TIL (Tumor-Infiltrating Lymphocyte) Therapy is a type of immunotherapy that uses a patient’s own T cells, harvested directly from their tumor, to fight cancer. These T cells, which naturally recognize and attack cancer cells, are expanded and activated in a laboratory and then infused back into the patient to target and kill tumor cells.

TIL therapy has shown the most success in treating advanced melanoma. However, it is being researched as a treatment for other cancers, such as cervical cancer, ovarian cancer, lung cancer, colorectal cancer, and mesothelioma. Clinical trials are ongoing to expand its use to more cancer types.

TILs are T cells already present in the tumor that naturally recognize cancer cells. During TIL therapy, these cells are collected from a patient’s tumor, expanded to billions in number in a lab, and activated to boost their effectiveness. Once ready, they are infused back into the patient to attack the cancer cells. This process enhances the body's natural immune response against the tumor.

TIL therapy uses the body’s natural T cells from the tumor, while CAR T therapy genetically modifies T cells from the blood to attack cancer cells. TIL therapy is more personalized and does not involve genetic modification, whereas CAR T therapy involves creating synthetic receptors to target cancer.

• Personalized Treatment: TILs are specific to the patient’s tumor, making the treatment highly personalized.

• Potential for Long-Term Remission: Some patients experience durable responses, meaning their cancer may stay under control for a long time.

• Treatment for Advanced Cancers: Especially for cancers like melanoma, TIL therapy has provided hope when other treatments have failed.

TIL therapy can cause side effects, such as:

• Cytokine Release Syndrome (CRS): A severe immune reaction due to T cell activation.

• Fatigue, fever, or infection due to lymphodepleting chemotherapy.

• Immune-related adverse effects, such as inflammation in the body. Your care team will monitor you closely to manage these risks.

The TIL therapy process generally includes: Tumor Removal: A portion of the tumor is surgically removed to harvest TILs. TIL Expansion: The TILs are grown and activated in a lab over 2-3 weeks. Chemotherapy Prep: Patients receive lymphodepleting chemotherapy to prepare their body for the infusion. TIL Infusion: The activated TILs are infused back into the patient. Supportive Care: IL-2 (Interleukin-2) is often given to help the TILs function effectively. Recovery: Patients are monitored closely for side effects and response to treatment.

TIL therapy requires several weeks. The lab process to grow and activate the TILs takes around 2–3 weeks. Afterward, patients undergo chemotherapy, TIL infusion, and recovery, which may require additional time. Overall, the entire treatment process can span 4-6 weeks, depending on individual patient needs and response to therapy.

Yes, the FDA has recently approved Lifileucel (brand name: Amtagvi), a TIL therapy specifically for advanced melanoma. However, TIL therapy for other types of cancer is still under clinical investigation and has not yet received FDA approval.

TIL therapy is offered at specialized cancer centers and is also available through clinical trials for certain cancer types. Speak with your oncologist to explore if this treatment is right for you or to find ongoing trials.

TIL therapy can be expensive due to its highly specialized and personalized nature. Costs may include tumor extraction, lab processing, and hospital care. Many patients access TIL therapy through clinical trials, which may cover some or all expenses.

TIL therapy differs from traditional treatments like chemotherapy and radiation by leveraging the immune system to fight cancer. Unlike chemotherapy and radiation, which target both cancerous and healthy cells, TIL therapy is highly specific, using the patient’s own immune cells to attack the tumor. This specificity can result in fewer long-term side effects. However, TIL therapy is not yet widely available and is typically reserved for cancers that have not responded to standard treatments.

Yes, researchers are exploring combining TIL therapy with other immunotherapies, such as checkpoint inhibitors (like PD-1 or CTLA-4 inhibitors), to enhance its effectiveness. Combining these therapies can help TILs overcome the immune-suppressive environment of the tumor, increasing their ability to kill cancer cells. While promising, these combinations are still under investigation in clinical trials and may not yet be standard practice. Always consult with your oncologist to understand the best treatment options for your specific case.

Some challenges of TIL therapy include:

• Tumor Availability: It requires a resectable tumor for TIL harvest, which may not always be possible.

• Time-Intensive Process: The lab expansion of TILs takes weeks, which may not be feasible for patients with aggressive cancers.

• Access to Treatment: TIL therapy is currently available at limited cancer centers or through clinical trials.

• Side Effects: While effective, the preparative chemotherapy and IL-2 infusion can cause significant side effects, such as fatigue, infection risk, or severe immune responses.

Despite these challenges, TIL therapy remains a promising option for patients with advanced or treatment-resistant cancers.