Can a Biopsy Help Predict Who Responds to TIL Therapy?

• A phase 2 trial tested TIL therapy in metastatic uveal melanoma
• Response rates were 37% with reactive TIL vs. 0% without
• Responses lasted a median of 17.3 months
• A pre-surgery biopsy score, UMIS, helped predict who responded
• Researchers are now applying the approach to other “cold” cancers

For years, many of us heard that uveal melanoma doesn’t respond well to immune-based treatments. That’s why this new interview with Dr. Udai S. Kammula caught my eye. Dr. Kammula is a professor of surgery and director of the Solid Tumor Cell Therapy Program at UPMC Hillman Cancer Center. He shared results from a phase 2 trial of TIL therapy in metastatic uveal melanoma, presented at the 2026 ASCO Annual Meeting, and the findings offer real reasons for hope.

What is TIL therapy?

TIL stands for tumor-infiltrating lymphocytes. Dr. Kammula explains that his team noticed years ago that these cancers contain special immune cells. In TIL therapy, a tumor is surgically removed, the most effective of these cells are isolated, and then they’re infused back into the patient as treatment. The goal is deep, lasting responses.

What the trial found

The single-center study made two key discoveries.

First, how well the treatment worked depended on how potent the infused T cells were. Among 32 evaluable patients, 37% of those who received a “tumor-reactive” TIL product responded, compared with none of those whose product wasn’t reactive. Responses lasted a median of 17.3 months, and patients have been followed for a median of 5.7 years. When the researchers combined these results with a separate National Cancer Institute trial, the pattern held: a 43% response rate with reactive TIL and 0% without.

Second, the team found a biomarker called the Uveal Melanoma Immunogenomic Score (UMIS). It comes from a core biopsy done before surgery. UMIS helped predict two things: whether a tumor contains these special T cells, and whether those cells would shrink the cancer. In the combined group, 44% of patients with high UMIS scores responded, compared with 8% of those with low scores.

A quick flag: the patient numbers in the article don’t add up exactly. For example, 19 plus 12 is 31, not 32. The article also doesn’t say clearly whether the 52-patient figure refers to the NCI cohort alone or to the combined group. The full study may clear this up.

Why this matters to us

Dr. Kammula describes TIL surgery today as essentially a “blind” operation. Many patients go through surgery and receive a TIL product that turns out not to work. A test done beforehand could help doctors decide who is most likely to benefit, which matters because every treatment comes with side effects. He also notes that the biomarker may change over time. That opens the possibility of preparing, or “priming,” a patient and then repeating the biopsy to find the best moment to collect a tumor. The article doesn’t explain what priming would involve.

For patients who aren’t suited to TIL therapy, Dr. Kammula mentioned other treatments in development. These include T-cell receptor–engineered cell products, which are showing early signs of effectiveness, though their durability isn’t yet known. Bispecifics, synthetic molecules that target the tumor and recruit the immune system to attack it, are also in development. All of these are still early, but as he puts it, “more options for these patients are always better.”

Finally, his team is now applying what they learned in uveal melanoma to other hard-to-treat “cold” cancers, such as pancreatic cancer and mesothelioma. Our community’s disease is helping to open doors for others.

The article doesn’t say whether the UMIS test is available outside of research, or whether the trial is currently enrolling. Both are great questions to bring to your care team.

Read the full article here: Tumor-Reactive TIL and UMIS Biomarker Predict Response in Metastatic Uveal Melanoma

Has TIL therapy come up in conversations with your oncologist? Have you or a loved one explored a cell therapy trial? Share your experience in the comments. Your story could help someone facing the same decision feel a little less alone. And please share this post to spread awareness of ocular melanoma and the research moving our community forward.