Cellular immunotherapy · UK and international
TIL (tumour-infiltrating lymphocyte) therapy private access.
Autologous cellular immunotherapy for advanced melanoma and selected solid tumours, delivered on a UK trial pathway at the Royal Marsden or Christie, or on a self-funded international pathway with a London consultant coordinating your care.
Why patients choose us
- 01
A named consultant medical oncologist
A cellular therapy oncologist with active links to Royal Marsden, Christie or international TIL programmes. Not a generalist.
- 02
The right pathway for your tumour
TIL is a solid-tumour therapy for a narrow group of patients. If a checkpoint rechallenge, BRAF combination or a CAR-T trial fits better, we say so.
- 03
Independent, and free
We are paid by no clinic or manufacturer, so the recommendation on UK trial versus international self-funded is impartial.
What TIL therapy is
Your own tumour-fighting T cells, expanded to billions.
TIL therapy is autologous cellular immunotherapy: the T cells doing the work are yours, harvested from your own tumour, grown in a lab, and given back to you.
A surgeon removes a piece of your tumour, roughly 1.5cm across, and it is shipped to a specialised manufacturing facility. There, tumour-infiltrating lymphocytes are isolated from the tissue, then expanded ex vivo with interleukin-2 into billions of tumour-reactive T cells over about 22 days.
You are admitted for five days of lymphodepleting chemotherapy with fludarabine and cyclophosphamide, which clears your existing immune system to make space. The TIL product is given back as a single intravenous infusion, followed by four to six doses of high-dose IL-2 to drive expansion and persistence, in an ICU-capable unit.
Product and approval
Lifileucel (Amtagvi), the first approved TIL therapy.
Made by Iovance Biotherapeutics. FDA-approved in February 2024 for advanced melanoma. UK access is next.
FDA approval, February 2024
Lifileucel is licensed for unresectable or metastatic melanoma that has progressed after a checkpoint inhibitor, and after a BRAF-targeted therapy where the tumour is BRAF V600 mutated.
MHRA review in the UK
Lifileucel is under MHRA review, with a NICE technology appraisal pending. Until a licence and NICE guidance are in place, UK access is trial and expanded-access only.
A living, autologous product
Every TIL infusion is made from one patient, for one patient. It is not a shelf drug. The manufacturing slot, the cell yield and the clinical timing all have to line up.
Indicative pricing
What TIL therapy costs, honestly.
Indicative ranges across UK trial, expanded access and international self-funded pathways. Send your oncology file and we quote firm figures within two working days.
In short
UK trial: free. International self-funded: £450,000 to £650,000 all-inclusive.
| Pathway | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Second-opinion review of your oncology file | £450–£850 | 45 min | 72 hours |
| UK trial screening (Royal Marsden / Christie) | No cost to patient | Weeks | Trial-dependent |
| International self-funded, US centre (all-inclusive) | £450,000–£650,000 | 8–10 weeks | On acceptance |
| UK commercial access (when MHRA-licensed) | £320,000–£450,000 | 8–10 weeks | Post-licence |
| Compassionate or expanded access application | £1,500–£3,000 | 2–4 weeks | Case by case |
| Bridging therapy while manufacturing (radiotherapy or systemic) | £4,000–£25,000 | 3 weeks | Immediate |
International pricing covers surgical harvest, manufacturing, admission, inpatient stay, IL-2, ICU and early follow-up. Travel, accommodation and repatriation of care are quoted separately. UK commercial pricing will be set once lifileucel is licensed and NICE guidance issues.
The pathway
From oncology file to reinfusion, what happens, in order.
One team from first enquiry to long-term follow-up back home with your UK oncologist.
Phase 1 · Before treatment
Screening and harvest
Phase 2 · Admission
Manufacture, lymphodepletion, infusion, IL-2
Phase 3 · After
Response and follow-up
- 01
Before
You send us the oncology summary
A short confidential form. Diagnosis, prior lines including checkpoint and BRAF, imaging, and which resectable lesion could be harvested.
