A combination of chemotherapy and immunotherapy appears to be a labor-intensive but feasible treatment for persons with metastatic melanoma.
In a small clinical trial, 19 patients with metastatic melanoma underwent nonmyeloablative chemotherapy along with immunotherapy consisting of adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TIL). In this process, tumor tissues were surgically removed from each patient, minced, and grown in culture to expand the number of antitumor T lymphocytes. The cells were then reinfused into the patient, accompanied by interleukin-2, which boosts the immune system in cancer therapy.
Over a median follow-up time of 10 months, the overall response rate among the 13 persons who finished treatment was 26% of the original 19, and 38% when considering only those 13 patients. Specifically, two patients had complete responses and three patients had partial responses.
Four other patients had stable disease for a period ranging from more than 2 months to more than 24 months. Three members of this group had disease control without additional therapy, including one at more than 24 months, by the time the researchers reported the results in Journal of Immunotherapy (2012;35:615-620).
“Although our clinical study successfully met its goal of demonstrating that ACT TIL therapy could be offered to advanced melanoma patients, strategies to improve on its feasibility and efficacy are under way,” explained study investigator Shari A. Pilon-Thomas, PhD, assistant member of the immunology program at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida, in a statement issued by the facility. “Combination therapies that enhance the proliferation and function of TIL are being explored.”