Vanderbilt-Ingram Cancer Center has treated its first patient in a newly launched therapy program that magnifies the power of a person’s natural defense system against tumors. 

Tumor-infiltrating lymphocyte (TIL) therapy involves isolating the white blood cells from a tumor after it is surgically removed, expanding the magnitude of those cells in a laboratory, and then infusing them back into the patient to elicit a more powerful counterattack. The highly personalized treatment is currently approved for patients with advanced stages of melanoma whose tumors have grown despite immunotherapies and/or targeted therapies. 

The patient who received the therapy in late January has melanoma that has spread to the bone, abdomen, liver and brain despite multiple lines of other treatments. A team of clinicians harvested white blood cells from a tumor in the patient’s liver, then shipped them to a laboratory where they were supercharged before being infused back into the patient, who is being monitored. Additional patients are scheduled to receive TIL therapy. Vanderbilt-Ingram launched the program as a standard of care service line after previously treating patients with TIL therapy in clinical trials. 

“The mission of Vanderbilt Health is to get treatments that are cutting-edge to the patients who need them the most,” said Olalekan Oluwole, MBBS, MPH, associate professor of Medicine and a hematologist who specializes in cellular therapies. “Some of these patients have exhausted prior standard of care options.” 

About a third of patients who receive TIL therapy respond to it. 

“On the surface that doesn’t sound like a lot, but the great thing about TIL therapy is when it does work, it can lead to long-term durable response. It can keep right on working for years or even indefinitely,” said Douglas Johnson, MD, MSCI, professor of Medicine and clinical director of melanoma, who holds the Susan and Luke Simons Directorship. 

Establishing the TIL program required assembling a team of multidisciplinary clinicians trained to handle the care needs of patients while simultaneously handling the logistics of getting their white blood cells shipped to a laboratory. 

Sarah Moseley, BSN, RN, the coordinator for immune effector cell and gene therapy patient care, led that process. She described the process of navigating care for patients who receive TIL therapy, which involves surgeons, oncologists, hematologists and specialized nurses. 

“I am with the patient from start to finish,” Moseley said. “Once a patient is identified by Dr. Johnson, he immediately gets me involved. The patient has to be approved by our cell therapy team and our surgery team as well as Dr. Johnson to make sure that they’re a good candidate. The next step is the insurance process, which is probably the hardest part because this is a new and expensive therapy. It is a detailed process involving our financial team, our managed care team and us nurses as well.” 

The nurses serving as patient care coordinators also include Leslie Mader, BSN, RN, OCN, and Brittney Baer, BSN, RN.  

“I or one of my nurse colleagues go to the surgery, and we transport the specimen from the operating room to the processing lab, where a courier picks it up,” Moseley said. “Without the specimen, there is no product for the therapy. It has to be done quickly, and it must be done right every time. Then we get the patients set up for cell infusion after about five to six weeks.” 

The launch of the TIL program is the latest achievement in cellular therapies for Vanderbilt-Ingram, which is an international leader in the field. The cancer center offered clinical trials for therapies, which became standards of care, most notably CAR-T, which is shorthand for chimeric antigen receptor T-cell therapy. Vanderbilt-Ingram established an outpatient protocol for patients to receive CAR-T and treats more patients with this immunotherapy than any other provider in the state. It is offering clinical trials to expand the treatment for additional types of cancer and to make it more easily accessible to patients. 

Clinicians with the cellular therapy team built the TIL program on the foundation of the CAR-T program. However, there are major differences between these treatment modalities. With CAR-T, immune cells are reengineered to attack cancer from the T cells in a patient’s blood. With TIL therapy, white blood cells are taken from a patient’s tumor and are then multiplied so they can stage a better counterattack against cancer. 

Currently, CAR-T is approved by the Food and Drug Administration only for certain blood cancers. TIL therapy is approved only for advanced melanoma when patients have not responded to other treatments. However, clinical trials are underway to expand the therapies for other types of cancers.  

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Four researchers at Vanderbilt-Ingram Cancer Center have assumed new leadership roles. 

Shared resources at Vanderbilt-Ingram are designed to support and enhance cancer-relevant research and scientific interaction by providing access to cutting-edge technologies and services, as well as scientific expertise.

Scott Hiebert, PhD, emeritus professor of Biochemistry and the Hortense B. Ingram Chair in Cancer Researchat Vanderbilt University, led these shared resources in the Cancer Center from 2010 to 2025. With his retirement from Vanderbilt University, Ben Ho Park, MD, PhD, director of Vanderbilt-Ingram, has appointed William Tansey, PhD, Ingram Professor of Cancer Research and professor of Cell and Developmental Biology, as the next associate director for Shared Resources for Vanderbilt-Ingram.  

As associate director for Shared Resources, Tansey will oversee 10 resources, including animal and human imaging, bioanalytics and proteomics, chemical synthesis and high-throughput analytics, cell imaging, data science, flow cytometry, genome editing, genomic sciences, survey and biospecimen, and translational pathology. In addition to his leadership roles at Vanderbilt-Ingram, Tansey has an active research lab that focuses on transcriptional dysregulation in cancer cells. 

“Shared resources provide Vanderbilt-Ingram Cancer Center investigators access to technologies, expertise, and a collaborative infrastructure that would be impractical to have in their own laboratories. Our shared resources are world-class in every respect, and each of them are backed by experienced teams of professionals dedicated to advancing and accelerating cancer discovery. I am honored and excited to oversee this vital and vibrant part of the Vanderbilt-Ingram Cancer Center mission,” said Tansey, who also serves as co-leader of the Genome Maintenance Research Program at Vanderbilt-Ingram. 

