Harnessing the immune system: Hollings brings advanced therapy to cancer patients

What if a powerful cancer treatment is already inside the body? At MUSC Health – the only hospital system in South Carolina offering tumor-infiltrating lymphocyte (TIL) therapy – doctors are unlocking the power of the immune system to treat advanced melanoma.

MUSC Hollings Cancer Center is an authorized treatment center for TIL therapy and performed its first collection this spring, marking a major step in bringing this advanced, cell-based therapy to patients across the state.

TIL therapy is currently approved for certain patients with advanced melanoma whose cancer cannot be removed through surgery alone. It is not a preventive treatment, and it is not intended for early-stage disease. Instead, it is designed for people whose cancer has spread, who have exhausted traditional therapies and who need a treatment that works throughout the body, targeting both visible tumors and microscopic disease.

Reawakening the immune system

The idea that the immune system can fight cancer is not new. Over the past decade, immunotherapy drugs have transformed care for melanoma and other cancers by helping immune cells to recognize tumors as a threat.

“When these treatments work, they work incredibly well,” said Russell Jenkins, M.D., Ph.D., a melanoma specialist at Hollings. “The immune system doesn’t just attack the cancer; it remembers it.”

That memory means some patients continue to benefit long after treatment ends. But existing immunotherapies do not work for everyone. That is where TIL therapy comes in.

TIL therapy harnesses the power of immune cells already inside the tumor. Often, those cells are there – just overwhelmed or exhausted. The goal is to give them a second chance at fighting cancer.

Doctors first remove a piece of the patient’s tumor through surgery. That tissue is sent to a specialized external lab, where the immune cells are isolated and expanded into the billions over several weeks. Once ready, the expanded cells are shipped back to MUSC, where the Cellular Therapy inpatient service team, including specialized doctors, nurses, physician assistants and pharmacists, oversees their infusion and patients’ clinical care.

“It’s the patient’s own immune system – just expanded and reactivated,” Jenkins explained. “Because this process takes time, the sooner we can meet potential candidates and get them started, the better.”

That process is already underway at Hollings. The first patient completed TIL collection this spring, starting with a “harvest” to procure tumor tissue performed by surgical oncologist Andrea Abbott, M.D., with the infusion to follow this summer. The expectation is that MUSC and Hollings will become a hub for patients from all over the state seeking this advanced cancer treatment.

A complex one-time treatment

Unlike many cancer therapies that require repeated treatments, TIL therapy is designed as a single, intensive course.

The process unfolds via a series of steps over several weeks:

• Surgery is performed to collect the tumor tissue.
• Tumor tissue is sent to a manufacturing site where the cells are isolated and expanded.
• A hospital stay for treatment follows that includes:
• Pre-conditioning chemotherapy.
• TIL infusion.
• IL-2 therapy, in which the TILs are expanded inside the body.
• Post-treatment monitoring.

Delivering TIL therapy also requires far more than administering the treatment – it depends on close coordination across a multidisciplinary team. That team meets regularly to review cases, determine eligibility and coordinate care to ensure the safe delivery of this complex treatment.

Patients are first evaluated by melanoma specialists like Jenkins, but their care quickly expands into a highly coordinated, team-based effort. Surgical oncologists and cell lab technologists remove and collect the tissue samples, while cellular therapy nurse coordinators serve as the central hub – managing logistics and connecting the melanoma, cryo lab, surgical oncology and inpatient cellular therapy teams.

Behind the scenes, financial, quality and accreditation teams help to ensure everything runs smoothly, alongside the broader cellular therapy team that manages the hospital stay. Together, a network of nurses, navigators and support staff guides patients through each step.

“There’s a huge network just to get patients to the right place at the right time,” Jenkins said.

Bringing advanced care closer to home

Becoming the only hospital system in South Carolina to offer TIL therapy has required years of preparation and coordination across clinical, research and regulatory teams.

That work is now reaching patients. MUSC is currently the only authorized treatment center in the state, giving patients access to this therapy closer to home instead of having to travel out of state for intensive treatment during one of the most physically and emotionally demanding periods of their lives.

“Being close to home matters,” Jenkins said. “It means being near your family, your support system and a care team that knows you. It makes a demanding treatment a little more manageable, both physically and emotionally.”

While TIL therapy is currently approved only for melanoma, work is underway at Hollings to expand its reach.

Clinicians and researchers across the cancer center are refining how the therapy works as well as exploring its use for other cancers. Mariam Alexander, M.D., Ph.D., is studying its potential in lung cancer, while Brian Orr, M.D., is investigating applications in gynecologic cancers. On the scientific side, Shikhar Mehrotra, Ph.D., co-scientific director of the MUSC Center for Cellular Therapy, is helping to refine how these immune cells are engineered and expanded to make them more effective and durable.

Together, these efforts reflect a push to bring cell-based therapies to more patients. For those patients, a single infusion, built from their own cells, may be enough to change the course of the disease.