L'IMMUNOTERAPIA ADOTTIVA NEL TRATTAMENTO DEL CARCINOMA POLMONARE NON A PICCOLE CELLULE IN FASE AVANZATA

Adoptive immunotherapy (AI) with TIL (Tumor-infiltrating lymphocytes) and Interleukin-2 (rIL-2) has been successfully used in the treatment of metastatic melanoma and other solid tumors. In vitro studies demonstrated that TIL, cells obtained from non-small cell lung cancers (NSCLC) are able to lyse autologous cancer cells. The present study was carried out to evaluate the feasibility, efficacy and toxicity of AI in the treatment of unresectable NSCLC. In 5 patients with supraclavicular node metastases or tumors that proved to be unremovable at thoracotomy, TIL cells were obtained from nodal or pulmonary biopsies, in vitro expanded and intravenously reinfused after a 4/5 week period. Interleukin-2 was administered subcutaneously, for 3 months starting from the infusion day. Numbers of TIL, ranging from 10 to 19 x 10⁹ cells and showing a significant cytolytic activity against the autologous tumor, were injected. Major toxic effects were never observed. No significant reduction of the tumor mass diameters was documented following AI, and treated patients died after 6/15 months from biopsy. The present experience, though demonstrating the feasibility and tollerability of AI in patients with unresectable NSCLC, evidences its lack of efficacy.