TY - JOUR
T1 - Intrathecal Administration of Tumor-Infiltrating Lymphocytes Is Well Tolerated in a Patient with Leptomeningeal Disease from Metastatic Melanoma
T2 - A Case Report
AU - Glitza, Isabella C.
AU - Haymaker, Cara
AU - Bernatchez, Chantale
AU - Vence, Luis
AU - Rohlfs, Michelle
AU - Richard, Jessie
AU - Lacey, Carol
AU - Mansaray, Rahmatu
AU - Fulbright, Orenthial J.
AU - Ramachandran, Renjith
AU - Toth, Christopher
AU - Wardell, Seth
AU - Patel, Sapna P.
AU - Woodman, Scott E.
AU - Hwu, Wen Jen
AU - Radvanyi, Laszlo G.
AU - Davies, Michael A.
AU - Papadopoulos, Nicholas E.
AU - Hwu, Patrick
N1 - Publisher Copyright:
© 2015 American Association for Cancer Research.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Patients with leptomeningeal disease (LMD) from melanoma have very poor outcomes and few treatment options. We present a case of intrathecal (i.t.) administration of autologous tumor-infiltrating lymphocytes (TIL) in a patient with LMD from metastatic melanoma. The patient developed LMD after previous treatments with surgery, high-dose bolus interleukin-2 (HD IL2), and systemic TIL infusion and experienced radiographic progression after intrathecal IL2 (i.t. IL2) therapy. The patient received weekly treatment with increasing numbers of i.t. TIL followed by twice-weekly i.t. IL2. The patient received three i.t. TIL infusions and did not experience any toxicities beyond those expected with i.t. IL2 therapy. Analysis of cerebrospinal fluid demonstrated increased inflammatory cytokines following the i.t. treatments. Subsequent imaging demonstrated disease stabilization, and neurological deficits also remained stable. The patient expired 5 months after the initiation of i.t. TIL therapy with disease progression in the brain, liver, lung, and peritoneal and retroperitoneal lymph nodes, but without LMD progression. These results demonstrate the safety of i.t. administration of TIL in melanoma patients with LMD and support the feasibility of conducting a prospective clinical trial to determine this therapy's clinical benefit among these patients.
AB - Patients with leptomeningeal disease (LMD) from melanoma have very poor outcomes and few treatment options. We present a case of intrathecal (i.t.) administration of autologous tumor-infiltrating lymphocytes (TIL) in a patient with LMD from metastatic melanoma. The patient developed LMD after previous treatments with surgery, high-dose bolus interleukin-2 (HD IL2), and systemic TIL infusion and experienced radiographic progression after intrathecal IL2 (i.t. IL2) therapy. The patient received weekly treatment with increasing numbers of i.t. TIL followed by twice-weekly i.t. IL2. The patient received three i.t. TIL infusions and did not experience any toxicities beyond those expected with i.t. IL2 therapy. Analysis of cerebrospinal fluid demonstrated increased inflammatory cytokines following the i.t. treatments. Subsequent imaging demonstrated disease stabilization, and neurological deficits also remained stable. The patient expired 5 months after the initiation of i.t. TIL therapy with disease progression in the brain, liver, lung, and peritoneal and retroperitoneal lymph nodes, but without LMD progression. These results demonstrate the safety of i.t. administration of TIL in melanoma patients with LMD and support the feasibility of conducting a prospective clinical trial to determine this therapy's clinical benefit among these patients.
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U2 - 10.1158/2326-6066.CIR-15-0071
DO - 10.1158/2326-6066.CIR-15-0071
M3 - Article
C2 - 26216417
AN - SCOPUS:84957588938
SN - 2326-6066
VL - 3
SP - 1201
EP - 1206
JO - Cancer Immunology Research
JF - Cancer Immunology Research
IS - 11
ER -