The Role of Tumor Infiltrating Lymphocyte (TIL) Therapy in NSCLC - Episode 5

Clinical Trials of TIL Therapy in NSCLC

A key opinion leader in the management of lung cancer offers insight into ongoing clinical trials of tumor-infiltrating lymphocyte (TIL) therapy in non–small cell lung cancer.

Adam J. Schoenfeld, MD: There are a number of clinical trials using TIL [tumor-infiltrating lymphocyte] therapy. We’ve learned a great deal from these trials, and we’ll continue to learn a great deal from them in the future. Some of the clinical trials that are enrolling include IOV-COM-202 and IOV-LUN-202. IOV-COM-202 is a basket study that involves patients with melanoma, head and neck cancer, and lung cancer. It looks at TIL therapy both combined with immunotherapy and in the setting after immunotherapy. That study is ongoing. I’m very excited to see some of the preliminary data in melanoma, lung cancer, as well as head and neck cancer.

IOV-LUN-202 is solely focused on lung cancer in patients who have progressed on first-line treatment with chemotherapy and immunotherapy. That trial is now accruing at multiple sites as well. We’ll learn a lot about both the effectiveness and safety of TIL therapy in lung cancer from that study. There are also other ongoing studies with TIL therapy. There are new ones each day. One that comes to mind is the CHIRON study. That uses a different approach by using specifically targeted TILs that they think will be effective against the tumor. They isolate and select the TIL populations that they want to use rather than using the entire TIL product.

With all clinical trials, we have to be very careful about meeting all eligibility criteria to make sure we investigate new therapies like TIL therapy in a safe manner. The eligibility criteria for many of these trials include making sure patients have adequate pulmonary function, so they undergo pulmonary function tests; making sure that their heart is functioning properly; and making sure there are no active or other acute illnesses that would make receiving treatments like TIL therapy unsafe. Those are all things we factor in while deciding whether TIL therapy might be a potential option for patients. In addition, there’s shared decision-making with the patient and the provider and going through what the therapy entails: tumor resection as well as treatment with the therapy. It can be appealing to a lot of people because it’s a one-time therapy, but it’s also a significant investment of time up front. We talk about all those things when we discuss these types of clinical trials.

These trials could have major implications for practice, depending upon the results. The IOV-LUN-202 study looks at the use of TIL therapy in the second-line setting, after patients have progressed on chemotherapy and immunotherapy. That’s a perfect setting to explore the use of TIL therapy and whether it might be a good option for patients who have progressed on first-line treatment, where options are generally limited.

Transcript edited for clarity.