Novel Immunotherapy Drives Patient’s Own Tumor Cells to Self-destruct

ChristianaCare’s Helen F. Graham Cancer Center & Research Institute is one of only a few select sites in the nation – and the only one in Delaware – to offer tumor-infiltrating lymphocyte (TIL) therapy to fight cancer. This novel cellular immunotherapy uses energized cells from the patient’s own tumor to destroy the tumor itself.

The Graham Cancer Center is one of 18 leading cancer centers in the country to provide TIL therapy for recurrent or metastatic squamous cell head and neck cancer as part of an investigative clinical trial.

Treatment is underway for the first patient enrolled at ChristianaCare, whose metastatic head and neck cancer has resisted all other forms of standard therapy. The opportunity to undergo personalized TIL therapy close to home could mean a second chance at life.

“Our ability to offer potentially life-extending TIL therapy means more options for patients with advanced head and neck cancers who need travel no further than the Graham Cancer Center for treatment,” said Nicholas J. Petrelli, M.D., Bank of America medical director of the Helen F. Graham Cancer Center & Research Institute.

“This is one more outstanding example of how well our multidisciplinary clinical teams work together to merge state-of-the-science with patient care.”

TIL therapy is highly personalized medicine that uses the body’s natural defenses to fight cancer. TIL capitalizes on the fact that cancer patients already have armies of disease fighting T-cells capable of attacking their cancers. However, the simple presence of these infiltrating T-cell lymphocytes is not a guarantee that the tumor will be destroyed.

“There is an intricate dance at play between the T-cells and the tumor,” said Michael Guarino, M.D., principal investigator for the Graham Cancer Center pharmaceutical trials.

“When faced with invading T-cells, the tumor mounts its own defenses that can weaken and limit the damage T-cells can cause, but adoptive cell therapies like TIL therapy are strategies we can use to potentially get around those defenses.”

TIL therapy harvests those tumor-infiltrating T-cells from a small sample of cancerous tumor that is surgically removed from the patient. The tissue is sent to the lab where the cells are energized and expanded into more powerful numbers.

Then, billions of energized TILs are given back to the patient by an intravenous infusion to help kill the cancer cells. These supercharged cells continue to multiply in the body after treatment, remaining on guard to seek and destroy any new cancers that might develop.

In preparation for their TIL infusion, patients receive pre-conditioning chemotherapy to reduce their body’s natural immune response. Patients also receive up to six doses of a drug called interleukin 2 (IL-2) immediately following the TIL infusion to further energize the TIL and boost their anti-cancer capabilities.

TIL therapy is a type of cellular immunotherapy that is considered to be a “living drug” with potential benefits that could last for years. In 2019 ChristianaCare introduced CAR T-cell therapy, another form of cellular immunotherapy approved to treat highly resistant B-cell blood cancers for which other options have failed.

TIL therapy is not without risks, but potential side effects can be managed safely when recognized and addressed early.

TIL therapy is based on an adoptive cell therapy regimen developed at the National Cancer Institute and studied in patients since 1988. So far, most of the data on TIL therapy has been obtained from studies in metastatic melanoma and cervical cancer. TIL is currently being applied to treat other cancers at a small selection of leading cancer centers around the world, including the Graham Cancer Center.