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• • G—PHYSICS
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Definitions

• TILs tumor infiltrating lymphocytes
• REP can result in a 1,000-fold expansion of TILs over a 14-day period, although it requires a large excess (e.g., 200-fold) of irradiated allogeneic peripheral blood mononuclear cells (PBMCs), often from multiple donors, as feeder cells, as well as anti-CD3 antibody (OKT3) and high doses of IL-2.
• PBMCs peripheral blood mononuclear cells
• TILs that have undergone an REP procedure have produced successful adoptive cell therapy following host immunosuppression in patients with melanoma.
• Current infusion acceptance parameters rely on readouts of the composition of TILs (e.g., CD28, CD8, or CD4 positivity) and on fold expansion and viability of the REP product.
• naive T cells rely on mitochondrial respiration to produce ATP
• mature, healthy effector T cells such as TIL are highly glycolytic, relying on aerobic glycolysis to provide the bioenergetics substrates they require for proliferation, migration, activation, and anti-tumor efficacy.
• the present invention is directed to methods for expanding and re- stimulating TIL populations that lead to improved phenotype and increased metabolic health of the TILs and towards methods of assaying for TIL populations to determine suitability for more efficacious infusion after re-stimulation.
• the present invention provides methods for expanding TILs in larger, sometimes therapeutic, populations in combination with optional cryopreservation.
• TILs tumor infiltrating lymphocytes
• the method further comprises:
• step (iv) performing an additional second expansion by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger therapeutic population of TILs than obtained in step (iii), wherein the larger therapeutic population of TILs comprises an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs.
• step (iii) the cells are removed from the cell culture and cryopreserved in a storage medium prior to performing step (iv).
• the cells are thawed prior to performing step (iv).
• step (iv) is repeated one to four times in order to obtain sufficient TILs in the therapeutic population of TILs for a therapeutically effective dosage of the TILs.
• steps (i) through (iii) or (iv) are performed within a period of about 40 days to about 50 days. In some embodiments, steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 48 days. In some embodiments, steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 45 days. In some embodiments, steps (i) through (iii) or (iv) are performed within about 44 days.
• the cells from steps (iii) or (iv) express CD4, CD8, and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the antigen presenting cells are peripheral blood
• PBMCs mononuclear cells
• the PBMCs are added to the cell culture on any of days 9 through 17 in step (iii).
• the effector T cells and/or central memory T cells in the therapeutic population of TILs in step (iv) exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the APCs are artificial APCs (aAPCs).
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high- affinity T cell receptor.
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising a single chain variable fragment antibody fused with at least one endodomain of a T-cell signaling molecule.
• CAR chimeric antigen receptor
• the therapeutic population of TILs are infused into a patient.
• step (iii) further comprises a step of removing the cells from the cell culture medium.
• step (iii) is repeated one to four times in order to obtain sufficient TILs in the therapeutic population of TILs for a therapeutically effective dosage of the TILs.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 ⁇ 10 10 to about 13.7* 10 10 .
• the present disclosure also provides a population of expanded TILs made according to the method of claim 1.
• the present disclosure also provides a population of expanded TILs made according to the method of claim 1, wherein the expanded TILs have at least a two-fold increase in basal glycolysis as compared to thawed cryopreserved TILs.
• the present disclosure also provides methods for assessing the metabolic activity of a TIL cell population made according to the methods described herein, comprising measuring the basal glycolysis of the cells.
• the present disclosure also provides methods for assessing the metabolic activity of a TIL cell population made according to the methods described herein, comprising measuring the basal respiration of the cells. [0029] The present disclosure also provides methods for assessing the metabolic activity of a TIL cell population made according to the methods described herein, comprising measuring the spare respiratory capacity (SRC) of the cells.
• SRC spare respiratory capacity
• the present disclosure also provides methods for assessing the metabolic activity of a TIL cell population made according to the methods described herein, comprising measuring the glycolytic reserve of the cells.
• the present disclosure also provides a method for expanding tumor infiltrating lymphocytes (TILs) into a therapeutic population of TILs comprising:
• the method further comprises:
• step (iii) performing an additional second expansion of the third population of TILs by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger therapeutic population of TILs than obtained in step (ii), wherein the larger therapeutic population of TILs exhibits an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs.
• the cells from the cell culture medium in step (ii) are removed and cryopreserved in a storage medium prior to step (iii).