Translational Research, which is an essential component of Vanderbilt-Ingram and how findings in the lab are “translated” to clinical practice, was previously led by Park. With an ever-increasing number of opportunities to perform translational cancer research at Vanderbilt-Ingram, Douglas Johnson, MD, MSCI, professor of Medicine and the holder of the Susan and Luke Simons Directorship, has been named the next associate director for Translational Research.  

Johnson will oversee the implementation of emerging treatments and therapy advancements, such as cellular therapies, immunotherapies and targeted therapies. Johnson, who is clinical director of melanoma at Vanderbilt-Ingram, has expertise in this realm, having been an investigator on early clinical trials for immunotherapies and having recently implemented a tumor-infiltrating lymphocyte therapy service line for patients. 

“Vanderbilt-Ingram Cancer Center has incredible strengths in translating observations in the lab to the clinic, and from the clinic to the lab. I look forward to continuing to work with so many talented scientists and physicians in this role,” Johnson said. 

Douglas Kojetin, PhD, Ingram Associate Professor of Cancer Research and associate professor of Biochemistry, will join two other experts as co-leader of the Genome Maintenance Research Program. He joins Tansey and David Cortez, PhD, the Richard N. Armstrong PhD Professor of Innovation in Biochemistry, at the helm. The Genome Maintenance Research Program is focused on understanding how DNA is damaged, repaired, packaged, expressed and replicated. These are the processes that take place in carcinogenesis. 

“Dr. Kojetin will be an outstanding leader of the Genome Maintenance Program,” Cortez said. “His own research program is creative, rigorous and impactful. His thoughtfulness, enthusiasm and dedication to service will help our entire research community to make discoveries that reduce the suffering caused by cancer. I look forward to working with him.”  

Kristen Ciombor, MD, MSCI, has been named co-leader of the Gastrointestinal (GI) Cancer Research Program. She brings a wealth of knowledge to this role, having previously been co-leader of the Translational Research and Interventional Oncology Research Program. She is nationally and internationally recognized for her clinical research program and clinical expertise in colon cancer.

Ciombor also serves as the principal investigator for the NCI-funded National Clinical Trials Network (NCTN) Lead Academic Participating Site (LAPS) grant at Vanderbilt-Ingram. Ciombor will join Cathy Eng, MD, who has led the GI Research Program for seven years, as she transitions away from this role over the next six months to focus more on her role as associate director of Strategic Relations and Research Partnerships and the Young Adult Cancers Program at Vanderbilt-Ingram.  

Park said the four researchers have established track records that make them the perfect choice for their new respective leadership roles. 

“Drs. Tansey, Johnson, Kojetin and Ciombor are all highly respected cancer researchers with the leadership skills to effectively lead these areas at Vanderbilt-Ingram,” Park said. “Cancer encompasses a myriad of complicated diseases, and our investigators are approaching it from many fronts. The research areas these scientists lead, and their ability to cultivate interactions across and between programs, are integral to our mission of advancing treatments and improving outcomes for people with cancer.” 

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Some cancer patients experience durable remissions from immune checkpoint inhibitors that spur their T cells to attack cancer cells, but these immunotherapies can also cause reactions.

One of the adverse effects of these treatments is skin reactions known as cutaneous immune-related adverse events (cirAEs), although it is not known how often they morph into a chronic condition. Research led by investigators at Vanderbilt University Medical Center published in JAMA Dermatology provides insight into chronic cirAEs. They recommended long-term follow-up for patients by dermatologists familiar with cirAEs and consideration of corticosteroid-sparing treatment options.

“Understanding the potential for side effects to become long-lasting has been an important advance recently, and managing them more effectively is a key unmet need,” said the study’s corresponding author, Douglas Johnson, MD, MSCI, professor of Medicine, holder of the Susan and Luke Simons Directorship, and co-leader of the Translational Research and Interventional Oncology Research Program at Vanderbilt-Ingram Cancer Center.

The investigators reviewed the records of 318 patients from a previous study who had been treated with immune checkpoint inhibitors. Of that number, 100 or 31% developed cirAEs with the skin conditions becoming chronic for 24 of the patients — nearly 8% of the full cohort. The study looked at 21 of those patients who underwent detailed follow-up. Another 31 patients were added from Vanderbilt clinics who were treated for cirAEs.

The 52 patients had received either pembrolizumab, nivolumab, ipilimumab or anti-PD1 and CTLA4 combination therapy.

The types of skin reactions varied, with 15 experiencing pruritus or itchy skin, 12 experienced morbilliform eruptions or drug-induced skin rashes, 12 experienced dermatitis or inflamed and scaly rashes, eight experienced bullous pemphigoid-like eruptions (fluid-filled blisters that resemble a rare autoimmune skin disease), five experienced eczema, four experienced lichenoid (flat-topped, scaly lesions), two experienced psoriasiform (breakouts that resemble psoriasis), and one experienced acneiform or acne-like eruptions.

The median duration of cirAE from treatment cessation was 446 days. Rare cases lasted more than five years.

Other Vanderbilt authors on the study included the study’s lead author, Kylie Fletcher, BS, Rachel Goodman, MD, MBA, J. Randall Patrinely, MD, MBA, and Anna Dewan, MD, MHS.

The research received support from Medical Scholars at Vanderbilt University School of Medicine, the Susan and Luke Simons Directorship, the James C. Bradford Jr. Fund in Melanoma Cancer Research and the Van Stephenson Memorial Cancer Research Fund.

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