A patient’s own immune cells, multiplied into an army of billions of immune cells in a lab, can be used as a living medicine against metastatic melanoma, an aggressive form of skin cancer, as the TIL trial has shown. The TIL trial is the world’s first comparative phase 3 trial looking into the effect of T cell therapy in melanoma, and solid tumors in general. Now that the results have come in , the Dutch National Health Care Institute will assess whether TIL therapy () could become a standard treatment, meaning that it will be covered by basic health insurance. The results are published in The New Engeland Journal of Medicine (NEJM) on December 8. The trial was headed by the Netherlands Cancer Institute in collaboration with the National Center for Cancer Immune Therapy in Copenhagen.
Powerful immunotherapy for metastatic melanoma
Medical oncologist John Haanen from the Netherlands Cancer Institute, who is leading the TIL trial, is very happy with the results: “Remember: these are patients with metastatic melanoma. Ten years ago, melanoma was so deadly that I would be seeing an entirely new patient population every year. Now I’ve been seeing some patients for ten years. This is largely due to the discovery of immunotherapy, which has revolutionized treatment for melanomas. But we still find that about half of people diagnosed with metastatic melanoma lose their lives within five years, so we’re still not where we want to be — not by a long shot. The TIL trial has shown that cell therapy using the patient’s own immune cells is an extremely powerful immunotherapy for metastatic melanoma, and that this therapy still offers a high chance of improvement, even if other immunotherapies fail.’
World’s first phase 3 study T cell therapy for melanoma
A melanoma is an aggressive form of skin cancer with a high rate of occurrence Ten years ago, a diagnosis with metastatic melanoma would almost certainly lead to death within the same year. In early clinical trials, cell therapy using the patient’s own T cells as a “living drug” showed promising results. However, a comparative phase 3 trial would be necessary to include TIL therapy in the arsenal of regular treatments, and no such trial had ever been conducted. Medical oncologist John Haanen from the Netherlands Cancer Institute decided to take on this task by initiating an international trial in 2014: the TIL trial, which compared TIL therapy to standard immunotherapy with the checkpoint inhibitor ipilimumab. The results of the TIL trial will now be presented at the annual conference of the European Society for Medical Oncology.
Metastases smaller in half of the patient group
In almost half (49%) of the patients with metastatic melanoma who received TIL therapy, the metastases had shrunk. In 20% of patients, the metastases had even disappeared completely. This also proved to be the case in patients who had already received another treatment prior to their trial participation. These percentages were significantly higher than those among the patient group receiving standard immunotherapy (ipilimumab). In the latter group, metastases had shrunk in 21% of patients, while 7% saw a disappearance of the condition.
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