Tumor-Infiltrating Lymphocyte (TIL) Therapy

Question 1

How does tumor-infiltrating lymphocyte therapy work?

Answer

TIL (rhymes with “will”) therapy grows and activates some of your body’s own T cells (immune cells) to fight cancer. Specifically, it uses T cells known as tumor-infiltrating lymphocytes (TILs) that have moved from your blood into your tumor.

Often, your body’s small population of TILs cannot destroy a tumor. But when TIL therapy introduces billions of new TILs into your body, they can sometimes destroy that tumor.

Question 2

What are the benefits of TIL therapy?

Answer

Although TIL therapy is not effective for all patients with advanced melanoma, those who do respond to TIL therapy may have a partial or complete remission. For some, TIL therapy can be a breakthrough treatment that helps them remain tumor-free for years after treatment.

TIL therapy is also personalized to you. Unlike many cancer treatments, TIL therapy multiplies your body’s own immune cells to fight cancer. These immune cells stay in your body and can continue to fight tumors. If you have TIL therapy, you only need one treatment.

Question 3

Who is a candidate for TIL therapy?

Answer

If you have advanced melanoma and your cancer is still growing after standard immunotherapy or targeted therapy, you may be a candidate for TIL therapy. We may also offer TIL therapy early on in your care plan if we think you may benefit.

However, we may not recommend TIL therapy if you are not able to have chemotherapy, which is part of this treatment.

Question 4

What types of cancer is TIL therapy used for?

Answer

TIL therapy is approved by the U.S. Food and Drug Administration for patients with advanced melanoma.

At UChicago Medicine, we are also testing TIL therapy in a clinical trial for patients with cervical cancer. Our physician-researchers also plan to study this treatment for other types of solid tumors in future clinical trials.

Question 5

How often can I get TIL therapy?

Answer

If you qualify, you will only have TIL therapy one time. If you respond to this treatment, your new T cells will continue to fight cancer cells in your body.

Question 6

What happens before TIL therapy?

Answer

TIL therapy involves several steps before you can receive your new TILs:

You will meet with your medical oncologist, who will explain the risks and benefits of TIL therapy. Together, you will decide if this treatment is right for you.
If you are a candidate for TIL therapy, your surgeon will remove a portion of your tumor. You may be able to go home the same day.
Your team will send your tumor sample to a biotech company that makes TIL therapy. The company will use special techniques to remove your TILs from your tumor and make more TILs. This takes about three weeks.
Once we receive your frozen TILs back from the company, we will give you conditioning chemotherapy. This reduces your old T cells, giving the new TILs room to grow. Our team will give you three treatments of two chemotherapy drugs (fludarabine and cyclophosphamide) over the course of a week. We may also give you medication to prevent infections. After chemo, you can return home to rest.

Question 7

What happens during TIL therapy?

Answer

After you’ve completed your conditioning chemotherapy, you are ready for your TIL therapy. You will receive your treatment in a specialized cellular therapy unit in the Center for Care and Discovery that is staffed by physicians and nurses who are experts in cellular therapy care. Here’s what you can expect:

We will place a temporary central venous catheter (central line) to deliver the TILs back into your body.
Your cancer team will give you the thawed TILs as an infusion through your central line. This process usually takes a few hours.
Later that day, we will give you an immunotherapy drug called interleukin-2 (IL-2) that stimulates your TILs to multiply.
We will give you more IL-2 over the next five days while you are in the hospital. You may feel feverish and weak, and we will closely monitor you for any complications.
After five days in the hospital, you can return home.

Question 8

What happens after TIL therapy?

Answer

After TIL therapy:

You will return to the clinic to see your medical oncologist once or twice a week for the first month. During these follow-up visits, we will monitor your blood counts and check for complications.
If your blood counts are low, we will give you a transfusion.
Three months after your TIL therapy, we will do an imaging scan, such as a computed tomography (CT) or positron emission tomography (PET) scan, to see if your tumors are shrinking.
We may ask you to return for scans every three months to monitor your tumors.

Question 9

What are the risks and side effects of TIL therapy?

Answer

TIL therapy is an intense treatment with some short-term risks from conditioning chemotherapy. These include:

Low blood counts that may require blood transfusions
Infections
Fatigue
Nausea and vomiting
Diarrhea
Hair loss
Mouth sores

IL-2, which is used to stimulate your TILs, can also cause temporary side effects, including:

Fever
Rash
Low blood pressure
Abnormal heart rate
Nausea
Diarrhea
Fatigue
Confusion
Leg swelling

Your entire team — including your oncologist, nurse practitioner, physician assistant and other clinicians — will closely monitor you for complications throughout your treatment. Because our cancer team has many years of experience treating patients with cell therapies like TIL therapy, we have strategies to minimize these side effects.

Question 10

Is TIL therapy painful?

Answer

You may have some temporary pain or discomfort during certain portions of your TIL therapy. For example, you may have some pain for a few days after your surgery to remove your tumor. You may also find the central line (central venous catheter) uncomfortable during the week you have your infusion. The TIL infusion itself is not painful.

Question 11

Do I need to take any precautions while I have TIL therapy?

Answer

During your conditioning chemotherapy and for a few weeks after your TIL therapy, you should take some common-sense precautions to avoid infections. For example, you should wash your hands frequently and avoid exposure to young children, if possible. You do not need to isolate yourself at home.

Question 12

How long will TIL therapy take?

Answer

TIL therapy takes several weeks. This timeframe includes your surgery, the preparation of your new TILs, your conditioning chemotherapy and your infusion.

Your medical oncologist will go over this timeframe in detail with you.

Question 13

How does TIL therapy differ from CAR T-cell therapy?

Answer

CAR T-cell therapy is another innovative cell therapy offered at UChicago Medicine. Like TIL therapy, CAR (chimeric antigen receptor) T-cell therapy uses your body’s immune cells to fight cancer. However, CAR T-cell therapy uses T cells from your blood, not from your tumor. Then, new T cells re-engineered in a laboratory to seek out a specific “target” on a tumor.

Unlike CAR T-cell therapy, TIL therapy uses T cells that have already invaded your tumor. Different populations of TILs may work in different ways against the tumor, rather than focusing on a single target like with CAR T-cell therapy. TIL therapy can harness multiple populations of TILs that already “recognize” your cancer, grow billions more in a lab and then send them back into your body in an “activated” state to shrink your tumor.

Tumor-Infiltrating Lymphocyte (TIL) Therapy

A Groundbreaking Cancer Treatment for Advanced Melanoma

Video Transcript

Frequently Asked Questions About TIL Therapy