• step (ii) is repeated one to four times in order to obtain sufficient TILs in the therapeutic population of TILs for a therapeutically effective dosage of the TILs.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 x 10 10 to about 13.7* 10 10 .
• the APCs are peripheral blood mononuclear cells (PBMCs).
• PBMCs peripheral blood mononuclear cells
• the effector T cells and/or central memory T cells exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• TILs tumor infiltrating lymphocytes
• the method further comprises prior to step (iv) a step of performing an additional second expansion by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger therapeutic population of TILs than obtained in step (iii), wherein the larger therapeutic population of TILs comprises an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs.
• step (ii) the cells are removed from the cell culture medium and cryopreserved in a storage medium prior to the additional second expansion according to the methods described herein.
• the cells are thawed prior to the additional second expansion of according to the methods described herein.
• step (iii) is repeated one to four times in order to obtain sufficient TILs in the therapeutic population of TILs for a therapeutically effective dosage of the TILs.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 x 10 10 to about 13.7* 10 10 .
• the APCs are peripheral blood mononuclear cells (PBMCs).
• PBMCs peripheral blood mononuclear cells
• the effector T cells and/or central memory T cells exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the cancer is selected from the group consisting of melanoma, cervical cancer, head and neck cancer, glioblastoma, ovarian cancer, sarcoma, pancreatic cancer, bladder cancer, breast cancer, triple negative breast cancer, and non-small cell lung carcinoma.
• the present disclosure also provides a method for treating a subject with cancer comprising administering expanded tumor infiltrating lymphocytes (TILs) comprising:
• the method further comprises prior to step (iii) a step of performing an additional second expansion by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger therapeutic population of TILs than obtained in step (ii), wherein the larger therapeutic population of TILs comprises an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs.
• the cells from the cell culture medium in step (ii) are removed and cryopreserved in a storage medium prior to the additional second expansion as described herein.
• the cells are thawed prior to the additional second expansion as described herein.
• step (ii) is repeated one to four times in order to obtain sufficient TILs in the therapeutic population of TILs for a therapeutically effective dosage of the TILs.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 x l O 10 to about 13.7* 10 10 .
• the APCs are peripheral blood mononuclear cells (PBMCs).
• PBMCs peripheral blood mononuclear cells
• the effector T cells and/or central memory T cells exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the cancer is selected from the group consisting of melanoma, cervical cancer, head and neck cancer, glioblastoma, ovarian cancer, sarcoma, pancreatic cancer, bladder cancer, breast cancer, triple negative breast cancer, and non-small cell lung carcinoma.
• the present invention also provides assay methods for determining TIL viability.
• the present disclosure provides methods for assaying TILs for viability by expanding tumor infiltrating lymphocytes (TILs) into a larger population of TILs comprising:
• the method further comprises:
• step (iv) performing an additional second expansion by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger population of TILs than obtained in step (iii), wherein the larger population of TILs comprises an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs, and wherein the third population is further assayed for viability.
• the cells prior to step (i), are cryopreserved. [0063] In some embodiments, the cells are thawed prior to performing step (i).
• step (iv) is repeated one to four times in order to obtain sufficient TILs for analysis.
• steps (i) through (iii) or (iv) are performed within a period of about 40 days to about 50 days.
• steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 48 days.
• steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 45 days.
• steps (i) through (iii) or (iv) are performed within about 44 days.
• the cells from steps (iii) or (iv) express CD4, CD8, and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the antigen presenting cells are peripheral blood
• PBMCs mononuclear cells
• the PBMCs are added to the cell culture on any of days 9 through 17 in step (iii).
• the effector T cells and/or central memory T cells in the larger population of TILs in step (iv) exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells, and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the APCs are artificial APCs (aAPCs).
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high- affinity T cell receptor.
• the step of transducing occurs before step (i).
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising a single chain variable fragment antibody fused with at least one endodomain of a T-cell signaling molecule.
• CAR chimeric antigen receptor
• step of transducing occurs before step (i).
• the TILs are assayed for viability.
• the TILs are assayed for viability after cryopreservation.
• the TILs are assayed for viability after cryopreservation and after step (iv).
• a method for assaying TILs for viability and/or further use in administration to a subject comprises:
• step (viii) determining based on the ratio in step (vii) whether the thawed population of TILs is suitable for administration to a patient;
• step (ix) administering a therapeutically effective dosage of the thawed third population of TILs to the patient when the ratio of the number of TILs in the fourth population of TILs to the number of TILs in the third population of TILs is determined to be greater than 5 : 1 in step (viii).
