TIL therapy: 6 things to know

Adoptive cellular therapy is a form of immunotherapy that uses cells from our immune systems, such as T cells, as a treatment for cancer. The immune cells are usually isolated from a patient, expanded and, in some cases, engineered to enhance their natural abilities to eliminate cancer. This field has grown significantly in recent years with the FDA approval of chimeric antigen receptor (CAR) T cell therapies for certain patients with blood cancers. CAR T cells are engineered to recognize specific targets on cancer cells. Tumor-infiltrating lymphocytes (TILs) are an experimental cell therapy being developed for treating solid tumors. To learn more about TIL therapy and MD Anderson’s research, we spoke with Jason Bock, Ph.D., vice president of Therapeutics Discovery and head of Biologics Development. What is a tumor-infiltrating lymphocyte? Lymphocytes, or white blood cells, are an important part of the immune system that helps the body fight off infections or eliminate diseased cells. Lymphocytes, made up of T cells and B cells, are constantly patrolling the body to identify cells that shouldn’t be present, including cancer. As cancers grow, lymphocytes recognize these cells as abnormal and penetrate into the tumor. These are the tumor-infiltrating lymphocytes, or TILs. Once in the tumor, the TILs begin working to kill cancer cells. Sometimes, they’re prevented from doing that by brakes in the immune system or signals from the tumor that weaken the immune response. Immune checkpoint inhibitors were developed to block some of those brakes and unleash the immune cells to attack cancer. We also can use the TILs themselves, with some improvements, as a form of cell therapy. How can...

Active surveillance versus treatment for prostate cancer: Weighing your options

Prostate cancer treatment options can include surgery, radiation therapy and hormone therapy. But some men are candidates for active surveillance – also known as “watchful waiting.” Prostate cancer patients on active surveillance have routine appointments with their care team to monitor the prostate cancer. By choosing active surveillance, many men are able to avoid some negative side effects of treatment, and to maintain their quality of life. To better understand active surveillance and which men should consider this option, we spoke with Justin Gregg, M.D. Here’s what he shared. Who should choose active surveillance instead of prostate cancer treatment? If you’re diagnosed with prostate cancer, the next step is to determine how likely it is to spread in the future. Using results from a digital rectal exam, a prostate-specific antigen (PSA) test and the Gleason Grading System, your doctor will determine if you have a low risk, intermediate risk or high risk of the cancer spreading. Low-risk prostate cancer patients are typically the best candidates for surveillance since the disease is very unlikely to spread in the future. But some patients may worry the cancer may spread without active treatment. Typically, the cancer is closely monitored, and delayed treatment can be offered (before the cancer has spread) if signs of progression are present. “Studies show that for men with low-risk prostate cancer, surveillance is very safe,” Gregg says. If you have intermediate- or high-risk prostate cancer, surveillance may not be the best option, especially if you are healthy or have a higher risk tumor. In these cases, it may be better to seek treatment to slow disease progression, even if that...

Can mushrooms help during cancer treatment?

In some parts of the world, mushroom extracts are often used by patients for their medicinal benefits. They’re packed with vitamin D, which is essential for the immune system. And their benefits may not stop there. In Japan and China, certain mushrooms are routinely used to complement cancer treatments. “These mushrooms have been around for hundreds of years,” says Santhosshi Narayanan, M.D., a physician in MD Anderson’s Integrative Medicine Center. “They're often used in Asian countries, not only in cancer care, but also to treat infections and other diseases.” There have been more than 2,000 studies focused on mushrooms and cancer in the last 10 years, and Narayanan is conducting a review of the findings. Here’s what she wants cancer patients to know about medicinal mushrooms. Medicinal mushrooms are not ordinary mushrooms. There are hundreds of different kinds of mushrooms. Those most frequently studied in cancer research are not usually sold in grocery stores. The most common medicinal mushrooms are: mitake reishi turkey tail shiitake Shiitake mushrooms are the only one of these that can easily be bought whole in grocery stores. The rest are often found in powdered forms in health food stores. Sometimes the active ingredient is removed and sold as a supplement. Mushrooms can strengthen the immune system Some studies show mushrooms boost parts of the immune system that are linked to cancer. “Certain mushrooms stimulate the compounds that are responsible for tumors suppression,” says Narayanan. “And there are also mushrooms that decrease inflammatory compounds, which is helpful for cancer patients.” Most studies show a positive effect on the immune system, but more research is needed....

Metastatic testicular cancer survivor: A positive attitude was everything for me

In 2001, I was 31 years old, working full time and engaged to be married. I had no symptoms or abnormalities. But one day, I noticed a knot on my left testicle.  After going to see my doctor in Monroe, Louisiana, I was diagnosed with a rare form of testicular cancer. I underwent surgery to have the testicle removed. I wanted the results of my biopsy sent to MD Anderson. A week after surgery, I received a call that the cancer had spread to my bones, including my pelvis and left lung. I was told that my cancer was aggressive and that my walking would be impaired. This was devastating to hear. My fiancée and I were excited to start our life together. But she assured me that whatever happened, we would face it together. Facing the unknown of a metastatic testicular cancer diagnosis It’s been 20 years, but I still remember everything about my first appointment at MD Anderson. It was on Sept. 11, 2001. The day terrorist attacks fell upon the World Trade Center. Before meeting with my doctors, my then-fiancée and I stopped to grab coffee, and that’s when we saw the devastation on everyone’s faces. We joined the crowd around a TV screen and learned of the news.  I met with care team, including my orthopedic surgeon, Dr. Patrick Lin. My treatment plan was an aggressive regimen of five types of chemotherapy, along with multiple surgeries to remove the tumors. Although my fiancée and I were scared, she vowed to stand by me through it all. I was ready to do whatever was needed to...

Mantle cell lymphoma survivor creates COVID-19-killing computer game

Musician Jeff Blankenship was playing guitar in the orchestra pit during a local theatre’s live production of “American Idiot” when he began experiencing severe stomach pains. “I had to leave in the middle of the show,” he says. “That’s how bad it was.” The pain, he soon learned, was caused by mantle cell lymphoma, a rare type of non-Hodgkin lymphoma. Jeff had been diagnosed with and treated for the disease eight years earlier at MD Anderson, where chemotherapy sent the cancer into remission. But now it was back. This time, his oncologist prescribed a newer treatment. “Mantle cell lymphoma is known to relapse and become resistant to chemotherapy,” says Felipe Samaniego, M.D., Jeff’s oncologist. “Clinical trials in recent years have led to newer, non-chemotherapy treatments.” A second remission, thanks to targeted therapy Jeff benefited from one of those new therapies after his relapse. He began taking ibrutinib, a type of targeted therapy drug known as a kinase inhibitor. Kinases are proteins that signal cancer cells to divide and multiply. Ibrutinib blocks these signals, so the cancer cells never get the message to expand their numbers. The treatment put Jeff into remission. It’s been seven years, and he continues to show no signs of cancer. Today, he’s taking a newer kinase inhibitor, acalabrutinib, which causes fewer side effects than ibrutinib in some patients. “I take two pills a day, and I feel great,” he says. “When my medical team asks me to rate my quality of life, I say, ‘Ten, with a capital ‘T.’” Getting revenge against COVID-19 Last year, Jeff retired from his “real” job as a program manager...