Liver Metastasectomy to Obtain Tumor-Infiltrating Lymphocytes - Technical Considerations and Report on Single-Center Experience

Sep 22, 2026

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Adoptive cell transfer using tumor-infiltrating lymphocytes (TIL) is an FDA-approved therapy for metastatic melanoma and is being studied for other cancers. Because liver metastases may enable TIL procurement, liver resection must achieve acceptably low complication risk. A retrospective review analyzed 158 patients undergoing liver resection for TIL procurement from 2000 to 2024, evaluating 30- and 90-day morbidity and mortality, including patients with metastatic melanoma or epithelial cancers.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Patient and Lesion Selection

Candidate evaluation

Feasible lesion procurement

[https://doi.org/10.1245/s10434-026-19242-8](https://doi.org/10.1245/s10434-026-19242-8) Annals of Surgical Oncology (2026) 33:5791–5800 ORIGINAL ARTICLE HEPATOBILIARY TUMORS Liver Metastasectomy to Obtain Tumor‑Infiltrating Lymphocytes: Technical Considerations and Report on Single‑Center Experience Lisa M. Kenney, MD1 · Aaron J. Dinerman, MD1 · Alexandra M. Gustafson, MD1 · Abraham A. Hakim, MD1 · Stephanie L. Goff, MD1 · Mei Li M. Kwong, MD1 · Udai S. Kammula, MD2 · Jonathan M. Hernandez, MD3 · James C. Yang, MD1 · Steven A. Rosenberg, MD, PhD1 · Nicholas D. Klemen, MD1 Received: 14 July 2025 / Accepted: 25 January 2026 / Published online: 20 February 2026 This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2026 Abstract Background Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TIL) is an FDA-approved treatment for metastatic melanoma and continues to be studied in other cancers. As a common site of metastatic disease, the liver is potentially a useful site for TIL procurement, but only if the procedures can be performed with an acceptably low risk of complications. Methods A retrospective analysis was performed on 158 patients who underwent liver resection for TIL procurement between 2000 and 2024. Patients had metastatic melanoma or epithelial cancers. The primary outcomes were 30 days and 90 days morbidity and mortality. Results Liver resection for TIL was performed in 81 patients with melanoma and 77 patients with epithelial cancers. The overall 30 days and 90 days mortality were 1% and 10%, respectively, and no deaths were attributed to surgery. Complication rates (Clavien-Dindo ≥ III) were 5% and 7%, respectively. Viable tumor was confirmed in 100% of resected lesions. Conclusions Liver resection for TIL procurement is feasible and safe in carefully selected patients. Candidate patients should be discussed in a multidisciplinary setting with both medical and surgical expertise reaching a consensus on the optimal siteselection to minimize risk and maximize therapeutic success. Keywords Liver metastasectomy · Tumor-infiltrating lymphocytes · Adoptive cell therapy · Metastatic cancer · Hepatobiliary surgery · Immunotherapy · Surgical oncology · Tumor-infiltrating lymphocytes procurement Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TIL) can mediate durable complete tumor regression in patients with metastatic melanoma. 1 In 2024, TIL was FDA-approved for the treatment of metastatic melanoma after a single arm phase II trial demonstrated it was effective in patients who were refractory to PD-1 blockade.2,3 Lisa M. Kenney and Aaron J. Dinerman have contributed equally to this work. * Nicholas D. Klemen, MD [nicholas.klemen@gmail.com](nicholas.klemen@gmail.com) 1 Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 2 Department of Surgery, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 3 Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD Tumor-infiltrating lymphocytes is available via special hospital exemptions in some European countries based on a randomized phase III trial comparing locally manufactured TIL to ipilimumab.4 Tumor-infiltrating lymphocytes is also an investigational therapy for patients with epithelial cancersin ongoing clinical trials.5–8 Metastasectomy to procure a tumor for ex vivo TIL culture is a necessary first step to build this therapy. Patientselection and technical considerations for surgical TIL procurement has been previously described.9, 10 A recent review by Mullinax and colleagues offers a helpful overview of surgical considerations reflecting the growing institutional experience with TIL therapy and represents a valuable step toward standardizing practices.11 Because the liver is a common site for met

FAQs

What is the purpose of liver metastasectomy in this TIL therapy approach?

The procedure is used to procure a tumor for ex vivo tumor-infiltrating lymphocyte (TIL) culture, which is a necessary first step to build the therapy.

How was safety assessed for patients undergoing liver resection for TIL procurement?

Safety was evaluated using 30-day and 90-day morbidity and mortality outcomes, including complication rates using Clavien-Dindo grades.

What criteria are used to determine whether a patient is suitable for TIL harvest?

Candidates generally have good performance status, normal basic laboratory values, and no major medical comorbidities, active infections, or uncontrolled brain metastases.

Sep 22, 2026

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