Medical oncologist John Haanen from the Netherlands Cancer Institute, who is leading the TIL trial, is very pleased with the results: “Remember: these are metastatic melanoma patients. Ten years ago, melanoma had such a bad prognosis that I would be seeing an entirely new patient population every year – but now I've been seeing some patients for ten years. This is largely due to the discovery of immunotherapy, which has revolutionized treatment for melanoma. But we still see that about half of the people diagnosed with metastatic melanoma succumb within five years, so we're still not where we want to be – not at all. 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 prior immunotherapies have failed."
Melanoma is an aggressive type of skin cancer. Ten years ago, metastatic melanoma was almost certainly a death sentence within a year after diagnosis. In earlier clinical trials, cell therapy using the patients' 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 have now been presented at the 2022 annual congress of the European Society for Medical Oncology (ESMO) in Paris.
In almost half (49%) of the patients with metastatic melanoma who received TIL therapy, the metastases had decreased in size. In 20% of patients, the metastases had even disappeared completely. This also proved to be the case in patients who had already received prior treatment at the time of their participation in the trial. These percentages were significantly higher compared to those seen in the patient group receiving standard immunotherapy (ipilimumab). In the ipilimumab group, metastases had decreased in size in 21% of patients, and in 7%, the metastases had disappeared completely.
The progression-free survival, the percentage of patients who do not experience disease progression after a specified time period, was 53% after six months for patients receiving TIL therapy, and 21% in the control group (ipilimumab).
At a median follow-up time of 33 months for all patients, the median progression-free survival of patients who had received TIL therapy was significantly better (7 months) than that of patients treated with ipilimumab (3 months).