• the reREP period is performed until the ratio of the number of TILs in the fourth population of TILs to the number of TILs in the third population of TILs is greater than 50: 1.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 lO 10 to about 13.7x l0 10 .
• steps (i) through (vii) are performed within a period of about 40 days to about 50 days. In some embodiments, steps (i) through (vii) are performed within a period of about 42 days to about 48 days. In some embodiments, steps (i) through (vii) are performed within a period of about 42 days to about 45 days. In some embodiments, steps (i) through (vii) are performed within about 44 days.
• the cells from steps (iii) or (vii) express CD4, CD8, and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the cells are TILs.
• the antigen presenting cells are peripheral blood
• PBMCs mononuclear cells
• the PBMCs are added to the cell culture on any of days 9 through 17 in step (iii).
• the effector T cells and/or central memory T cells in the larger population of TILs in steps (iii) or (vii) exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells, and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the APCs are artificial APCs (aAPCs).
• the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high-affinity T cell receptor occurs before step (i).
• the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising a single chain variable fragment antibody fused with at least one endodomain of a T-cell signaling molecule.
• CAR chimeric antigen receptor
• step of transducing occurs before step (i).
• the TILs are assayed for viability after step (vii).
• the present disclosure also provides further methods for assaying TILs.
• the disclosure provides a method for assaying TILs comprising:
• step (iv) determining based on the ratio in step (iii) whether the first population of TILs is suitable for use in therapeutic administration to a patient;
• step (v) determining the first population of TILs is suitable for use in therapeutic administration when the ratio of the number of TILs in the second population of TILs to the number of TILs in the first population of TILs is determined to be greater than 5: 1 in step (iv).
• the ratio of the number of TILs in the second population of TILs to the number of TILs in the portion of the first population of TILs is greater than 50: 1.
• the method further comprises performing expansion of the entire first population of cryopreserved TILs from step (i) according to the methods as described in any of the embodiments provided herein. [0099] In some embodiments, the method further comprises administering the entire first population of cryopreserved TILs from step (i) to the patient.
• the present disclosure also provides further methods for assaying TILs.
• the disclosure provides a method for assaying TILs comprising:
• step (iv) determining based on the ratio in step (iii) whether the first population of TILs is suitable for use in therapeutic administration to a patient;
• step (v) therapeutically administering the remainder of the first population of TILs to the patient when the ratio of the number of TILs in the second population of TILs to the number of TILs in the first population of TILs is determined to be greater than 5: 1 in step (iv).
• the ratio of the number of TILs in the second population of TILs to the number of TILs in the portion of the first population of TILs is greater than 50: 1.
• the method further comprises performing expansion of the entire first population of cryopreserved TILs from step (i) according to the methods of any of the preceding claims.
• the method further comprises administering the entire first population of cryopreserved TILs from step (i) to the patient.
• the method further comprised the step of assessing the metabolic health of the second population of TILs.
• the method further comprises the step of assessing the phenotype of the second population of TILs.
• the antigen presenting cells are allogeneic peripherial blood mononuclear cells.
• REREP antigen restimulation rapid expansion protocol
• FIG. 2 Composition of fresh vs. thawed TIL. TIL were stained for TCR P and CD56 to define T-cell and NK populations. The data shown are averages of 6 individual TILs.
• FIG. 3 Memory phenotype is defined by CD45RA and CCR7 Expression.
• CD4 and CD8 TIL are mainly Effector Memory (EM) This remains the same in the thawed TIL. Each point is one sample analyzed. No significant difference is found in a Wilcoxon matched-pairs signed rank test.
• Figure 4 Pearson's correlation of CD4, CD8, CD4+CD28+, and CD8+CD28+ frequency between fresh and thawed TIL. Cells were stained with above markers. Each dot represents one individual with the fresh value on the x axis and the thawed value on the y axis. The fit line was drawn using linear regression analysis.
• Figure 5 Comparable Activation Markers on Fresh and Thawed TILs. No significant difference in activation status of fresh vs. thawed TIL was found using a
• Figure 6 Maintenance of LAG-3 Staining Following Cryopreservation and Thaw.
• A LAG-3 staining of CD8 TIL.
• B % frequency of regulatory molecules of the CD4 and CD 8 populations on fresh and thawed TIL.
