Tumor-Infiltrating Lymphocyte (TIL) Therapy

A Groundbreaking Cancer Treatment for Advanced Melanoma

Tumor-infiltrating lymphocyte (TIL) therapy is an innovative new cancer treatment for patients with advanced melanoma. TIL therapy is a type of cellular immunotherapy that can help your immune system kill cancer cells when other treatments have failed.

Tumor-infiltrating lymphocytes are your body’s own immune cells that can “recognize” tumors. During this treatment, we remove some TILs from your tumor so more of these cancer-fighting cells can be grown in a laboratory. Then we put large numbers of “activated” TILs back into your body so they can destroy tumors.

The University of Chicago Medicine is among the first hospitals in the nation to offer TIL therapy.

Video Transcript

TIL therapy amplifies your body's immune cells to fight cancer and can help patients who didn't respond to other treatments. What are TILs? Tumor Infiltrating Lymphocytes, or TILs, are a type of T-cell, your body's own immune cells, that can recognize tumors. For TIL therapy, we create billions more activated TILs. These TILs then seek out and destroy the tumors.

TIL therapy is an intense but short treatment that includes five steps. First, there is a surgical procedure to remove a small tumor sample that contains TILs. That tumor sample is sent to a lab where the TILs are removed and reproduced to create billions of tumor fighting cells. You'll then go through conditioning chemotherapy to reduce the existing T-cells and give the new TILs room to grow and fight the cancer. This is when the new TILs are introduced to the body.

Later that same day IL-2, an immune stimulating protein, is given to help activate the TILs and stimulate them to multiply. The entire process takes a few weeks. Most people recover and return to their normal routines without any long term side effects. Over time, TILs may work to shrink the tumor. Because TIL therapy uses your own T-cells, it will stay in your body. You'll only need one treatment.

Our physicians and scientists at the University of Chicago Medicine, David and Etta Jones Center for cellular therapy, are the most experienced cellular therapy team in the region. The trials and research they lead are at the forefront of cellular therapy, revolutionizing treatment for cancer and blood diseases. To learn more and to schedule an appointment, visit uchicagomedicine.org/tils.

Frequently Asked Questions About TIL Therapy

Here are answers to commonly asked questions about the treatment.

How does tumor-infiltrating lymphocyte therapy work?

TIL (rhymes with “will”) therapy grows and activates some of your body’s own T cells (immune cells) to fight cancer. Specifically, it uses T cells known as tumor-infiltrating lymphocytes (TILs) that have moved from your blood into your tumor.

Often, your body’s small population of TILs cannot destroy a tumor. But when TIL therapy introduces billions of new TILs into your body, they can sometimes destroy that tumor.

What are the benefits of TIL therapy?

Although TIL therapy is not effective for all patients with advanced melanoma, those who do respond to TIL therapy may have a partial or complete remission. For some, TIL therapy can be a breakthrough treatment that helps them remain tumor-free for years after treatment.

TIL therapy is also personalized to you. Unlike many cancer treatments, TIL therapy multiplies your body’s own immune cells to fight cancer. These immune cells stay in your body and can continue to fight tumors. If you have TIL therapy, you only need one treatment.

Who is a candidate for TIL therapy?

What types of cancer is TIL therapy used for?

How often can I get TIL therapy?

What happens before TIL therapy?

TIL therapy involves several steps before you can receive your new TILs:

You will meet with your medical oncologist, who will explain the risks and benefits of TIL therapy. Together, you will decide if this treatment is right for you.
If you are a candidate for TIL therapy, your surgeon will remove a portion of your tumor. You may be able to go home the same day.
Your team will send your tumor sample to a biotech company that makes TIL therapy. The company will use special techniques to remove your TILs from your tumor and make more TILs. This takes about three weeks.
Once we receive your frozen TILs back from the company, we will give you conditioning chemotherapy. This reduces your old T cells, giving the new TILs room to grow. Our team will give you three treatments of two chemotherapy drugs (fludarabine and cyclophosphamide) over the course of a week. We may also give you medication to prevent infections. After chemo, you can return home to rest.

What happens during TIL therapy?

