Tumor-Infiltrating Lymphocyte (TIL) Therapy for Metastatic Melanoma

TIL therapy is approved by the FDA for patients with advanced melanoma that has not responded or stopped responding to a PD-1 blocking drug either by itself or in combination with other treatments. If your tumor harbors a BRAF V600 mutation, you must also have been previously treated with BRAF targeted therapy.

At MedStar Georgetown, our team will screen patients to determine eligibility based on a patient’s diagnosis, treatment history, and medical conditions that may impact the ability to tolerate the TIL therapy process. Because the treatment involves lymphodepleting chemotherapy and interleukin-2, patients must generally have good functional status and cardiovascular and respiratory health.

To request an appointment, patients and referring providers can contact us by calling Monica Chacha at 202-993-0492.

Currently, TIL therapy is FDA-approved as a second-line or third-line treatment for metastatic melanoma.

At MedStar Georgetown, we continue studying cellular therapies in clinical trials for patients with other types of solid tumors including triple negative breast cancer, lung cancer, kidney cancer, liver cancer, and other types of cancers.

The time from your initial consultation with a medical oncologist to your infusion will be several weeks. During this time, you’ll undergo surgery to remove a tumor, your tumor will be shipped to the laboratory for the TIL manufacturing, and you’ll begin preparations for undergoing the infusion. It can take up to five weeks from shipment of the tumor to the time the TIL therapy is ready for use.

When ready, TIL therapy is administered in the hospital and requires an inpatient stay. Your length of stay in the hospital may vary based on your body’s response to the treatment and any side effects. On average, most patients remain in the hospital for around two weeks.

Your comfort during cancer treatment is one of our highest priorities. Before treatment, your care team will thoroughly review any potential side effects of TIL therapy, including the lymphodepleting chemotherapy given before the cell infusion and the IL-2 administered after the cell infusion.

The chemotherapy and IL-2 treatment courses that are given with the TIL cell infusion are associated with additional side effects that can be life threatening. The most common side effects reported for the full treatment course in 20% or more of patients include chills, fevers, fatigue, fast heart rate, diarrhea, low white blood counts with fever, swelling/fluid retention, rash, low blood pressure, hair loss, infection, low oxygen levels, and shortness of breath. Most side effects are transient, occur during the hospitalization, and improve or resolve after treatment is complete.

We’ll also explain how we plan to minimize and manage the impact of treatment on your body. Throughout the entire treatment process, we’ll keep a close eye on how you are responding to the TIL therapy regimen so we can quickly counteract any unpleasant side effects of treatment. Our nursing team is specially trained in caring for patients who receive cell therapy.

CAR-T cellular therapy is another cellular immunotherapy offered at MedStar Georgetown. Both CAR-T and TIL therapy involve collecting a patient’s immune cells and reinfusing them into the body to more effectively stimulate the body’s immune response against cancer. However, there are distinct differences:

• TIL therapy is derived from a patient’s tumor. The T-lymphocytes in TIL therapy recognize a range of proteins on the patient’s tumor surface that are specific to that patient’s tumor. In general, one patient's TIL therapy cannot be used for another patient. TIL therapy usually involves the administration of IL-2 after the infusion, where this is not the case for CAR-T therapy.
• CAR-T therapy is derived from filtered blood T-lymphocytes (a process called apheresis). These are most often with a patient’s own T-lymphocytes but also can be from a donor in clinical trials. The T-lymphocytes are then re-engineered to target a specific protein on tumor cells.

We are actively involved in clinical trials investigating the use of CAR-T-cell therapy to treat solid tumor cancers.

At MedStar Health, we have dedicated financial coordinators who work closely with patients and their families to seek health insurance coverage for patients who are eligible for TIL therapy.