How T cell therapy works
Annual Report 2019 : TIL therapy offers new cervical cancer treatment option
TIL therapy offers new cervical cancer treatment option
A type of immunotherapy called TIL therapy uses T cells from the tumor itself to fight cancer. And it’s showing promise for treating a growing number of cancers, including cervical cancer.
Amir Jazaeri, M.D., led a clinical trial testing TIL cells for the treatment of cervical cancer. The trial was so successful that the Food and Drug Administration granted TIL therapy a breakthrough designation to expedite its development. Photo by Adolfo Chavez III
When it comes to killing cancer, T cells are some of the most important players in the field of immunotherapy.
Typically, T cell therapy involves extracting T cells from a patient’s blood. These T cells are reprogrammed in the lab to recognize and attack cancer cells, multiplied to make more, then infused back into the patient so they can start attacking cancer cells. This process is known as adoptive cell therapy.
But sometimes, T cells are removed directly from the tumor. Why use T cells from a tumor itself?
“These T cells actually navigated to the tumor, so they’re ahead of the game. They must already recognize something threatening about the cancer cells,” says Amir Jazaeri, M.D., professor of Gynecologic Oncology and Reproductive Medicine. “What better place to find T cells reacting against the cancer than in the cancer itself?”
How TIL therapy works
T cells are a type of lymphocyte – white blood cells that fight infection and disease.
TILs, or tumor-infiltrating lymphocytes, are T cells found inside some tumors. In TIL therapy, TILs are collected from the tumor during a biopsy or surgery. They’re then multiplied in the lab using interleukin-2 (IL-2), a protein that promotes rapid TIL growth.
Once grown to billions in number, the TILs are infused back into the patient, where they attack cancer cells while leaving healthy cells alone. Before the TIL infusion, patients undergo chemotherapy to help the TIL attack the tumor. Patients undergo close monitoring.
“This is not a treatment that can be safely administered to everyone,” says Rodabe Amaria, M.D., assistant professor of Melanoma Medical Oncology. “We do a lot of screening to make sure the heart and lungs can tolerate the high doses of chemotherapy and IL-2.”
These T cells actually navigated to the tumor, so they’re ahead of the game.
TIL therapy expands to treat cervical cancer
Until recently, TIL therapy was primarily used to treat melanoma. In fact, the National Cancer Institute first began using TIL therapy to treat melanoma patients in 1986. Patrick Hwu, M.D., head of MD Anderson’s Cancer Medicine division, left the NCI in 2003 to start MD Anderson’s TIL program.
Today, TIL therapy is being used to treat more cancers, including colorectal, bile duct, breast and now, cervical cancers.
Jazaeri recently led a study in which almost half of advanced cervical cancer patients who received TIL therapy saw improvement.
Out of 27 patients in the clinical trial, three had no visible signs of cancer after the therapy, nine saw their cancer shrink, and 11 saw their cancer stabilize. These results were so impressive that the Food and Drug Administration granted TIL therapy a breakthrough designation to expedite its development so it could be used to treat more cervical cancer patients sooner.
Collaboration enables expansion of TIL therapy clinical trials
Clinical trials are now underway to test TILs in sarcomas, pancreatic cancer, colorectal cancer and other gynecologic cancers.
“The whole reason we can do these trials at MD Anderson is the cooperative team effort,” says Jazaeri. “It’s as much a success of collaboration at MD Anderson as it is a medical innovation.”
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