National Cancer Institute - Cancer.gov

Surgery Branch FAQ

Thank you for your interest in experimental immunotherapy and adoptive cell therapy at the Surgery Branch of the National Cancer Institute.

If you are looking for general information about your cancer, please explore the resources available at cancer.gov.

1. What kind of cancer are you studying?

We are currently treating patients with the following metastatic (Stage IV) or advanced cancers:

2. Who can participate?

The ideal candidate is between the ages of 18 and 70, and is essentially healthy and active with normal heart, kidney, liver, and lung function. A list of inclusion and exclusion criteria for each protocol can be found at clinicaltrials.gov.

Certain clinical conditions (e.g. biliary stents, infection, bowel obstruction, bleeding) can increase complications during treatment and will make potential participants ineligible for an initial screening visit.

Our cell therapy trials are not for newly diagnosed early stage cancer patients – they are strictly for patients with disease that has not been controlled by at least one standard treatment.

One trial is studying combination immunotherapy in patients with newly diagnosed, untreated metastatic or advanced melanoma. Similar to our cell therapy trials, this combination study also enrolls patients with melanoma and kidney cancer that has not been controlled by standard treatment.

Please discuss your unique clinical situation with your oncologist or oncology team.

3. What is adoptive cell therapy? Is it different from immunotherapy?

Adoptive cell therapy is one form of immunotherapy. Immunotherapy is a field of cancer treatment that utilizes your body’s own immune system to attack your cancer, and research is ongoing in many different ways to enhance that attack to make tumors go away. The underlying idea is that your body has immune cells capable of destroying your tumor under the right conditions.

For patients with hematologic malignancies (multiple myeloma or lymphoma), we can engineer your immune cells to target certain markers on your cancer in the hopes of enabling them to destroy your cancer.

4. What are the specifics of adoptive cell transfer?

For most patients with solid tumors, adoptive cell transfer starts with an operation at the National Cancer Institute. By removing one of your tumors, we are able to find and grow the immune cells that live there, known as tumor-infiltrating lymphocytes or TIL. We will grow and study TIL from your tumor in our labs.

For patients with metastatic melanoma, this process may take three to four weeks. For all other patients, that lab process sometimes takes three to four months, during which time we coordinate care with your home oncologist.

With your permission, our referral team may request samples of your tumor to test for certain proteins of interest.  For solid tumors expressing those proteins, patients with certain blood typing (HLA) can be treated without the need for an operation. For multiple myeloma and lymphoma, certain blood typing is not required, but a bone marrow biopsy is likely to be needed. We then perform a large blood collection (called an apheresis) and genetically engineer your white blood cells to recognize those targets.

If you are eligible for a screening appointment, our staff will discuss the specifics of each protocol in detail at the time of your clinic visit.

All of our cell therapy protocols for solid tumors require an inpatient stay of approximately three weeks at the NIH Clinical Center in Bethesda, MD. The treatment regimen consists of chemotherapy, cells, and supportive immune medications. For patients with multiple myeloma or lymphoma, care is coordinated as a combination of inpatient and outpatient care in the Bethesda area.

5. What is my first step?

For patients with solid tumors:

If you are interested in participating in one of our experimental protocols, please start the eligibility-screening process by completing the Surgery Branch Immunotherapy Clinic Application.  If you have any questions or have an issue filling out the form, please contact our team at 1-866-820-4505 or IRC@nih.gov.

For patients with multiple myeloma or lymphoma:

If you are interested in participating in one of our experimental protocols, please start the eligibility screening process by contacting our Hematologic Malignancies referral team at NCICAR@nih.gov. If you have any questions or do not have access to email, please contact our team at 240-858-3190.

We strongly recommend that you discuss your decision to pursue experimental protocols with your oncologist.