Gene therapy for cancer.

SELECTED CASES CASE 1. —A 26-year-old woman was referred to the Surgery Branch, National Cancer Institute, Bethesda, Md, with metastatic melanoma. A year earlier the patient had noted an enlarging mole on her right upper extremity; the results of the biopsy revealed a melanoma. She underwent a wide local excision and right axillary lymph node dissection. Of 30 lymph nodes, two contained melanoma. Despite experimental treatment with vaccinia tumor oncolysate, her disease progressed. On presentation to the National Institutes of Health in June 1989, she had about 30 subcutaneous deposits of melanoma, multiple lung metastases, and oral lesions on her tonsils and soft palate. On June 21,1989, she underwent resection of six separate subcutaneous lesions ranging in diameter from 2 to 5 cm to harvest tumor-infiltrating lymphocytes (TIL) (T cells that infiltrate into animal and human tumors and can be grown in culture with interleukin 2 [IL-2]). 1 Eight days