Kottschade Lisa, Rodriguez Emily Webb, Harding Susan, Ranjan Smita, Mcintyre Lori, Prieto Peter A, Gray Lissa, Joseph Jannakie, Swank Jennifer
From Mayo Clinic, Rochester, Minnesota.
Memorial Sloan Kettering Cancer Center, New York, New York.
J Adv Pract Oncol. 2025 Mar 16:1-14. doi: 10.6004/jadpro.2025.16.7.8.
Adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) was recently approved for patients with advanced melanoma (metastatic or unresectable) previously treated with immune checkpoint inhibitors and BRAF/MEK targeted therapies (where appropriate). Tumor-infiltrating lymphocytes isolated from patient-derived tumor tissues enter the tumor microenvironment and recognize tumor-specific antigens, leading to the destruction of tumor cells. The multistep TIL cell therapy journey is led by a multidisciplinary health care team. Patients selected for TIL cell therapy undergo tumor tissue procurement for TIL generation, followed by preparative lymphodepletion before receiving a single-dose infusion of TIL and a short course of high-dose interleukin-2. Successful implementation of TIL cell therapy requires well-established procedures and workflows to select and screen patients, procure tumor tissue, administer TIL cell therapy, and monitor patients during treatment and after discharge. The advanced practice provider plays a central role in a patient's TIL treatment journey by planning and coordinating care across the health-care system, educating patients and staff, and providing direct and supportive patient care. Here, we review the treatment landscape for advanced melanoma and clinical data supporting TIL cell therapy. We also provide guidance related to patient selection, tumor tissue procurement, TIL cell therapy regimen, safety monitoring, symptom management, and post-discharge follow-up.
采用肿瘤浸润淋巴细胞（TILs）的过继性细胞疗法最近已被批准用于先前接受过免疫检查点抑制剂和BRAF/MEK靶向疗法（如适用）的晚期黑色素瘤（转移性或不可切除）患者。从患者来源的肿瘤组织中分离出的肿瘤浸润淋巴细胞进入肿瘤微环境并识别肿瘤特异性抗原，从而导致肿瘤细胞的破坏。多步骤的TIL细胞治疗过程由一个多学科医疗团队主导。被选入TIL细胞治疗的患者要进行肿瘤组织采集以生成TIL，然后在接受单剂量TIL输注和短疗程高剂量白细胞介素-2之前进行预处理性淋巴细胞清除。TIL细胞治疗的成功实施需要完善的程序和工作流程，以选择和筛选患者、采集肿瘤组织、给予TIL细胞治疗，并在治疗期间和出院后对患者进行监测。高级执业提供者在患者的TIL治疗过程中发挥核心作用，通过规划和协调整个医疗系统的护理、教育患者和工作人员，并提供直接和支持性的患者护理。在此，我们回顾了晚期黑色素瘤的治疗情况以及支持TIL细胞治疗的临床数据。我们还提供了有关患者选择、肿瘤组织采集、TIL细胞治疗方案、安全监测、症状管理和出院后随访的指导。
