{
  "abstract": "Purpose Treatment strategies for patients with advanced melanoma resistant to adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) remain undefined. The efficacy of immune checkpoint inhibitors (ICIs) after TIL has not been previously described.Patients and methods Patients with unresectable melanoma who received ICI therapy both before and after TIL treatment were retrospectively identified at 14 international centers. Safety was evaluated among all patients that received one dose of ICI therapy after TIL. Objective response rates (ORR) were determined based on investigator-assessed Response Evaluation Criteria in Solid Tumors (RECIST) V.1.1 responses based on radiology reports. Kaplan-Meier methodology was used to estimate overall survival (OS) and melanoma-specific survival.Results Among 133 patients assessed for response to ICI therapy after progression on TIL therapy, the ORR was 11% (n=14; 95% CI 5.9% to 17%), including 3 complete responses (2.3%) and 11 partial responses (8.3%). Among patients treated with a programmed death-1 inhibitor prior to TIL (n=121), the ORR was 8.3% (95% CI 4.0% to 15%). At a median follow-up among survivors of 21 months, median OS from post-TIL ICI was 8.8 months (95% CI 6.5 to 12 months). Among 14 patients with response to post-TIL ICI, 13 received an ICI they had not previously received. In the safety cohort (n=138), post-TIL ICI therapy-related toxicity occurred in 31 patients(22%), among which 7 patients (5.1%) experienced recurrence of an adverse event experienced with prior ICI treatment.Conclusion Efficacy with ICI after TIL was limited, with no evidence of synergistic toxicity. As TIL therapy becomes more widely available, these data highlight the need for novel therapies in this setting and support the inclusion of this population in future clinical trials.",
  "authors": [
    {
      "affiliations": [
        "Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA",
        "Department of Medicine, Weill Cornell Medical College, New York, New York, USA"
      ],
      "name": "James William Smithy"
    },
    {
      "affiliations": [
        "Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Allison Betof"
    },
    {
      "affiliations": [
        "Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands"
      ],
      "name": "Sebastian Klobuch"
    },
    {
      "affiliations": [
        "Department of Oncology, National Center for Cancer Immunotherapy, Herlev, Denmark"
      ],
      "name": "Troels Holz Borch"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Hannah L Kalvin"
    },
    {
      "affiliations": [
        "Cancer Center, Yale University, New Haven, Connecticut, USA"
      ],
      "name": "Nitzan Hasson"
    },
    {
      "affiliations": [
        "Sheba Medical Center, Tel Hashomer, Israel"
      ],
      "name": "Shirly Grynberg"
    },
    {
      "affiliations": [
        "The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"
      ],
      "name": "Rodabe Amaria"
    },
    {
      "affiliations": [
        "Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Juliane A Czapla"
    },
    {
      "affiliations": [
        "The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Megan D Schollenberger"
    },
    {
      "affiliations": [
        "Renal, Skin and Cell Therapy, Royal Marsden NHS Foundation Trust, London, UK"
      ],
      "name": "Andrew J S Furness"
    },
    {
      "affiliations": [
        "NCT, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Jessica C Hassel"
    },
    {
      "affiliations": [
        "Medical Faculty Heidelberg, TUD Dresden University of Technology Faculty of Medicine Carl Gustav Carus, Dresden, Germany"
      ],
      "name": "Martin Wermke"
    },
    {
      "affiliations": [
        "National Center for Cancer Immune Therapy, Copenhagen University Hospital of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Sidsel Pedersen"
    },
    {
      "affiliations": [
        "Herlev Hospital National Center for Cancer Immune Therapy, Herlev, Denmark"
      ],
      "name": "Inge Marie Svane"
    },
    {
      "affiliations": [
        "University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida, USA"
      ],
      "name": "Antonio Ocejo"
    },
    {
      "affiliations": [
        "Dana Farber Cancer Institute, Boston, Massachusetts, USA"
      ],
      "name": "Elizabeth Buchbinder"
    },
    {
      "affiliations": [
        "Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Douglas B Johnson"
    },
    {
      "affiliations": [
        "Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Michael Postow"
    },
    {
      "affiliations": [
        "Netherlands Cancer Institute / Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands"
      ],
      "name": "Cristy Los"
    },
    {
      "affiliations": [
        "University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida, USA"
      ],
      "name": "Jose Lutzky"
    },
    {
      "affiliations": [
        "Oncology, Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Evan J Lipson"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA"
      ],
      "name": "Ryan J Sullivan"
    },
    {
      "affiliations": [
        "Medical Oncology, Yale University School of Medicine, New Haven, Connecticut, USA"
      ],
      "name": "Harriet M Kluger"
    },
    {
      "affiliations": [
        "Mem Sloan Kettering Canc Ctr, New York, New York, USA"
      ],
      "name": "Katherine S Panageas"
    },
    {
      "affiliations": [
        "National Center for Cancer Immune Therapy (CCIT-DK), Herlev Hospital Department of Oncology, Herlev, Denmark"
      ],
      "name": "Marco Donia"
    },
    {
      "affiliations": [
        "Medical Oncology, Antoni van Leeuwenhoek Nederlands Kanker Instituut, Amsterdam, The Netherlands"
      ],
      "name": "John B A G Haanen"
    },
    {
      "affiliations": [
        "Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Alexander Noor Shoushtari"
    }
  ],
  "title": "Immune checkpoint inhibitor therapy after tumor-infiltrating lymphocytes in unresectable melanoma",
  "uid": "a0b26187-0f74-5e95-9cf8-6226b5f4b26f"
}