Abstract

BackgroundVarious immunotherapeutic strategies for cancer are aimed at augmenting the T cell response against tumor cells. Adoptive cell therapy (ACT), where T cells are manipulated ex vivo and subsequently re-infused in an autologous manner, has been performed using T cells from various sources. Some of the highest clinical response rates for metastatic melanoma have been reported in trials using tumor-infiltrating lymphocytes (TILs). These protocols still have room for improvement and furthermore are currently only performed at a limited number of institutions. The goal of this work was to develop TILs as a therapeutic product at our institution.Principal FindingsTILs from 40 melanoma tissue specimens were expanded and characterized. Under optimized culture conditions, 72% of specimens yielded rapidly proliferating TILs as defined as at least one culture reaching ≥3×107 TILs within 4 weeks. Flow cytometric analyses showed that cultures were predominantly CD3+ T cells, with highly variable CD4+:CD8+ T cell ratios. In total, 148 independent bulk TIL cultures were assayed for tumor reactivity. Thirty-four percent (50/148) exhibited tumor reactivity based on IFN-γ production and/or cytotoxic activity. Thirteen percent (19/148) showed specific cytotoxic activity but not IFN-γ production and only 1% (2/148) showed specific IFN-γ production but not cytotoxic activity. Further expansion of TILs using a 14-day “rapid expansion protocol” (REP) is required to induce a 500- to 2000-fold expansion of TILs in order to generate sufficient numbers of cells for current ACT protocols. Thirty-eight consecutive test REPs were performed with an average 1865-fold expansion (+/− 1034-fold) after 14 days.ConclusionsTILs generally expanded efficiently and tumor reactivity could be detected in vitro. These preclinical data from melanoma TILs lay the groundwork for clinical trials of ACT.

Highlights

  • Recent experimental evidence solidifies the concept that the immune system surveys the body for tumors and can eliminate them [1,2]

  • tumor-infiltrating lymphocytes (TILs) generally expanded efficiently and tumor reactivity could be detected in vitro. These preclinical data from melanoma TILs lay the groundwork for clinical trials of Adoptive cell therapy (ACT)

  • Other strategies are aimed at disrupting negative regulators of the T cell response, such as blockade of the cytotoxic T lymphocyte antigen-4 (CTLA-4) molecule, which is currently in late-phase clinical trials [9,10,11], or the more recent development of blocking antibodies against the programmed death-1 (PD-1) molecule [12,13,14]

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Summary

Introduction

Recent experimental evidence solidifies the concept that the immune system surveys the body for tumors and can eliminate them [1,2]. Various immunotherapeutic approaches for cancer have been developed, with the aim of enhancing the anti-tumor T cell response. Other strategies are aimed at disrupting negative regulators of the T cell response, such as blockade of the cytotoxic T lymphocyte antigen-4 (CTLA-4) molecule, which is currently in late-phase clinical trials [9,10,11], or the more recent development of blocking antibodies against the programmed death-1 (PD-1) molecule [12,13,14]. Some of the highest clinical response rates for metastatic melanoma have been reported in trials using tumor-infiltrating lymphocytes (TILs). These protocols still have room for improvement and are currently only performed at a limited number of institutions. The goal of this work was to develop TILs as a therapeutic product at our institution

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