Current Treatment Options in Oncology

, Volume 13, Issue 3, pp 340–353 | Cite as

Adoptive Immunotherapy of Advanced Melanoma

  • Ronnie Shapira-Frommer
  • Jacob Schachter
Skin Cancer (WH Sharfman, Section Editor)

Opinion statement

Adoptive cell therapy (ACT) has emerged as an effective therapy for patients with metastatic melanoma. Since the first introduction of the protocol in 1988 [1], major improvements have been achieved with response rates of 40%–72% among patients who were resistant to previous treatment lines. Both cell product and conditioning regimen are major determinants of treatment efficacy; therefore, developing ACT protocols explore diverse ways to establish autologous intra-tumoral lymphocyte cultures or peripheral effector cells as well as different lymphodepleting regimens. While a proof of feasibility and a proof of concept had been established with previous published results, ACT will need to move beyond single-center experiences, to confirmatory, multi-center studies. If ACT is to move into widespread practice, it will be necessary to develop reproducible high quality cell production methods and accepted lymphodepleting regimen. Two new drugs, ipilimumab (Yervoy, Bristol-Myers Squibb) and vemurafenib (Zelboraf, Roche), were approved in 2011 for the treatment of metastatic melanoma based on positive phase III trials. Both drugs show a clear overall survival benefit, so the timing of when to use ACT will need to be carefully thought out. In contrast to these 2 new, commercially available outpatient treatments, ACT is a personally-specified product and labor-intensive therapy that demands both acquisition of high standard laboratory procedures and close clinical inpatient monitoring during treatment. It is unique among other anti-melanoma treatments, providing the potential for a durable response following a single, self-limited treatment. This perspective drives the efforts to make this protocol accessible for more patients and to explore modifications that may optimize treatment results.

Keywords

Adoptive immunotherapy ACT Metastatic melanoma Selected TIL Young-TIL Chimeric antigen receptor 

Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ronnie Shapira-Frommer
    • 1
  • Jacob Schachter
    • 1
    • 2
  1. 1.Ella Institute for the Treatment and Research of MelanomaSheba Medical CenterRamat-GanIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv University, Ramat AvivTel AvivIsrael

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