According to experts, the next significant development in cancer treatment will likely include an experimental treatment for metastatic melanoma.
The treatment, which uses a super concentrated boost of the patient’s own immune cells, was more successful than the top existing treatment at putting patients into remission, according to the findings of a phase 3 clinical trial that were published on Wednesday in the New England Journal of Medicine.
The experiment, carried out by Dutch experts, marks the end of a remarkable ten years of advancement in the treatment of metastatic melanoma, a condition with a 5-year survival rate of only 5% less than ten years ago.
The brand-new strategy, known as TIL therapy, fights cancer by using immune cells taken directly from the tumor. Tumor-infiltrating lymphocytes, or «TILs,» are the cells used in TIL treatment.
According to Dr. Patrick Hwu, president and chief executive officer of the Moffitt Cancer Center in Tampa, Florida, «These are immune cells that are present in the tumor, attempting to destroy the tumor, but obviously not doing a good enough job since the tumor is growing.»
The cells are reproduced in a lab until they reach billions in order to boost them, creating an army powerful enough to battle the tumor.
How TIL went
168 patients with metastatic melanoma participated in the new clinical trial, almost all of whom had already attempted and failed to react to anti-PD-1 therapy, a first-line treatment. (The findings were first presented in September at the European Cancer Meeting ESMO Congress 2022 in Paris; they were then published on Wednesday.)
In the experiment, TIL treatment was administered to half of the patients, while ipilimumab, an immunotherapy medication, was administered to the other half. Patients were monitored for a median of 33 months after therapy.
Comparing individuals who received TIL therapy to those who received ipilimumab treatment, the study indicated that both disease progression and mortality were reduced by 50%.
Not all of the individuals responded well to the treatment.
Compared to 21% of patients who received ipilimumab, 49% of TIL patients had at least partial remission, which meant a reduction of at least 30% in their metastatic tumors.
The 20% of TIL patients who experienced full remissions, in which all of their tumors vanished, was even more unexpected. According to trial leader Dr. John Haanen, a medical oncologist at the Netherlands Cancer Institute, this outcome was «better than we had expected.»
7% of patients receiving ipilimumab had a complete remission.
Patients who are in full remission have a very good outlook, he added. More than 80% of them, in our estimation, may be treated.
Hwu has conducted his own study on TIL treatment and has seen outcomes that are comparable to those of the Dutch experiment.
He stated, «I have patients that we treated with TIL therapy ten years ago, and they are not receiving any treatment at this time, just going about their daily lives.»
Treatments for melanoma have improved.
The most serious type of skin cancer is melanoma, and for many years, metastatic melanoma, which refers to disease that has spread to other regions of the body, was thought to be fatal.
Dr. Hussein Tawbi, a melanoma oncologist at the MD Anderson Cancer Center in Houston who was not involved in the current research, stated «I used to call the melanoma clinic «the sad clinic.» «That is no longer the case. There is a great deal of potential and optimism. We have a lot of options for such patients.
According to research published in the journal JAMA Network Open on Tuesday, that transformation has occurred during the previous ten years. For the first time in forty years, mortality rates from metastatic melanoma declined from 2013 to 2017.
According to the study’s authors, the increase in survival can be attributed to the FDA’s 2011 approval of ipilimumab and other novel cancer medicines. Five years after being diagnosed with metastatic melanoma, a person’s chances of survival have climbed from 5% to more than 50% because to these cutting-edge therapies.