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Comprehensive single institute experience with melanoma TIL: Long term clinical results, toxicity profile, and prognostic factors of response.
Molecular Carcinogenesis ( IF 4.6 ) Pub Date : 2020-04-06 , DOI: 10.1002/mc.23193
Michal J Besser 1, 2, 3 , Orit Itzhaki 1 , Guy Ben-Betzalel 1 , Douglas B Zippel 4, 5 , Dragoslav Zikich 1 , Adva Kubi 1 , Karin Brezinger 1 , Abraham Nissani 1 , Michal Levi 1 , Li-At Zeltzer 1 , Alon Ben-Nun 6 , Nethanel Asher 1 , Avichai Shimoni 7 , Arnon Nagler 7 , Gal Markel 1, 2 , Ronnie Shapira-Frommer 8 , Jacob Schachter 1
Affiliation  

Adoptive cell transfer (ACT) of tumor‐infiltrating lymphocytes (TIL) mediates objective responses in 30% to 50% of patients with metastatic melanoma according to multiple, small phase 2 trials. Here we report the long‐term clinical results, intent‐to‐treat analysis, predictors of response and toxicity profile in a large patient cohort. A total of 179 refractory melanoma patients were enrolled in the ACT trial. TIL were administered in combination with high‐dose bolus interleukin‐2 following preconditioning with cyclophosphamide and fludarabine. Patients were followed‐up for a median of 7.2 years. A total of 107 (60%) of 179 enrolled patients were treated. The main reason for the drop out of the study was clinical deterioration. Of 103 evaluated patients, 29 patients (28%) achieved an objective response (OR), including complete remission (8%) or partial response (20%). Sixteen pateints exhibited stable disease. Predictors of response were performance status, time of TIL in culture and CD8 frequency in the infusion product. The absolute lymphocyte count 1 and 2 weeks after TIL infusion was the most predictive parameter of response. With a medium follow‐up time of 7.2 years, OR patients reached a median overall survival (OS) of 58.45 months and a median progression‐free survival (PFS) of 15.43 months, as compared with nonresponders, with 6.73 months OS and 2.60 months PFS. By 6 years, 50% of OR patients were alive and 43% had no documented progression. TIL ACT can yield durable objective responses, even as salvage therapy in highly advanced metastatic melanoma patients.

中文翻译:

黑色素瘤TIL的单一研究所的全面经验:长期临床结果,毒性反应和反应的预后因素。

根据多项小型2期临床试验,肿瘤浸润性淋巴细胞(TIL)的过继细胞转移(ACT)介导了30%至50%的转移性黑色素瘤患者的客观反应。在这里,我们报告了一个大型患者队列的长期临床结果,意图治疗分析,反应的预测因子和毒性特征。ACT试验总共招募了179名难治性黑色素瘤患者。在用环磷酰胺和氟达拉滨预处理后,将TIL与大剂量推注白介素-2联合使用。对患者进行了平均7.2年的随访。179名入组患者中总共有107名(60%)得到了治疗。退出研究的主要原因是临床恶化。在103位接受评估的患者中,有29位患者(28%)达到了客观反应(OR),包括完全缓解(8%)或部分缓解(20%)。16例患者表现出稳定的疾病。反应的预测指标是性能状态,培养中TIL的时间和输液产品中CD8的频率。TIL输注后1和2周的绝对淋巴细胞计数是反应的最预测参数。中位随访时间为7.2年,OR患者的平均总生存期(OS)为58.45个月,无进展生存期(PFS)的中位数为15.43个月,而无反应者的OS为6.73个月和2.60个月PFS。到6年时,有50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。反应的预测指标是性能状态,培养中TIL的时间和输液产品中CD8的频率。TIL输注后1和2周的绝对淋巴细胞计数是反应的最预测参数。中位随访时间为7.2年,OR患者的平均总生存期(OS)为58.45个月,无进展生存期(PFS)的中位数为15.43个月,而无反应者的OS为6.73个月和2.60个月PFS。到6年时,有50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。反应的预测指标是性能状态,培养中TIL的时间和输液产品中CD8的频率。TIL输注后1和2周的绝对淋巴细胞计数是反应的最预测参数。中位随访时间为7.2年,OR患者的平均总生存期(OS)为58.45个月,无进展生存期(PFS)的中位数为15.43个月,而无反应者的OS为6.73个月和2.60个月PFS。到6年时,有50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。TIL输注后1和2周的绝对淋巴细胞计数是反应的最预测参数。中位随访时间为7.2年,OR患者的平均总生存期(OS)为58.45个月,无进展生存期(PFS)的中位数为15.43个月,而无反应者的OS为6.73个月和2.60个月PFS。到6年时,有50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。TIL输注后1和2周的绝对淋巴细胞计数是反应的最预测参数。中位随访时间为7.2年,OR患者的平均总生存期(OS)为58.45个月,无进展生存期(PFS)的中位数为15.43个月,而无反应者的OS为6.73个月和2.60个月PFS。到6年时,有50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。50%的OR患者还活着,而43%的患者无进展。TIL ACT可以产生持久的客观反应,甚至可以作为高度晚期转移性黑色素瘤患者的挽救疗法。
更新日期:2020-04-06
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