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PD-1 failure → TIL therapy
When checkpoint blockade fails in melanoma, harvesting and expanding the patient's own tumour-reactive T cells still works in a third of patients.
Lifileucel approved after anti-PD-1; TIL retains activity because it supplies tumour-reactive T cells that were quantitatively insufficient rather than absent.
Rationale
Checkpoint failure often reflects too few tumour-reactive T cells; TIL therapy multiplies them a thousand-fold.
Evidence
Accelerated approval; 5-year durability data.