Randomized trial of adoptive transfer of melanoma tumor-infiltrating lymphocytes as adjuvant therapy for stage III melanoma

• Published in: Cancer Immunology, Immunotherapy Vol. 51; no. 10; pp. 539 - 546
• Main Authors: DRENO, Brigitte, NGUYEN, Jean-Michel, JOTEREAU, Francine, KHAMMARI, Amir, PANDOLFINO, Marie Christine, TESSIER, Marie Hélène, BERCEGEAY, Sylvain, CASSIDANIUS, Alain, LEMARRE, Philippe, BILLAUDEL, Sylviane, LABARRIERE, Nathalie
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.11.2002; Springer Nature B.V; Springer Verlag; Springer-Verlag
• Subjects: Adjuvants, Immunologic - therapeutic use; Adolescent; Adult; Aged; Antineoplastic agents; Biological and medical sciences; Cancer; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Immunology; Immunotherapy; Immunotherapy, Adoptive; Interleukin-2 - therapeutic use; Life Sciences; Lymphatic Metastasis; Lymphocytes, Tumor-Infiltrating - transplantation; Male; Medical sciences; Melanoma - diagnosis; Melanoma - mortality; Melanoma - therapy; Middle Aged; Original; Pharmacology. Drug treatments; Survival Rate; T-Lymphocytes - immunology; Antineoplastic agent; Human; Postoperative; Drug combination; Lymph node; Cytokine; Adjuvant treatment; Tumor infiltrating lymphocyte; Autologous system; Malignant tumor; Metastasis; Adoptive transfer; Randomization; Treatment; Interleukin 2; Follow up study; Surgery; Immunotherapy; T-Lymphocyte; Malignant melanoma; Adoptive immunity; Clinical trial; Advanced stage
• ISSN: 0340-7004; 1432-0851
• DOI: 10.1007/s00262-002-0315-1

The aim of this study was to demonstrate the interest of using tumor-infiltrating lymphocytes (TIL) as adjuvant therapy for stage III (regional lymph nodes) melanoma. After lymph node excision, patients without any detectable metastases were randomly assigned to receive either TIL plus interleukin-2 (IL-2) for 2 months, or IL-2 only. The primary endpoint was determination of the duration of the relapse-free interval. Eighty-eight patients determined as eligible for treatment were enrolled in the study. After a median follow-up of 46.9 months, for the study population the analysis did not show a significant extension of the relapse-free interval or overall survival. However, a significant interaction ( P<0.001) was found between the treatment and the number of invaded lymph nodes. In the group with only one invaded lymph node, the estimated relapse rate was significantly lower ( P(adjusted)=0.0285) and the overall survival was increased ( P(adjusted)=0.039) in the TIL+IL-2 arm compared with the IL-2 only arm. No differences between the two arms, either as regards the duration of disease-free survival or overall survival, were noted in the group with more than one invaded lymph node whatever the number of invaded lymph nodes. Treatment was compatible with normal daily activity. This study demonstrates for the first time that the efficiency of TIL in stage III melanoma (AJCC) is directly related to the number of invaded lymph nodes, indicating that tumor burden might be a crucial factor in the efficacy and/or in vitro expansion of T cells specific for autologous tumor antigen, a finding which could be of value in future vaccine development for the treatment of melanoma.