Metastasectomy for Tumor-Infiltrating Lymphocytes: An Emerging Operative Indication in Surgical Oncology - PubMed (original) (raw)

Metastasectomy for Tumor-Infiltrating Lymphocytes: An Emerging Operative Indication in Surgical Oncology

Joseph G Crompton et al. Ann Surg Oncol. 2018 Feb.

Erratum in

Abstract

Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs) is an emerging immunotherapy for metastatic cancer. Surgeons play a central role in ACT treatments by performing resection of tumors from which TILs are isolated. It is important that surgeons have familiarity with this emerging treatment method because it is increasingly performed for an expanding variety of solid tumors at institutions around the world. This report offers a brief introduction to ACT for cancer, highlights historical milestones in its development, and provides patient selection and operative considerations for surgeons called upon to perform metastasectomy for the purpose of isolating TILs.

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Figures

Fig. 1

Fig. 1

Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs). A generalized model of ACT using TILs is summarized with the following critical steps: (1) performance of metastasectomy to isolate TILs, (2) expansion of TILs in the laboratory with interleukin-2, (3) reinfusion of TILs after administration of lympho-depleting chemotherapy regimen (not shown), (4) TILs entering circulation and extravasating to tumor sites to eliminate malignant cells

Fig. 2

Fig. 2

Regression of metastatic uveal melanoma after adoptive cell transfer. Example of rapid clinical response in a 52-year-old woman with metastatic uveal melanoma after adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs). Pre-therapy and sequential post-therapy positron emission tomography (PET) scan images are shown, which demonstrate the partial regression by Response Evaluation Criteria in Solid Tumors (RECIST) of multiple peritoneal (Per), omental (Om), liver (Liv), and bone (Bo) metastases. *Normal physiologic 2-deoxy-2-[fluorine-18]fluoro-

d

-glucose (18F-FDG) uptake in the heart

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