Case Report of Advanced Melanoma Disappearing After T Cell Therapy

One patient with advanced melanoma and metastases in the lymph nodes and lung made a dramatic recovery and was still in complete remission 2 years later, after an experimental treatment using his own T cells. The case report was published in the June 19 issue of the New England Journal of Medicine.

The only treatment was an infusion of CD4+T cells, which had been removed from the patient earlier and vastly expanded in the laboratory. The 52-year-old man had recurrent melanoma, which had not responded to high-dose interferon-alfa, high-dose interleukin-2, or excision. He had developed metastases in the groin lymph nodes and in 1 lung. Two months after the T cell infusion, the tumors were no longer visible on positron emission tomography (PET) or computed tomography (CT) scans. He was still disease-free 2 years later, at his most recent follow-up.

Usually such a patient, with progressive disease refractive to therapy, would be expected to survive for less than a year.  Eight other patients have been treated with the same method, but it is too early to report on them yet.

The process of expanding the T cells is complex and time consuming (>4 months), so only a fraction of patients would be eligible.

The success of this novel strategy and the clear immune mechanisms of action point to feasible new directions for adoptive cellular therapy of cancer.

Process is Complex and Expensive

The process by which the T cells were expanded is complex and expensive. T cells are custom-made for each patient.

CD4+ T cells make their own growth factors and attack tumor cells themselves, but they also recruit other effector cells, including CD8 T cells, to mount an immune response, broadening of the immune response to other tumor antigens.

N Engl J Med. 2008;358:2698-2703 and 2664-2665.


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