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实施新型特异性主动细胞疗法的准备情况:肿瘤浸润淋巴细胞疗法

Readiness to Implement Novel SACT: Tumor-Infiltrating Lymphocyte Therapy.

作者信息

Gomm Linda

机构信息

Guys & St Thomas' NHS Foundation Trust, London, United Kingdom.

出版信息

Semin Oncol Nurs. 2025 Apr;41(2):151841. doi: 10.1016/j.soncn.2025.151841. Epub 2025 Feb 11.

Abstract

OBJECTIVES

Adoptive cell therapy using tumor-infiltrating lymphocyte (TIL) therapy has demonstrated promising results in clinical trials. Recognizing the growing potential of cell therapies for solid tumors, oncology services need to prepare for an increasing number of trials and, in the near future, optimize patient access to TIL. Consultation with clinical trials professionals in England, however, highlighted low organizational readiness and significant knowledge gaps for use of adoptive cell therapy. The aim of this discussion paper is to provide guidance about the role of the nurse in the delivery of TIL therapy.

METHODS

Guidance was written based on peer-reviewed literature and best practice guidelines between 2006 and 2024 identified through electronic database searches on PubMed, CINAHL, and MEDLINE and expert experience of managing patients in clinical trials who are receiving TIL.

RESULTS

TIL therapy is set to transform current care pathways with treatments that can potentially induce long-lasting tumor responses. There are, however, numerous challenges for successful and safe implementation of TIL therapy in practice. Nurses have a central role in coordinating the safe delivery and patient care of patients receiving TIL therapy. Nurses need knowledge and understanding about the regulatory processes and extensive treatment pathways involved whilst also managing novel side effects and patient expectations.

CONCLUSIONS

TIL therapy requires a specialist team to safely deliver these complex treatments and support colleagues nursing patients receiving TIL therapy. Specialist knowledge and skills and close coordination is required to ensure a smooth process from patient referral, product ordering, manufacturing, storage, and administration of the treatment to the patient.

IMPLICATIONS FOR NURSING PRACTICE

Organizations planning to initiate TIL therapy should review their infrastructure, identify and address specialist knowledge and skills needs of oncology professionals, and seek guidance and support from expert teams. There needs to be a robust governance structure in place and ensure all healthcare professionals involved are trained and educated on a high level on how to care for these patients.

摘要

目的

采用肿瘤浸润淋巴细胞(TIL)疗法的过继性细胞疗法在临床试验中已显示出有前景的结果。鉴于实体瘤细胞疗法的潜力不断增长,肿瘤学服务需要为越来越多的试验做好准备,并在不久的将来优化患者获得TIL疗法的途径。然而,与英国临床试验专业人员的咨询凸显了组织准备不足以及在使用过继性细胞疗法方面存在重大知识差距。本讨论文件的目的是就护士在TIL疗法实施中的作用提供指导。

方法

基于2006年至2024年期间通过在PubMed、CINAHL和MEDLINE上进行电子数据库搜索确定的同行评审文献和最佳实践指南以及管理接受TIL治疗的临床试验患者的专家经验编写指导意见。

结果

TIL疗法有望通过可能诱导持久肿瘤反应的治疗方法改变当前的护理途径。然而,在实践中成功且安全地实施TIL疗法存在诸多挑战。护士在协调接受TIL疗法患者的安全治疗和患者护理方面发挥着核心作用。护士需要了解监管流程和所涉及的广泛治疗途径,同时还要应对新出现的副作用和患者期望。

结论

TIL疗法需要一个专业团队来安全地提供这些复杂治疗,并支持护理接受TIL疗法患者的同事。需要专业知识和技能以及密切协调,以确保从患者转诊、产品订购、生产、储存到给患者进行治疗的整个过程顺利进行。

对护理实践的启示

计划启动TIL疗法的组织应审查其基础设施,确定并解决肿瘤学专业人员的专业知识和技能需求,并寻求专家团队的指导和支持。需要建立一个强大的治理结构,并确保所有参与的医疗保健专业人员在如何护理这些患者方面接受高水平的培训和教育。

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