- 02
Before
We come back with a recommendation
Within two working days: whether TIL is realistic, which UK trial or international centre fits, and an indicative all-in cost.
- 03
Before
Tumour harvest and shipment
A surgical resection of 1.5cm of viable tumour, packaged and shipped to the Iovance manufacturing facility or the trial lab.
- 04
Admission
Manufacture, around 22 days
T cells are isolated from your tumour and expanded ex vivo with IL-2 into billions of tumour-reactive lymphocytes.
- 05
Admission
Lymphodepletion, then reinfusion
Five days of fludarabine and cyclophosphamide, one single infusion of your TIL product, then four to six doses of high-dose IL-2.
- 06
Admission
Inpatient recovery, 10 to 21 days
ICU-level monitoring for cytokine effects, cytopenias and infection, with staged transfer to the ward as counts recover.
- 07
After
Response assessment and follow-up
First scan at 6 weeks, then every 12 weeks. Long-term follow-up with your UK oncologist. Durable responses are the goal.
Typical end-to-end: 8 to 10 weeks. Inpatient stay: 10 to 21 days. First response scan: 6 weeks post infusion.
Indications
Who TIL therapy is for, and who it is not.
The licensed melanoma indication, the expanding trial landscape, and the eligibility flags that decide whether TIL is realistic.
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Unresectable or metastatic melanoma post-checkpoint
The core Amtagvi indication: melanoma progressing after anti-PD-1, and after BRAF-targeted therapy where BRAF V600 mutated.
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Cervical cancer, recurrent or metastatic
Active phase II data with lifileucel in cervical cancer post-chemoradiation and post-checkpoint. Trial pathway preferred.
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Head and neck squamous cell carcinoma
HNSCC trials of TIL therapy post-platinum and post-checkpoint are recruiting in the US and selected EU centres.
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Non-small cell lung cancer
NSCLC TIL trials for patients progressing after immunotherapy, particularly in tumours with an inflamed phenotype.
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Selected sarcoma
Early sarcoma TIL trials in specialised centres, generally in the context of a resectable primary or oligometastatic disease.
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A resectable lesion of adequate size
The programme needs 1.5cm of viable tumour, safely accessible for surgical harvest, without excessive necrosis.
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Adequate performance status and organ function
ECOG 0 or 1, adequate cardiac, renal and pulmonary reserve to tolerate lymphodepletion and high-dose IL-2 safely.
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Red flag: rapidly progressive or bulky disease
Very rapid progression or high tumour burden can outpace the 8 to 10 week manufacture window. Bridging therapy is planned in advance.
Treatment options
TIL is a family, and CAR-T sits beside it.
What each option involves, and where TIL and CAR-T differ. Both are autologous cellular therapies, but they treat different diseases: TIL for solid tumours, CAR-T for haematological cancers.
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Lifileucel (Amtagvi), Iovance
The first FDA-approved TIL therapy, February 2024, for unresectable or metastatic melanoma after checkpoint inhibitor and, where relevant, BRAF-targeted therapy.
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Investigational TIL, solid-tumour trials
Next-generation TIL products for cervical, HNSCC, NSCLC and sarcoma, often with genetic modifications to improve persistence or reduce IL-2 dependence.
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Lymphodepletion, FluCy
Fludarabine plus cyclophosphamide over five days to clear the endogenous immune system and make space for the TIL product to expand in vivo.
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High-dose IL-2 support
Four to six doses of interleukin-2 after reinfusion to drive TIL expansion and persistence. Delivered in an ICU-capable unit.
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Bridging therapy
Radiotherapy, targeted therapy or a further line of systemic treatment during the 22-day manufacture window to hold disease stable.
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Compassionate and expanded access
Named-patient routes into unlicensed cell therapy in the US, EU and UK. Documentation-heavy and centre-dependent, but sometimes the fastest path.
