TIL Trial for Brain Mets – FYI and Q&A

I’ve noticed that there is not a ton of information on these boards from folks who have been treated with TIL. For those who may want to know what the experience is like, I’m going to share mine.

I am participating in the following trial at Memorial Sloan Kettering in NYC: Pilot Trial of Autologous Tumor Infiltrating Lymphocytes (LN-144) for Patients With Asymptomatic Melanoma Brain Metastases (NCT05640193). Although the trial is limited to those with asymptomatic brain metastases, the treatment is almost identical to the Lifileucel TIL therapy from Iovance that has been approved for expanded access by the FDA and which has previously excluded those with active CNS involvement.

Background
I was diagnosed Stage 3a in December 2019. I got adjuvant nivo for a year, and remained clear until January 2021, when I progressed in my lung and groin. I did 4 rounds of pembro/low-dose ipi and did not respond. A month later I was thrown off the expanded access TIL trial because of brain mets, which I quickly treated with SRS. After the radiation, I noticed immune side effects (vitiligo, arthritis), and the ground lymph node shrinked. A scan a month later showed almost complete resolution of the existing tumors.

Unfortunately, my three month scans showed one new brain met and several other new subcutaneous lesions. My oncologist at Hopkins (Evan Lipson) immediately referred me to MSK, where this trial was pending approval. It is hard to consider myself “lucky”, but I definitely feel fortunate to have gotten into this when I did, and to have my fact pattern (one, small low-risk untreated brain met). Based on recent data, the docs have quoted a 30% response rate, with a decent chance to “hit a homerun”.

My experience so far
I’m currently sitting in my hospital bed, having just been checked into MSK. I had tumors harvested from subcutaneous lesions in my thighs on December 13th from which Iovance is harvesting and growing my TIL. My initial Baseline testing was November 28th, and my second Baseline testing was January 8th. My wife has relocated from DC and is staying nearby, as I’m required to have a caregiver close at all times.

Tomorrow I’ll get my first dose of the preparatory chemo, which I’ll receive for 7 days total. On day 8 I’ll get the TIL cells. On days 9-11 I’ll receive up to 6 doses of IL-2. I’m required to remain in the hospital for a minimum of three weeks, after which I’ll be moved to MSK apartments a few blocks away where I’ll stay for another 16 days or so. I’m very fortunate to have family to help with my two kids and good health insurance.

I’ll continue to post about my experience every now and then, but also will check in to see if anyone has questions.

Jeff