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Inspiring Hope – TIL Immunotherapy for Metastatic Melanoma

This is the tale of Mike and Michaela Herstig. High school sweethearts, they have been married for the last 40 years and have lived in the Far East for 35 years, most recently in Bangkok. In many ways, they’re the perfect couple – still very much in love and always supportive of each other.

Initial Diagnosis

Their story began to change about 15 years ago when, while they were living in Indonesia, Michaela noticed a freckle on Mike’s back. The freckle changed in shape and color – features concerning for skin cancer.

Mike: “Michaela insisted I have it checked out, so that same day I went to a doctor. He immediately sent me to Singapore to have a biopsy, as it looked suspicious to him. I didn’t feel it was urgent, so a week later I flew to Bangkok to attend business meetings. I underwent the biopsy there and it turned out to be malignant. The doctors said they needed to perform an excision, and I went ahead and had the procedure there. Luckily, the tumor was relatively small, so the doctors were able to entirely remove it. They did a good job.”

TIL Melanoma Treatment

Stage 4 Melanoma

Mike: “Then I started to follow up in Singapore every three months, and everything was clear for many years. Ten years later, we moved to Bangkok. I then discovered a small lump near the previous excision spot. I had a PET- CT scan, and there it was. This was the beginning of my fight with melanoma.”

The PET-CT revealed a dire situation. Mike’s cancer had metastasized to his lungs and was categorized as stage 4 melanoma, meaning the disease had spread far from its origin.

Jacob Schachter
Jacob Schachter
Oncology Specialist

Michaela: “I was terrified of losing him, but I was not willing to just accept this. In my eyes Mike was sick but he was going to get better, and I would do anything to make that happen. I prefer to face the monster. I can’t fight the unknown, but as long as I know what I’m fighting against, I’m able to struggle on.”

Mike: “My wife is a very thorough person. She went online and studied everything there was about my disease, the available treatments, and their outcomes.”

Michaela’s constant research led her to Prof. Jacob Schachter, the leader of the Ella Lemelbaum Institute for Immuno-Oncology, at Sheba Medical Center in Israel. Prof. Schachter came highly recommended, due to his expertise in melanoma treatment and his patients’ successes.

Mike and Michaela’s first impressions of Prof. Schachter were very positive.

As Mike put it, “We liked him from the first moment. He came up with a plan. No doctor we saw before Prof. Schachter had an organized plan of action. Prof. Schachter laid it all out in front of us – the entire plan, the statistics, all the steps. We felt reassured and agreed to go with his plan. I began with Zelboraf for about 6 months, and it helped for a while. Then the melanoma stopped responding to Zelboraf and one of the tumors began to grow back.”

Tumor-Infiltrating Lymphocytes (TIL) Treatment

The Herstigs again consulted with Prof. Schachter, who explained Mike’s treatment options. These options included TIL, a cutting edge treatment for melanoma. While other treatments could possibly extend Mike’s life, TIL offered a potential cure for his melanoma. Prof. Schachter determined that Mike was a good candidate for TIL, and Mike and Michaela decided to try this new therapy.

Mike had some of his own lymphocytes, cancer-fighting immune cells, removed. These lymphocytes were then grown to very large numbers in a specialized laboratory and introduced back into Mike’s system.

TIL immunotherapy for melanoma is a cutting-edge procedure that involves drastically increasing the number of elite cancer-killing lymphocytes in your body. Specific cells, called tumor-infiltrating lymphocytes, are extracted from the tumor and isolated in a highly specialized laboratory, where they are grown to very large numbers before being injected back into your body.

While a very promising treatment, TIL is not without side effects. Mike experienced some of those side effects himself. At one point, his heart rhythm became erratic. Mike elected to continue with the TIL treatment. Later, he slipped into a coma.

Mike recounted what happened next, “I woke up in the morning feeling refreshed. Still, I understand that this night was critical and very frightening to Michaela and my family, who were near me and thought that the time had come to say goodbye.”

“After I had another PET-CT scan one month later, I received a call from Dr. Ronnie Shapira (senior oncologist at the Ella Lemelbaum Institute for Immuno-Oncology). She told me that the metastases were not getting smaller. They were completely gone! I was melanoma free. That was in May 2013. Since that time, I’ve had routine checkups at Sheba and visited Prof. Schachter and Dr. Shapira. I’m free of cancer thanks to them and the TIL treatment. I also want to mention Dr. Michal Besser (head of the clinical laboratory at the Ella Lemelbaum Institute for Immuno-Oncology), a brilliant researcher, who was responsible for growing the TILs. The bottom line is it was the team. They are the reason TIL works and people are cured. I’m grateful to them for the rest of my life. They are absolutely brilliant.”

Michaela also attributes Mike’s recovery to the TIL therapy and his treatment team, “We think choosing TIL was undoubtedly the best decision. That is what saved my husband.”

Melanoma is treatable with advanced medicine and quality care, and early detection is paramount.

Contact Sheba Medical Center for a consultation about possible TIL melanoma therapy.

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