Tumor-infiltrating lymphocyte transfusion in a patient with treatment refractory triple negative breast cancer.

BACKGROUND: Triple negative breast cancer (TNBC) is an aggressive form of breast cancer that is treated with chemotherapy. Recently, programmed death 1 (PD1) inhibition, as well as antibody-drug conjugates, have been added to the available treatment regimen, yet metastatic disease is fatal. Adoptive cell therapy (ACT) using tumor infiltrating lymphocytes (TILs) has been well described in melanoma, but less data is available on other solid malignancies. CASE: Herein, we present a case of a 31-year-old patient diagnosed with Breast Cancer gene 1 (BRCA1) positive, TNBC. The patient's disease rapidly progressed while under standard treatment protocols. As a result, additional genetic testing of the tumor was carried out and revealed loss of BRCA1 heterozygosity, a double Tumor Protein 53 (TP53) mutation, and MYC amplification. Due to resistance to conventional therapy, an experimental approach was attempted using tumor-infiltrating lymphocytes in November 2021 at Hadassah University Medical Center. While receiving this treatment, the patient exhibited a reported subjective clinical improvement including a month spent out of the hospital. However, the final result, presumably due to Interleukin 2 (IL-2) toxicity, was the patient's passing. CONCLUSION: This case is unique and peculiar regarding the treatment modality chosen, due to the extremely refractory disease the patient suffered from. After standard therapies rapidly failed, adoptive cell therapy was attempted with the infusion of TILs. This treatment has been shown effective in melanoma, however, there is an extreme paucity of data on other solid tumors, including TNBC. Although the patient ultimately demised presumably due to treatment side effects, brief clinical benefit was apparent. Further studies are warranted.

Myopic reactivity in repeated-choice: The case of competing with others for a scarce, unevenly distributed resource.

Foraging for a scarce resource takes place when fewer resource-units than agents are distributed among several locations and agents choose at which location to look for the resource. But how do foragers distribute themselves over the different locations? Optimal foraging theory postulates that the distribution of agents should match the distribution of resource units (ideal free distribution [IFD]), but research with animals and humans has revealed undermatching at the location at which the resource is most abundant. For the IFD to be reached, full information about other foragers' choices and outcomes is required, information that is usually not available. We conducted a theoretical analysis of the implications of relying on different levels of information: on the incomplete, but still valid information usually available in foraging scenarios and on full information. The analysis demonstrates that myopic reactivity to disappointment, or to regret, which are likely to arise in the wake of incomplete information, leads to undermatching, with either affect leading to different degrees of undermatching. Importantly, these analyses indicate that behavior would be sensitive not only to resource distribution (as in IFD), but also to its overall abundance. Three experiments employing incentivized repeated choices were conducted. The information provided to participants, the number of locations, and resource abundance were manipulated to test the predictions of the models. Analyses of aggregate choice probabilities and trial-to-trial choice dynamics indicate that myopic reactivity to regret provides the best explanation for the observed data. With more information available, behavior matches more closely the IFD predictions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).