Patient case: 73-year-old male with melanoma; genetic feature: tumor cells negative for PD-L1 expression

Clinical trial: Treatment of Metastatic Melanoma With TSA-CTL(Tumor Specific Antigen-Induced Cytotoxic T Lymphocytes)

Summary: The primary purpose of this study is to evaluate the safety of TSA-CTL in the treatment of the advanced melanoma.
  The secondary purpose of this study is to evaluate preliminarily the effect of TSA-CTL in the treatment of the advanced melanoma.


Eligibility: Inclusion Criteria:
  1. Greater than or equal to 18 years of age and less than or equal to 70 years of age；all genders.
  2. Confirmation of diagnosis of metastatic melanoma by the Laboratory of Pathology.
  3. Measurable metastatic melanoma with at least one lesion that is resectable or tumor biopsies for DNA extraction.
  4. The Malignant skin and mucosal melanoma patients who is HLA - A0201 subtypes.
  5. The advanced melanoma patients who have failed in conventional treatment and received at least a routine treatment for metastatic melanoma before (such as chemotherapy、PD-1antibody、CTLA-4 antibody and targeted therapeutics ).
  6. Able to understand and sign the Informed Consent Document.Willing to sign a durable power of attorney.
  7. Clinical performance status of ECOG 0 or 1 and Life expectancy of greater than six months；able to cooperate to observe adverse reactions and the effect of the treatment.
  8. Patients of both genders must be willing to practice birth control from the time of enrollment on this study and for up to twelve months after treatment.
  9. Women of child-bearing potential must have a negative pregnancy test because of the potentially dangerous effects of the treatment on the fetus.
  10. Serology：Seronegative for HIV antibody，Seronegative for hepatitis B antigen, and seronegative for hepatitis C antibody.
  Hematology：Absolute neutrophil count greater than 1000/mm(3) without the support of filgrastim，WBC greater than or equal to 3000/mm(3)，lymphocyte count greater than or equal to 800/mm(3)，Platelet count greater than or equal to 100,000/mm(3)，Hemoglobin > 9.0 g/dl Chemistry：Serum ALT/AST less than or equal to 2.5 times the upper limit of normal，Serum Creatinine less than or equal to 1.6 mg/dl，Total bilirubin less than or equal to 1.5 mg/dl, except in patients with Gilbert s Syndrome who must have a total bilirubin less than 3.0 mg/dl.
  11. More than four weeks must have elapsed since any prior systemic therapy at the time the patient receives the preparative regimen, and patients toxicities must have recovered to a grade 1 or less (except for toxicities such as alopecia or vitiligo).Note: Patients may have undergone minor surgical procedures within the past 3 weeks, as long as all toxicities have recovered to grade 1 or less.
  12. Eight weeks must have elapsed from the time of any antibody therapy that could affect an anti cancer immune response, including anti-PD1 antibody and anti-CTLA4 antibody therapy, so at the time the patient receives the preparative regimen to allow antibody levels to decline.
  Exclusion Criteria:
  1. Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the treatment on the fetus or infant.
  2. Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency Disease).
  3. Concurrent opportunistic infections (The experimental treatment being evaluated in this protocol depends on an intact immune system. Patients who have decreased immune competence may be less responsive to the experimental treatment and more susceptible to its toxicities).
  4. The medical history of autoimmune disease.
  5. Active systemic infections, coagulation disorders or other active major medical illnesses of the cardiovascular, respiratory or immune system.
  6. Concurrent systemic steroid therapy.
  7. History of severe immediate hypersensitivity reaction to any of the agents used in this study.
  8. Patients who generate level 3-4 correlation adverse reactions after anti-PD1/PDL1 antibody treatment.
  9. Patients with brain metastases.
  10. The choroid melanoma and clear cell sarcoma patients.
  11. Negative for expression of MHC molecules.

Relevance to patient case: not relevant