Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Surg Oncol. 2021 Sep;124(4):699-703. doi: 10.1002/jso.26548. Epub 2021 May 31.
Adoptive T-cell therapies (ACTs) using expansion of tumor-infiltrating lymphocyte (TIL) populations are of great interest for advanced malignancies, with promising response rates in trial settings. However, postoperative outcomes following pulmonary TIL harvest have not been widely documented, and surgeons may be hesitant to operate in the setting of widespread disease.
Patients who underwent pulmonary TIL harvest were identified, and postoperative outcomes were studied, including pulmonary, cardiovascular, infectious, and wound complications.
83 patients met inclusion criteria. Pulmonary TIL harvest was undertaken primarily via a thoracoscopy with a median operative blood loss and duration of 30 ml and 65 min, respectively. The median length of stay was 2 days. Postoperative events were rare, occurring in only five (6%) patients, including two discharged with a chest tube, one discharged with oxygen, one episode of urinary retention, and one blood transfusion. No reoperations occurred. The median time from TIL harvest to ACT infusion was 37 days.
Pulmonary TIL harvest is safe and feasible, without major postoperative events in our cohort. All patients were able to receive intended ACT infusion without delays. Therefore, thoracic surgeons should actively participate in ongoing ACT trials and aggressively seek to enroll patients on these protocols.
利用肿瘤浸润淋巴细胞（TIL）群体的扩增进行过继性 T 细胞疗法（ACT）对于晚期恶性肿瘤具有很大的吸引力，在试验环境下有很好的响应率。然而，肺 TIL 采集后的术后结果尚未得到广泛记录，并且外科医生可能会因为广泛的疾病而不愿进行手术。
确定接受肺 TIL 采集的患者，并研究术后结果，包括肺部、心血管、感染和伤口并发症。
83 名患者符合纳入标准。肺 TIL 采集主要通过胸腔镜进行，平均手术失血量和手术时间分别为 30ml 和 65min。平均住院时间为 2 天。术后仅发生 5 例（6%）患者出现罕见并发症，包括 2 例带管出院、1 例吸氧出院、1 例尿潴留和 1 例输血。无再次手术。从 TIL 采集到 ACT 输注的中位时间为 37 天。
在我们的队列中，肺 TIL 采集是安全且可行的，没有出现重大的术后事件。所有患者都能够及时接受预期的 ACT 输注，没有延迟。因此，胸外科医生应积极参与正在进行的 ACT 试验，并积极招募这些方案的患者。
