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ESMO 2026 | Patient fitness & disease burden guide lifileucel selection in refractory melanoma
Gino In, MD, MPH, University of Southern California, Los Angeles, CA, comments on the potential role of lifileucel in the relapse setting where these checkpoint inhibitors may be less effective. Patient selection is critical in the refractory setting, as lifileucel requires adequate fitness and involves a multi-step process spanning several months, whereas off-the-shelf therapies can be initiated immediately. Treatment decisions should be individualized based on disease burden, pace of disease progression, and patient tolerance, with consideration given to the practical advantages of readily available alternatives. This interview took place at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, Spain.
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Transcript
Well, I think one thing that we found from the RELATIVITY-020 study was that the response rates to PD-1 and LAG-3. In the second line, or later line of therapy, were quite low. And so we really wanted to better understand that. Of course, lifileucel has only been studied in a refractory setting. So this data sort of suggests that lifileucel definitely should be considered in the relapse setting, where PD-1 and LAG-3 may not be as effective as in front line...
Well, I think one thing that we found from the RELATIVITY-020 study was that the response rates to PD-1 and LAG-3. In the second line, or later line of therapy, were quite low. And so we really wanted to better understand that. Of course, lifileucel has only been studied in a refractory setting. So this data sort of suggests that lifileucel definitely should be considered in the relapse setting, where PD-1 and LAG-3 may not be as effective as in front line. Well, this is definitely one of the important variables that we have to consider in the refractory setting. Not every patient is fit for lifileucel. It is a therapy that requires a certain degree of fitness, and it is also a therapy which has multiple steps, which can take a few months. So we have identify the patients who have the correct pace and burden of disease as well, whereas lifileucel or some the other therapies which are available off the shelf start right away and may be better tolerated as well. So it can become kind of an individualized decision for each patient.
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