Outpatient Treatment-Related Toxicity After Hospital Discharge Among Patients Receiving Lifileucel for Advanced Melanoma

Analysis drawing on tumor-infiltrating lymphocyte (TIL) therapy performed at Memorial Sloan Kettering Cancer Center in New York, with collaboration at Weill Cornell Medical College and Stanford University School of Medicine, demonstrated that severe toxicity following hospital discharge is uncommon following TIL therapy for melanoma, and that the intensive follow-up schedules borrowed from chimeric antigen receptor (CAR) T-cell therapy may be more than patients require. Reported in JCO Oncology Practice, the study found that patients exhibited a low rate of severe side effects after returning home, supporting less-intensive monitoring than CAR T-cell protocols require.

Inpatient toxicity from TIL therapy and interleukin-2 (IL-2) administration is well characterized, however, the risks patients face following hospital discharge are less understood. Therefore, stronger characterization of outpatient adverse events (AEs) could guide how often and how long these patients require follow-up. The investigators retrospectively analyzed every patient with advanced melanoma discharged from Memorial Sloan Kettering Cancer Center after receiving investigational or commercial lifileucel between October 2020 and October 2024, reviewing the incidence and timing of new treatment-related AEs (TRAEs), blood product administration, and readmission from discharge until the start of a subsequent systemic therapy or death.Fifty-one patients were included, with a median age of 61 years. Of these patients, the most common subtype was cutaneous (37%), followed by uveal (18%) and acral (16%). Eighty-four percent received lifileucel in the investigational setting, including 7 with active brain metastases, and all received up to 6 doses of IL-2, at a median of 4.

Over a median follow-up of 5 months following discharge (IQR, 3 to 18), two patients (3.9%) developed new grade 3 TRAEs, grade 3 neutropenia and hypoxia, at 73 and 104 days following discharge. Four patients (7.8%) were readmitted for TRAEs including cytopenias, dyspnea, and syncope, at a median of 49 days following discharge (IQR, 22 to 81). Twelve patients (24%) received outpatient transfusions, a median of two units of packed red blood cells (IQR, 1 to 4) and four units of platelets (IQR, 2 to 4). Readmissions came a median of 60 days following infusion and lasted a median of 3.5 days.

Reference:

Andreoli M, Kalvin HL, Cathcart ER, et al. Outpatient treatment-related toxicity after hospital discharge among patients receiving lifileucel for advanced melanoma. JCO Oncol Pract. 2026 Aug 25:OP2600407. https:doi.org/10.1200/OP-26-00407