Clinical Scorecard: Adoptive TIL Therapy for a Patient with Metastatic Melanoma and Well-Controlled HIV: A Case Study

At a Glance

Key Highlights

• First known case of TIL therapy in a patient with well-controlled HIV.
• Patient experienced a partial response after TIL therapy with manageable toxicity.
• TIL therapy included lifileucel infusion and high-dose IL-2.
• CD4 counts fluctuated but virologic suppression was restored by day 100.
• Demonstrates the need for inclusion of HIV patients in cellular therapy trials.

Guideline-Based Recommendations

Diagnosis

• Consider TIL therapy for patients with metastatic melanoma refractory to immune checkpoint inhibitors.

Management

• Administer TIL therapy with lymphodepleting chemotherapy and high-dose IL-2.

Monitoring & Follow-up

• Monitor CD4 counts and HIV viral load throughout treatment.

Risks

• Potential for cytokine release syndrome and IL-2 associated hypotension.

Patient & Prescribing Data

37-year-old man with well-controlled HIV and metastatic melanoma.

TIL therapy can be safely administered to patients with well-controlled HIV.

Clinical Best Practices

• Conduct multidisciplinary reviews before initiating TIL therapy.
• Ensure virologic suppression of HIV prior to treatment.
• Monitor for treatment-related toxicities and manage accordingly.

Related Resources & Content

• HIV/AIDS Cancer Match Study
• FDA Approval of Lifileucel
• Emerging Evidence on ICIs in HIV Patients