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CAR-T (a related, but different, therapy)
CAR-T is autologous cell therapy for haematological cancers (CD19, BCMA). TIL is autologous cell therapy for solid tumours. They are cousins, not the same.
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Second-opinion review
A specialist review of your oncology file, scans and molecular profile. Sometimes the answer is a clinical trial nearer home, not TIL therapy.
Response rates
What the data actually shows.
The lifileucel C-144-01 dataset in advanced melanoma progressing after checkpoint inhibitor therapy.
~31%
Objective response rate
RECIST-confirmed responses in a heavily pretreated post-checkpoint melanoma population.
8–10%
Complete responses
A meaningful fraction of complete radiological responses in patients who had exhausted standard options.
NR
Median duration of response
Not reached at data cutoff, meaning many responders were still in response at the last assessment. Durability is the point.
UK access and international pathway
A small panel of oncologists who actually do this work.
UK trial pathways at Royal Marsden and Christie Manchester. International self-funded pathways to MD Anderson, Moffitt Cancer Center and the NIH, coordinated from London.
Selection criteria
How we choose every oncologist in our network.
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Consultant medical oncologists with active links to UK TIL trial sites (Royal Marsden, Christie)
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Direct referral routes into US programmes at MD Anderson, Moffitt Cancer Center and the NIH
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ICU-capable inpatient units experienced in high-dose IL-2 and cellular therapy toxicity
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MDT-led review that says no to TIL when a trial, checkpoint rechallenge or targeted line fits better
Toxicity and recovery
What the inpatient stay is really like.
TIL therapy is a demanding regimen. The early toxicities are mostly lymphodepletion and IL-2 driven, are largely manageable in an expert cellular therapy unit, and give way to a long tail of durable response when treatment works.
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Severe cytopenias from lymphodepletion
Fludarabine and cyclophosphamide cause deep pancytopenia for 10 to 14 days. Neutropenic sepsis is the main early risk, managed in an ICU-capable unit.
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IL-2 capillary leak syndrome
Hypotension, oedema, oliguria and weight gain from high-dose IL-2. Nearly universal, mostly reversible in expert hands with vasopressors and fluid management.
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Fevers, rigors and hypotension
Cytokine-mediated fevers and rigors after IL-2 dosing. Usually managed with antipyretics, fluids and, if needed, brief vasopressor support.
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Infection during the aplastic window
A 10 to 14 day period of profound immunosuppression after lymphodepletion. Antibacterial, antifungal and antiviral prophylaxis are standard.
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Cardiac and pulmonary events
Arrhythmias, transient cardiomyopathy and non-cardiogenic pulmonary oedema from IL-2 are recognised. Pre-treatment cardiac and pulmonary screening is mandatory.
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Prolonged fatigue
Fatigue lasting weeks to months after discharge is the rule, not the exception. Rehabilitation and staged return to activity are planned from the outset.
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Autoimmune events
Vitiligo, thyroiditis and uveitis are seen, more often in melanoma responders. Endocrine and ophthalmology follow-up are part of the pathway.
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Rare treatment-related mortality
Treatment-related mortality is reported at around 1 to 2% in expert centres. Discussed frankly during consent, alongside the response and durability data.
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Long recovery, then durable response
The trade-off, when TIL works, is a demanding 4 to 6 week inpatient course for a chance at a response that lasts years rather than months.
Reading your treatment record
Your TIL record in four parts. Read the last one first.
Whether the treatment was delivered on a UK trial or in an international centre, the record keeps to the same shape.
A quiet reminder
Cellular therapy language is dense. We translate it into a plan you can act on.
If you would like us to talk you through the record before your review, just ask.
- 01 Header
Diagnosis, prior lines and mutation status
Confirmed histology, all prior systemic lines including checkpoint and BRAF-targeted therapy, and BRAF, NRAS, HLA and PD-L1 status.