• CD8+TIM-3+ and CD8+LAG-3+ thawed TIL have a lower % than fresh TIL. Mann-Whitney statistical test.
• FIG. 7 Remarkably stable tumor-infiltrating lymphocytes (TIL) for infusion phenotype following cryopreservation.
• Figure 8 Scatter plot showing phenotypic characterization of reREP TILs.
• Ql shows 19.0% CD45RA + /CCR7 " ;
• Q2 shows 0.066% CD45RA + /CCR7 + ;
• Q4 shows 80.6% CD45RA7CCR7 " ;
• Q3 shows 0.36% CD45RA7CCR7 +
• Figure 9 Diagram and data showing the phenotypic characterization of reREP TILs, during the first and second expansion phases 0.08% CD45RA + /CCR7 " ; 0.03%
• CM Central Memory
• EM Effector Memory
• central memory TIL and effector memory TIL were gated for L/D Aqua-/CFSE-/TCRa/p +/CD45RA-/CCR7+ and L/D Aqua- /CFSE-/TCRa/p +/CD45RA-/CCR7- population respectively and flow cytometry sorted. Purity of the cell population was 97%. 1 x 10 4 flow sorted CM or EM or unsorted TIL were then cultured 1 x 10 6 PBMC feeders, OKT3 (30 ng/nl) and IL-2 (3000 IU/ml) in triplicates for 7 days. Cell were counted and recorded. Central memory TIL were more proliferative when compared to Effector memory TIL. We are repeating this experiment with more post REP TIL lines.
• FIG. 10A and 10B Phenotypic characterization of TILs during ReREP.
• Cells were gated on AquaVTCR a/p+/CD4+ or CD8+ to show Central Memory TILs (CD45RA " CCR7 + ) or Effector Memory TILs (CD45RA " CCR7-) memory phenotype.
• Student "t” was used to calculate statistical significance. *p ⁇ 0.05, ns non-significant.
• FIG 11 Exemplary schematic of the TIL preparation process, sometimes referred to herein as the 1C process.
• FIG. 12 Successful expansion of TILs from non-melanoma tumors. Data shows the distribution of TIL (CD4+/CD8+) in non-melanoma tumors.
• Figure 13 Non-melanoma TILs expressed CD27 and CD38, consistent with young TILs.
• Figure 14 Activated TILs skew towards effector memory population.
• Figure 15 Fresh versus reREP TIL phenotypes. DETAILED DESCRIPTION OF THE INVENTION
• T cells undergo a profound metabolic shift during the course of their maturation from naive to effector T cells (see Chang, et al. , Nat. Immunol. 2016, 17, 364, hereby expressly incorporated in its entirety, and in particular for the discussion and markers of anaerobic and aerobic metabolism).
• naive T cells rely on mitochondrial respiration to produce ATP
• mature, healthy effector T cells such as TIL are highly glycolytic, relying on aerobic glycolysis to provide the bioenergetics substrates they require for proliferation, migration, activation, and anti-tumor efficacy.
• the present invention is directed in preferred aspects to novel methods of augmenting REPs with an additional restimulation protocol, sometimes referred to herein as a "restimulation Rapid Expansion Protocol” or "reREP", which leads surprisingly to expanded memory T cell subsets, including the central memory (CD45RA " CCR7 + ) or effector memory (CD45RA " CCR7 “ ) phenotypes, and/or to marked enhancement in the glycolytic respiration as compared to freshly harvested TILs or thawed cryopreserved TILs for the restimulated TILs (sometimes referred to herein as "reTILs"). That is, by using a reREP procedure (i.e.
• the present invention provides methods of assaying the relative health of a TIL population using one or more general evaluations of metabolism, including, but not limited to, rates and amounts of glycolysis, oxidative phosphorylation, spare respiratory capacity (SRC) and glycolytic reserve.
• SRC spare respiratory capacity
• the present invention is further directed in some embodiments to methods for evaluating and quantifying this increase in metabolic health.
• the present invention provides methods of assaying the relative health of a TIL population using one or more general evaluations of metabolism, including, but not limited to, rates and amounts of glycolysis, oxidative phosphorylation, spare respiratory capacity (SRC), and glycolytic reserve.
• optional additional evaluations include, but are not limited to, ATP production, mitochondrial mass and glucose uptake.
• the reREP cell population with increased metabolic health are infused into a patient as is generally known in the art.
• TILs tumor infiltrating lymphocytes
• TILs include, but are not limited to, CD8+ cytotoxic T cells
• TILs include both primary and secondary TILs.
