Abstract

Epithelial ovarian cancer (EOC) is the leading cause of gynaecological cancer-related death in Europe. Although most patients achieve an initial complete response with first-line treatment, recurrence occurs in more than 80% of cases. Thus, there is a clear unmet need for novel second-line treatments. EOC is frequently infiltrated with T lymphocytes, the presence of which has been shown to be associated with improved clinical outcomes. Adoptive T-cell therapy (ACT) using ex vivo-expanded tumour-infiltrating lymphocytes (TILs) has shown remarkable efficacy in other immunogenic tumours, and may represent a promising therapeutic strategy for EOC. In this preclinical study, we investigated the efficacy of using anti-CD3/anti-CD28 magnetic beads and IL-2 to expand TILs from freshly resected ovarian tumours. TILs were expanded for up to 3 weeks, and then subjected to a rapid-expansion protocol (REP) using irradiated feeder cells. Tumours were collected from 45 patients with EOC and TILs were successfully expanded from 89.7% of biopsies. Expanded CD4+ and CD8+ subsets demonstrated features associated with memory phenotypes, and had significantly higher expression of key activation and functional markers than unexpanded TILs. Expanded TILs produced anti-tumour cytokines when co-cultured with autologous tumour cells, inferring tumour cytotoxicity. Our findings demonstrate that it is possible to re-activate and expand tumour-reactive T cells from ovarian tumours. This presents a promising immunotherapy that could be used sequentially or in combination with current therapeutic strategies.

Highlights

  • Epithelial ovarian cancer has the highest mortality rate of all gynaecological cancers, with more than 4000 deaths each year in the UK [1]

  • tumour-infiltrating lymphocytes (TILs) can readily be expanded from melanoma biopsies by the addition of high-dose IL-2 alone [36], expanding TILs from other solid tumours has been significantly more challenging

  • To determine the feasibility of isolating and expanding TILs from epithelial ovarian cancers, we adapted our previous experience with renal cell carcinoma to establish ovarian TIL cultures [23]

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Summary

Introduction

Epithelial ovarian cancer has the highest mortality rate of all gynaecological cancers, with more than 4000 deaths each year in the UK [1]. Infiltration of C­ D3+ and C­ D8+ T cells into the tumour has been associated with improved overall and progression-free survival in patients with epithelial ovarian cancer [11, 12]. Ovarian tumours acquire mechanisms to escape immune surveillance, skewing the tumour microenvironment towards a tolerogenic state. These mechanisms include the recruitment of regulatory T cells and MDSCs, expression of co-inhibitory ligands such as PD-L1, reduced antigen presentation and immunosuppressive soluble factors such as TGF-β, IL-10 and IDO [13,14,15,16,17]

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