A new cancer treatment that uses a person’s own immune cells has been approved by the U.S. Food and Drug Administration (FDA) for treating the most dangerous type of skin cancer. Now this form of cellular therapy (tumor-infiltrating lymphocyte - or TIL therapy) is showing promise in advanced lung cancers through clinical trials underway at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James).

Giving immune system cancer-attacking power back

For a cancerous tumor to grow, it must overpower immune cells known as T cells. TIL therapy restores the immune system's natural ability to fight cancer cells.

"T cells are major cancer-attacking immune cells. But we think they might not be robust enough to completely block and destroy the cancer; that's why cancer grows. TIL therapy shifts the power back to the immune system to overcome the abnormal microenvironment inside a tumor that allows the cancer to grow unchecked by the immune system," said Kai He, MD, PhD, a thoracic medical oncologist and physician-scientist with Pelotonia Institute for Immuno-Oncology at the OSUCCC - James.

Unlike some other cellular therapy techniques such as CAR T-cell therapy, however, TIL cells are not genetically re-engineered. Instead, specific immune-fighting T cells are extracted from the patient and grown from a few dozen immune cells to billions of cancer-blasting immune cells in a lab and then infused back into the patient. This new army of healthy immune cells can then take hold in the body and target the cancer.

To prep for this therapy, patients receive a one-time chemotherapy treatment to clear out unhealthy T cells and create space for the new TIL T cells to take root.

First TIL therapy for advanced melanoma FDA-approved

In February, the company Iovance received the first FDA approval of a TIL therapy product for metastatic melanoma. Working with Iovance, trials led in partnership by OSUCCC - James physician-scientists Richard Wu, MD, Joel Beane, MD, Kari Kendra, MD, PhD, Claire Verschraegen, MD and Dr. He provided essential clinical data that supported this approval. The OSUCCC - James Cellular Therapy Program is investigating TIL therapy for the treatment of other solid tumors, including lung and cervix cancers, as well as sarcoma and others. The team consists of scientists and physicians from various departments/divisions at OSU, including medical oncology, hematology, surgical oncology, pathology and others.

"Our goal is to give the most robust treatment early in the process to maximize benefit and increase chances of cancer control. It is very exciting to see TIL clinical trials producing complete responses in patients with stage 4 cancers with no evidence of disease afterward, especially in difficult-to-treat diseases like lung cancer and metastatic melanoma," said Dr. He.

The team is working to produce novel TIL therapy products in-house at Ohio State for the treatment of lung and other solid tumors at the hospital's 2,500-square-foot cell therapy manufacturing facility.