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TIL Treatment

TIL Treatment

Posted By
MarkR
9/10/2019 3:09pm
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Replies: 14

Hi all
Heard today that my hospital will be opening a TIL treatment soon so guessing this is my Oncs plan for me if the Nivo fails as I expect. I have found out some info on TIL and there are some encouraging results but does anyone know the procedure on patients? I read one item that suggested a 4 week stay in hospital which I’m not too keen on....
Any info gratefully received
Cheers
Mark

ed williams - (9/10/2019 - 4:14pm)

Hi Mark, I will give you a few links and you can read for yourself some of the different approaches as well a couple of video's. The first video features Dr. Rosenberg of NIH who is considered the father of TIL's research in melanoma and has trained a lot of the experts working in other hospital like Patrick Hwu at Md Anderson. https://www.youtube.com/watch?v=_Xc7e7No4hQ https://www.mdanderson.org/publications/cancer-frontline/pioneering-endo...

ed williams - (9/10/2019 - 4:18pm)

Here are a couple of more links including LN-144 which is a new approach of having a central facility that hospital can send tumor to and have them make the cells or gets them ready to be put back into the patient.https://www.onclive.com/web-exclusives/fda-grants-ln144-fast-track-statu... https://www.mdanderson.org/newsroom/immatics-and-md-anderson-announce-la... https://www.mdanderson.org/newsroom/immatics-and-md-anderson-announce-la...

ed williams - (9/10/2019 - 4:30pm)

Final point would be different hospitals are developing different approaches and using some twists on basic Til's, for example in Toronto they have a Til's program with Dr. Butler, for those that have the NY-ESO-1 gene and are testing a lymphodepletion protocol that requires less chemo drugs. https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.2537 https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Study-...

ed williams - (9/10/2019 - 4:44pm)

Here is a link from Feb of this year on the forum with some more links from Celeste and Brain P. https://melanoma.org/legacy/find-support/patient-community/mpip-melanoma...

Bubbles - (9/10/2019 - 8:22pm)

TIL has come a long way over the years. It also has a fair amount of variety in what is offered and how it is completed these days. Ed's links are far better and more up-to-date than what I have. But if you want a rough explanation....I wrote this up for a dear one a couple of years ago: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2016/05/til-t...

Hang tough! c

MarkR - (9/11/2019 - 5:54am)

Thanks both will read through these
From what I can see the biggest issue for me might be harvesting a tumour big enough for TIL. I don’t know the location of my lung / liver nodules and how accessible they are but from what I have seen from other trials the expectation must be that you are able to go home no more than 3 days after surgery. Having never had such surgery before I don’t know if this is possible or whether the location of my lesions are suitable.
I was with my Derm yesterday for removal of some other bits and she told me my Onc has said no to removing anymore lumps and bumps as this may help me get into a trail. Everything seems to be leading to a TIL trial and I am encouraged by results. ORR reported between 38-55% and disease control in up to 80%. But it looks like my limitation may be the harvesting of a tumour big enough to complete this.
I don’t know for sure, but my best guess is this will be an extension of the LN-144 trial. Will have to wait and see I guess
Cheers
Mark

ed williams - (9/11/2019 - 9:39am)

Hi Mark, I came across this description of the different treatment types of TiL's on CRI ( cancer research institute) this morning and thought you might find it helpful. I can't remember if you have to sign up for CRI to use the site but if you do they don't spam you afterwards and if you go to CRI home page and click on "patients" link and look down the list you will see link to "webinars" and they have one coming up on Til's this month. https://www.cancerresearch.org/immunotherapy/treatment-types/adoptive-ce...

MarkR - (9/12/2019 - 6:17am)

Thanks Ed will have a look at this as well
Cheers
Mark

Ellie_82 - (9/11/2019 - 9:52pm)

Hi Mark, LN-144 seems to be a promising drug. Is this trial you are thinking about is NCT02360579? I looked it up on clinicaltrials.gov and here is the eligibility criteria for tumor tissue:

At least one resectable lesion (or aggregate of lesions resected) of a minimum 1.5 cm in diameter post-resection to generate TIL; surgical removal with minimal morbidity (defined as hospital stay for 3 days or less).

1.5cm doesn't seem to be that much. If you are concerned, I suggest you discuss this with your oncologist the sooner the better.

MarkR - (9/12/2019 - 6:21am)

Thanks Ellie
I think it may be that trial or something similar. It is the lesion requirement that is concerning me and i’ll discuss with my Onc when i next see him. Spoke with my nurse yesterday and she confirmed they are looking to put me on the trial if i need it and that’s why they don’t want to remove any more skin lesions. The skin lesions i have at present aren’t anywhere near 1.5cm so i guess its either wait for them to grow or use something from an organ, which is less appealing and of course i may not be out of hospital quickly enough o meet the criteria of 3 days.
As you have said i need to talk this through with my Onc to get a clearer picture.
Cheers
mark

Ellie_82 - (9/12/2019 - 9:05am)

A friend of mine had biopsy of her liver lesion (turned out to be lung cancer) and she was able to go home the same day. She was in a very good health otherwise though. So depending on where the internal mets are, it may not be as bad as it sounds. Good idea to talk to your onc about it! He/she would know best!

MarkR - (9/12/2019 - 9:22am)

Thanks Ellie - good to know will follow up with my Onc soonest as i don’t have much hope of the Nivo kicking in!
Cheers
Mark

MelanomaMike - (9/12/2019 - 12:01pm)

Hell ya bro! That would awesome if you could be part of the TIL program! I too may have some who knows! Im in good hands now with my new doctor! Lets get some Injectables! Haha...good news Mark!

Melanoma Will Not Beat Me or my MRF Family!
www.wespark.org
www.covvha.net

MarkR - (9/13/2019 - 2:17am)

I’m hoping for the best but preparing for the next step. Really glad to hear you have options and Immunocore looks to have had some good results and I’m hoping you get them as well!!