After you’ve completed your conditioning chemotherapy, you are ready for your TIL therapy. You will receive your treatment in a specialized cellular therapy unit in the Center for Care and Discovery that is staffed by physicians and nurses who are experts in cellular therapy care. Here’s what you can expect:

We will place a temporary central venous catheter (central line) to deliver the TILs back into your body.
Your cancer team will give you the thawed TILs as an infusion through your central line. This process usually takes a few hours.
Later that day, we will give you an immunotherapy drug called interleukin-2 (IL-2) that stimulates your TILs to multiply.
We will give you more IL-2 over the next five days while you are in the hospital. You may feel feverish and weak, and we will closely monitor you for any complications.
After five days in the hospital, you can return home.

What happens after TIL therapy?

After TIL therapy:

You will return to the clinic to see your medical oncologist once or twice a week for the first month. During these follow-up visits, we will monitor your blood counts and check for complications.
If your blood counts are low, we will give you a transfusion.
Three months after your TIL therapy, we will do an imaging scan, such as a computed tomography (CT) or positron emission tomography (PET) scan, to see if your tumors are shrinking.
We may ask you to return for scans every three months to monitor your tumors.

What are the risks and side effects of TIL therapy?

TIL therapy is an intense treatment with some short-term risks from conditioning chemotherapy. These include:

Low blood counts that may require blood transfusions
Infections
Fatigue
Nausea and vomiting
Diarrhea
Hair loss
Mouth sores

IL-2, which is used to stimulate your TILs, can also cause temporary side effects, including:

Fever
Rash
Low blood pressure
Abnormal heart rate
Nausea
Diarrhea
Fatigue
Confusion
Leg swelling

Your entire team — including your oncologist, nurse practitioner, physician assistant and other clinicians — will closely monitor you for complications throughout your treatment. Because our cancer team has many years of experience treating patients with cell therapies like TIL therapy, we have strategies to minimize these side effects.

Is TIL therapy painful?

Do I need to take any precautions while I have TIL therapy?

How long will TIL therapy take?

How does TIL therapy differ from CAR T-cell therapy?

CAR T-cell therapy is another innovative cell therapy offered at UChicago Medicine. Like TIL therapy, CAR (chimeric antigen receptor) T-cell therapy uses your body’s immune cells to fight cancer. However, CAR T-cell therapy uses T cells from your blood, not from your tumor. Then, new T cells re-engineered in a laboratory to seek out a specific “target” on a tumor.

Unlike CAR T-cell therapy, TIL therapy uses T cells that have already invaded your tumor. Different populations of TILs may work in different ways against the tumor, rather than focusing on a single target like with CAR T-cell therapy. TIL therapy can harness multiple populations of TILs that already “recognize” your cancer, grow billions more in a lab and then send them back into your body in an “activated” state to shrink your tumor.

A Leader in TIL Therapy

Medical oncologists and scientists at the David and Etta Jonas Center for Cellular Therapy at UChicago Medicine are nationally recognized experts in cell therapy like TIL therapy for cancer. Our team is currently studying TIL therapy for cervical cancer. We plan to study TILs for even more tumor types in the future.

Through this life-changing research, our physicians-researchers aim to make TIL therapy as effective as possible for as many patients who may benefit.

Why Should I Choose UChicago Medicine for Cancer Care?

UChicago Medicine is home to a National Cancer Institute-designated Comprehensive Cancer Center, where patients have access to TIL therapy. Our center also offers many innovative treatments and clinical trials that are not widely available at most hospitals.

We also provide other life-extending treatments to people with advanced melanoma and other cancers through our Limited Metastatic Cancer Program.

TIL Therapy Care Team

Michael R. Bishop, MD

Hematology and Oncology (Cancer)

Thomas F. Gajewski, MD, PhD

Hematology and Oncology (Cancer)

J. Michael Millis, MD

General Surgery

Daniel Olson, MD

Hematology and Oncology (Cancer)

‘A one-and-done treatment’: UChicago Medicine among the first in the U.S. to use TIL therapy for advanced skin cancer

University of Chicago Medicine patient Alla Pinzour was the first person in Illinois, and one of the first people in the country, to receive commercially approved tumor-infiltrating lymphocyte (TIL) therapy for treatment of her advanced melanoma.

Read Pinzour's story

Alla Pinzour had TIL therapy for melanoma at UChicago Medicine

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