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April 16, 2011Clinical Cancer Research2,147 citationsOpen Access

Durable Complete Responses in Heavily Pretreated Patients with Metastatic Melanoma Using T-Cell Transfer Immunotherapy

SRSteven A. RosenbergJYJames Chih‐Hsin YangRSRichard M. Sherry

Key Points

  • To evaluate the efficacy and durability of adoptive cell transfer using autologous tumor-infiltrating lymphocytes (TIL) combined with interleukin-2 in heavily pretreated patients with metastatic melanoma.
  • Treated 93 patients with measurable metastatic melanoma across three sequential clinical trials using autologous TIL transfer and interleukin-2 following lymphodepleting chemotherapy alone or combined with total-body irradiation (2 or 12 Gy).
  • Assessed objective tumor response according to RECIST criteria over a median potential follow-up duration of 62 months.
  • Objective response rates across the three preparative regimens (chemotherapy alone, with 2 Gy, or with 12 Gy irradiation) were 49%, 52%, and 72%, respectively.
  • Complete tumor regression occurred in 20 of 93 patients (22%), with 19 maintaining ongoing complete responses beyond 3 years.
  • Actuarial 3- and 5-year overall survival rates were 36% and 29% for all patients, but reached 100% and 93% among complete responders, with response correlating significantly with longer infused cell telomeres, higher CD8(+)CD27(+) cell counts, and 1-month cell persistence (all P < 0.001).

Abstract

PURPOSE: Most treatments for patients with metastatic melanoma have a low rate of complete regression and thus overall survival in these patients is poor. We investigated the ability of adoptive cell transfer utilizing autologous tumor-infiltrating lymphocytes (TIL) to mediate durable complete regressions in heavily pretreated patients with metastatic melanoma. EXPERIMENTAL DESIGN: Ninety-three patients with measurable metastatic melanoma were treated with the adoptive transfer of autologous TILs administered in conjunction with interleukin-2 following a lymphodepleting preparative regimen on three sequential clinical trials. Ninety-five percent of these patients had progressive disease following a prior systemic treatment. Median potential follow-up was 62 months. RESULTS: Objective response rates by Response Evaluation Criteria in Solid Tumors (RECIST) in the 3 trials using lymphodepleting preparative regimens (chemotherapy alone or with 2 or 12 Gy irradiation) were 49%, 52%, and 72%, respectively. Twenty of the 93 patients (22%) achieved a complete tumor regression, and 19 have ongoing complete regressions beyond 3 years. The actuarial 3- and 5-year survival rates for the entire group were 36% and 29%, respectively, but for the 20 complete responders were 100% and 93%. The likelihood of achieving a complete response was similar regardless of prior therapy. Factors associated with objective response included longer telomeres of the infused cells, the number of CD8(+)CD27(+) cells infused, and the persistence of the infused cells in the circulation at 1 month (all P(2) < 0.001). CONCLUSIONS: Cell transfer therapy with autologous TILs can mediate durable complete responses in patients with metastatic melanoma and has similar efficacy irrespective of prior treatment. Clin Cancer Res; 17(13); 4550-7. ©2011 AACR.

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Cite This Study

Rosenberg et al. (2011) studied this question.

synapsesocial.com/papers/6a04e1be09bd45543c9d385dhttps://doi.org/10.1158/1078-0432.ccr-11-0116
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