Tumor-Infiltrating Lymphocytes in Metastatic Lung Cancer
Posted: Monday, July 6, 2020
Tumor-infiltrating lymphocyte treatment was tolerated and appeared to be efficacious in patients with metastatic non–small cell lung cancer (NSCLC), according to research presented as part of the 2020 American Association for Cancer Research (AACR) Virtual Annual Meeting I (Abstract CT056). The study focused on patients who had experienced disease progression following nivolumab therapy.
“[Tumor-infiltrating lymphocytes] may be a promising option for fit patients with metastatic NSCLC,” concluded Ben Creelan, MD, of H. Lee Moffitt Cancer Center, Tampa, Florida, and colleagues.
The study included 20 eligible patients with a median PD-L1 proportion score of 6%. A total of 20% of participants had an EGFR mutation. All patients had at least one lesion measurable by Response Evaluation Criteria in Solid Tumors and one lesion accessible for resection. Tumor-infiltrating lymphocyte cultures were performed on the resected samples. After four cycles of nivolumab treatment, patients who experienced tumor enlargement or new lesions began lymphodepletion cyclophosphamide/fludarabine, tumor-infiltrating lymphocytes, and attenuated interleukein-2 (IL-2) treatment. Following the first of two CT scans, nivolumab therapy was reinstated to enhance the presence of tumor-infiltrating lymphocyte.
A total of 13 patients received cyclophosphamide/fludarabine, tumor-infiltrating lymphocytes, and attenuated IL-2 treatment after disease progression on nivolumab, with 2 more set to begin tumor-infiltrating lymphocyte treatment within 2 months of presentation. At the first CT scan after tumor-infiltrating lymphocyte exposure, most patients experienced tumor regression, with a median best overall change of –38% in target lesion diameters. Complete responses have been achieved and sustained for almost 1 year by two patients, and three other patients have maintained remission via local ablation of isolated new lesions 6 to 17 months after tumor-infiltrating lymphocyte treatment.
The most common adverse events associated with the tumor-infiltrating lymphocyte regimen included hypoalbuminemia (92%), hypophosphatemia (85%), nausea (77%), hyponatremia (69%), and diarrhea (62%). Most of these complications resolved within 10 days of treatment implementation.
Disclosure: The study authors reported no conflicts of interest.