Efficacy of adoptive cell transfer of tumor-infiltrating lymphocytes after lymphopenia induction for metastatic melanoma

Abstract

A single-institution pilot clinical trial was performed combining nonmyeloablative chemotherapy and the adoptive transfer of tumor-infiltrating lymphocytes with interleukin-2 in patients with metastatic melanoma. Nineteen patients were enrolled with 13 patients (68%) successfully completing treatment. An overall response rate (partial and complete responses) of 26% by intention to treat was achieved with a median follow-up time of 10 months. Of the 13 treated patients, there were 2 complete responses and 3 partial responses (38% response rate among treated patients), along with 4 patients with stable disease ranging from 2+ to 24+months. Three of the 4 patients with stable disease have had disease control without additional therapy, including one at 24+ months. Adoptive therapy with infiltrating lymphocytes is labor intensive but feasible and has a high response rate in treated patients.

Figure 1

Lymphodepletion and ACT induced regression of metastatic disease in multiple sites in one patient. Complete regressions were measured in (Top) a 2.0 X 1.7 cm lesion in the axilla, (Middle) a 1.4 X 0.8 cm lesion in the subcutaneous chest, and (Bottom) a 1.5 X 1.5 cm intraperitoneal lesion.

Figure 2

Lymphodepletion and ACT induced regression of metastatic disease in the lungs, with a small degree of radiographic residua indicative of a partial response. In the pretreatment scans, (a) measured 1.3 cm × 1.0 cm, (b) measured 1.1 × 0.8, and (c) measured 2.0 × 1.5 cm. In the post-treatment scans, all lesions were less than 1.0 cm.