New treatment for advanced melanoma becomes available in Utah

MURRAY — Intermountain Medical Center recently became one of the first medical centers in Utah to offer a genetically personalized skin cancer treatment option for those with advanced melanoma.

AMTAGVI is a tumor-infiltrating lymphocyte therapy medication used for patients with melanoma that cannot be removed surgically, has spread to other areas in the body, and has not responded well to other treatment options. The treatment became FDA-approved in 2024 and is available in about 50 medical centers in the country, but Utahns previously had to travel outside the state to receive it.

The therapy uses special immune cells, or lymphocytes, from the patient's own tumor to target and destroy cancer cells in the body. A walnut-sized piece of the tumor is surgically removed and sent to a lab that extracts and expands the lymphocytes. The extracted cells are then frozen in liquid nitrogen and mailed back to the treatment center to be infused into the patient intravenously.

"It's really the cutting edge of melanoma treatment," said Dr. Caroline Nebhan, Intermountain Health medical oncologist. "We are one of the first two centers in the state of Utah to offer this, because this is a more specialized treatment that requires a lot of multidisciplinary coordination between surgical oncology, medical oncology and bone marrow transplant teams. But we're really proud that we're one of the first sites that has done the surgery for this new treatment, and we anticipate the first infusions here in the next few weeks."

Immunotherapy is one of the most common and effective treatments for melanoma, but about 50% of immunotherapy patients still see their cancer progress despite treatment.

Based on results from clinical trials, about one-third of patients respond well to tumor-infiltrating lymphocyte therapy. While the success rate may be considered low, Nebhan believes the therapy will provide hope to those with progressive melanoma who previously had limited options.

"(Tumor-infiltrating lymphocyte) therapy will be a really important part of treatment for any patients where their disease is no longer responding to the conventional immunotherapies that we have available," said Nebhan.

"Now, the challenge is that, because this is a more intensive treatment ... we know folks will have to be healthy enough to even receive this treatment," she continued. "For many patients, that can be a challenge by the time their disease has progressed. So, it will take picking the right patients and working to optimize folks to make sure they are as good of candidates as possible for this new treatment."

The therapy also represents a new approach to personalized cancer treatment because it uses lymphocytes unique to the individual. The immune cells are not edited or genetically modified, which Nebhan says is unique for a treatment like tumor-infiltrating lymphocyte therapy.

"Historically, when we treat melanoma, we use off-the-shelf treatment — things like immunotherapy that come in a bag, and every patient gets the same type of medicine. This treatment is very unique because it's personalized," said Nebhan. "So, it's a really exciting advancement in our quest for more personalized cancer medicine."

Utah has the highest incident rate of melanoma in the country, according to data from the National Cancer Institute. This is likely due to the combination of living at a higher altitude, where UV rays are stronger, and the popularity of outdoor activities, according to Nebhan.

Melanoma is a skin cancer that begins in melanin-producing cells, often manifesting in new or existing moles, and is considered the deadliest form of skin cancer due to its tendency to metastasize, or spread. When detected early, melanoma can be treated effectively by surgically removing the mole before it spreads to other areas.

To help with early melanoma detection, Nebhan recommends seeing a dermatologist once a year for a total body scan and regularly checking oneself for abnormal moles. She recommends looking for the ABCDE's that may indicate a mole is cancerous: asymmetry, irregular borders, changing color, diameter larger than a pencil eraser and evolution over time.

The new treatment is available at LDS Hospital in Salt Lake City in conjunction with cancer experts from Intermountain Medical Center in Murray. It is also available at the Huntsman Cancer Institute at University of Utah, according to the AMTAGVI Authorized Treatment Center map.

Currently, two patients have undergone surgery to remove part of the tumor for the treatment at Intermountain Medical Center and are waiting to receive the lymphocyte infusions, which can take a little over a month. Intermountain Health expects to see high numbers of patients from the region seeking the new treatment in Utah now that it is available in the state.

"I do think we've already seen an increase in referrals now that we have this treatment available here. It's really only been available for a few months, and we're already getting referrals almost weekly, at this point. So, patients really from around our region will likely come here just to get this treatment before going back home," said Nebhan.

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