Cellular Therapy

Cellular Therapy, also called Cell-based therapy, is a type of medical treatment that involves the use of living cells to treat or prevent diseases. It is a rapidly evolving field in medicine that holds great promise for various conditions, including the treatment of melanoma and other cancers.

Cell-based therapies can involve the use of different types of immune cells, such as T lymphocyte cells, natural killer (NK) cells, or dendritic cells which play important roles in the immune response against cancer. These different cell-based therapies are an active area of research for the potential treatment of cancer.

It's important to note that cell-based therapies either approved or those still being tested in the clinic are still relatively new and may not be available in all healthcare settings. The availability and suitability of cell-based therapies depend on various factors, including the specific type and stage of cancer, as well as the patient's overall health. 

What is a Cellular Therapy?

Cellular therapies are created to improve the way a patient’s immune system responds to and fights cancerous cells in the body. They are created individually for each patient through a labor-intensive process that involves collecting a specific set of cells from blood or tumor tissue, modifying or expanding them in a lab, and then reinfusing them back into a patient. There may also be other therapies used before, during, or after the infusion of these cells to further stimulate an immune reaction.

Over the last several years, genetically modified immune T-cell based therapies called Chimeric Antigen Receptor therapies (CAR-Ts) have been approved for the use in different types of blood cancers.1 In melanoma, the first Tumor-Infiltrating Lymphocyte (TIL) Therapy called AMTAGVI (lifileucel) earned FDA approval in early 2024. During this type of TIL therapy, T lymphocyte cells –– are isolated from surgically removed tumor tissue. These cells are then multiplied in a laboratory and activated before being infused back into the patient. AMTAGVI is the first cellular therapy approved for use in a solid tumor cancer.

What is Tumor Infiltrating Lymphocyte (TIL) T Cell Immunotherapy?

Tumor-Infiltrating Lymphocyte (TIL) therapy is a type of cellular therapy that can be used in the treatment of certain cancers, including melanoma. Here's how TIL therapy like AMTAGVI works: 

  1. Tumor Tissue Collection: The first step in TIL therapy is the surgical removal of a tumor from the patient. This tumor tissue contains immune cells called lymphocytes, including T cells, that have infiltrated the tumor. 
  2. Manufacturing: The tumor tissue is then taken to a laboratory where immune T cells, called  lymphocytes, are isolated from the tumor. These T cells are then grown and expanded in the laboratory a billion-fold.
  3. Conditioning: Before the T cells can be infused back into the patient, the patient will undergo a conditioning regimen of chemotherapy. This conditioning helps to suppress the patient's immune system and create space for the infused T cells to expand and function effectively. 
  4. Infusion: The activated and expanded T cells are then infused back into the patient's bloodstream. These T cells can then travel to the tumor site and target melanoma cells.
  5. Post Infusion: Once infused the patient receives doses of IL-2 (aldesleukin) to activate the infused T cells.

TIL therapy aims to harness the patient's own immune system to target and destroy melanoma cells. The infused TILs have been specifically selected and expanded to recognize and attack tumor cells. 

Once the TILs are infused, they can migrate to the tumor site and infiltrate tumor tissue. These activated T cells recognize were selected because they are able to identify unique characteristics found on the surface of melanoma cells and then initiate an immune response against them. The TILs can directly kill the cancer cells and can help attract other immune cells to the tumor site. 

TIL therapy is used to treat patients with advanced melanoma when other treatments have not been successful. It's important to note that TIL therapy is a complex and personalized treatment approach. The success of TIL therapy depends on various factors, including the quality and quantity of the isolated TILs, the conditioning regimen, and the characteristics of the patient's tumor. 

If you or someone you know is considering TIL therapy for melanoma, it is crucial to consult with a qualified healthcare professional who can provide personalized advice and guidance based on the individual's specific medical condition and circumstances.

Latest Cell Therapies for Melanoma

The U.S. Food and Drug Administration (FDA) has approved one cellular therapy for melanoma: 

  • AMTAGVI (lifileucel) – a Tumor Infiltrating Lymphocyte (TIL) T cell immunotherapy for patients with advanced melanoma who have progressed on PD1 based immunotherapy and BRAF/MEK therapy if their melanoma is BRAF mutant.