- 02 Technique
Harvest site, manufacture and lymphodepletion
Which lesion was resected, the manufacture facility and TIL yield, the FluCy dose delivered, and the IL-2 dose schedule.
- 03 Findings
Toxicities and response assessment
Peak toxicities, ICU length of stay, imaging response at 6 weeks and 12 weeks by RECIST, and any autoimmune events.
- 04 Impression
Ongoing surveillance and long-term plan
Read this first: scan interval, endocrine and ophthalmology follow-up, and the plan if disease progresses despite TIL therapy.
Recognised by major UK insurers
UK insurance does not yet routinely fund TIL therapy. Most patients today self-fund an international pathway or are treated on a UK trial. We confirm cover in writing before you commit.
Frequently asked
Everything we get asked about TIL therapy.
Quick answers on eligibility, UK access, insurance, travel, response and the level of inpatient care involved.
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Am I eligible for TIL therapy?
The licensed indication is unresectable or metastatic melanoma that has progressed on a checkpoint inhibitor, and on a BRAF-targeted therapy where the tumour carries a BRAF V600 mutation. You also need ECOG 0 or 1, a resectable lesion of about 1.5cm for harvest, and adequate cardiac, pulmonary and renal reserve to tolerate FluCy lymphodepletion and high-dose IL-2. Cervical, head and neck, NSCLC and sarcoma indications are trial-only for now.
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Can I access TIL therapy in the UK right now?
Lifileucel is under MHRA review with a NICE assessment pending, so commercial UK access is not yet routine. Access today is through clinical trials at the Royal Marsden and Christie Manchester, a small number of compassionate-use routes, or a self-funded international pathway to MD Anderson, Moffitt or the NIH. A London-based consultant can coordinate whichever route fits your case.
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Will insurance cover TIL therapy?
UK private medical insurance rarely covers TIL therapy today. Some international policies will consider it once lifileucel is licensed and NICE guidance issues, but the norm right now is self-funded international treatment or a fully funded UK trial. We confirm cover in writing before you commit to anything.
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Do I have to travel abroad?
For most patients today, yes, unless a UK trial slot is available. The all-inclusive US pathway typically runs 8 to 10 weeks including harvest, manufacture, admission, inpatient stay and initial follow-up. We arrange the referral, second opinions, tumour shipment logistics, travel, accommodation and repatriation of your care to a UK oncologist.
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What are the response rates?
In the pivotal C-144-01 study of lifileucel in melanoma post-checkpoint, the objective response rate was around 31%, with complete responses in roughly 8 to 10% of patients. Median duration of response was not reached at data cutoff, meaning many responders were still in response at the last assessment. These are the best durable-response numbers we have in this heavily pretreated group.
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Do I really need ICU-level care?
Yes. Lymphodepletion causes deep pancytopenia and high-dose IL-2 can cause capillary leak, hypotension and cardiopulmonary stress. Modern regimens are safer than the historical NIH protocols, but the treatment is only delivered in units with ICU capability, an experienced cellular-therapy team, and 24/7 access to critical-care physicians.
Related treatments
Looking for something else?
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CAR-T cell therapy
Autologous cellular therapy for haematological cancers.
Learn more -
Immunotherapy infusion clinic
Private checkpoint inhibitor infusions in the UK.
Learn more -
Bispecific antibody therapy
T-cell engaging antibodies for solid and haematological cancers.
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Oligometastasis SBRT
Ablative radiotherapy for limited metastatic disease.
Learn more -
Tumour molecular profiling
Comprehensive genomic testing to guide therapy.
Learn more -
Breast cancer
Diagnosis, staging and treatment pathways.
Learn more
Speak to a cellular therapy oncologist
Send us your oncology file. We come back within two working days.
Whether the answer is a UK trial slot at the Royal Marsden, an international self-funded pathway to MD Anderson, or a different line of therapy entirely, we tell you honestly, and we do it fast.