specialized treatment centers.
Related reading: Top 7 Things That Increase Your Risk of Melanoma and Other Skin Cancers.
New hope for patients with metastatic melanoma.
MedStar Georgetown Cancer Center’s cellular therapy experts are glad to offer this exciting new treatment. Patients who are referred to our program will be treated by a team of specialists that includes medical oncologists, cellular therapy specialists, surgeons, and nurse navigators. We work together to provide our patients the highest quality, most compassionate and coordinated care.
Research with TIL therapy is ongoing for other diseases, including head and neck cancers, non-small cell lung cancer, and endometrial cancer. Other cellular therapy strategies are also in development in clinical trials and offer hope for effective treatment in a range of cancers beyond melanoma.
If other treatments have not worked in the treatment of your metastatic melanoma, talk with your doctor about whether TIL therapy is an option for you.