• Primary TILs are those that are obtained from patient tissue samples as outlined herein (sometimes referred to as “freshly harvested")
• secondary TILs are any TIL cell populations that have been expanded or proliferated as discussed herein, including, but not limited to bulk TILs, expanded TILs ("REP TILs”) as well as “reREP TILs” as discussed herein.
• TILs can generally be defined either biochemically, using cell surface markers, or functionally, by their ability to infiltrate tumors and effect treatment.
• TILs can be generally categorized by expressing one or more of the following biomarkers: CD4, CD8, TCR ⁇ , CD27, CD28, CD56, CCR7, CD45Ra, CD95, PD-1, and CD25. Additionally, and alternatively, TILs can be functionally defined by their ability to infiltrate solid tumors upon reintroduction into a patient.
• TILS may further be characterized by potency - for example, TILS may be considered potent if, for example, interferon (IFN) release is greater than about 50 pg/mL, greater than about 100 pg/mL, greater than about 150 pg/mL, or greater than about 200 pg/mL.
• Interferon can include interferon gamma (IFNy).
• cryopreserved TILs herein is meant that TILs, either primary, bulk, or expanded (REP TILs), are treated and stored in the range of about -150°C to -60°C. General methods for cryopreservation are also described elsewhere herein, including in the Examples. For clarity, “cryopreserved TILs” are distinguishable from frozen tissue samples which may be used as a source of primary TILs.
• cryopreserved TILs herein is meant a population of TILs that was previously cryopreserved and then treated to return to room temperature or higher, including but not limited to cell culture temperatures or temperatures wherein TILs may be
• population of cells including TILs
• populations generally range from 1 X 10 6 to 1 X 10 10 in number, with different TIL populations comprising different numbers.
• initial growth of primary TILs in the presence of IL-2 results in a population of bulk TILs of roughly 1 ⁇ 10 8 cells.
• REP expansion is generally done to provide populations of 1.5 ⁇ 10 9 to 1.5 x 10 10 cells for infusion.
• TILs are initially obtained from a patient tumor sample ("primary TILs") and then expanded into a larger population for further manipulation as described herein, optionally cryopreserved, restimulated as outlined herein and optionally evaluated for phenotype and metabolic parameters as an indication of TIL health.
• the harvested cell suspension is called a "primary cell population" or a “freshly harvested” cell population.
• the TILs are initially prepared by obtaining a primary population of TILs from a tumor resected from a patient as discussed herein (the "primary cell population” or “first cell population”). This is followed with an initial bulk expansion utilizing a culturing of the cells with IL-2, forming a second population of cells (sometimes referred to herein as the "bulk TIL population” or “second population”).
• cytotoxic lymphocyte includes cytotoxic T (CTL) cells (including CD8 + cytotoxic T lymphocytes and CD4 + T-helper lymphocytes), natural killer T (NKT) cells and natural killer (NK) cells.
• CTL cytotoxic T
• NKT natural killer T
• NK natural killer cells
• cytotoxic lymphocytes can include, for example, peripheral blood- derived a/pTCR-positive or a/pTCR-positive T cells activated by tumor associated antigens and/or transduced with tumor specific chimeric antigen receptors or T-cell receptors, and tumor-infiltrating lymphocytes (TILs).
• TILs tumor-infiltrating lymphocytes
• central memory T cell refers to a subset of T cells that in the human are CD45RO+ and constitutively express CCR7 (CCR7 hi) and CD62L (CD62 hi).
• the surface phenotype of central memory T cells also includes TCR, CD3, CD127 (IL-7R), and IL-15R. Transcription factors for central memory T cells include BCL-6, BCL-6B, MBD2, and ⁇ .
• Central memory T cells primarily secret IL-2 and CD40L as effector molecules after TCR triggering.
• Central memory T cells are predominant in the CD4 compartment in blood, and in the human are proportionally enriched in lymph nodes and tonsils.
• effector memory T cell refers to a subset of human or mammalian T cells that, like central memory T cells, are CD45R0+, but have lost the constitutive expression of CCR7 (CCR71o) and are heterogeneous or low for CD62L expression
• central memory T cells The surface phenotype of central memory T cells also includes TCR, CD3, CD 127 (IL-7R), and IL-15R. Transcription factors for central memory T cells include BLIMP 1. Effector memory T cells rapidly secret high levels of inflammatory cytokines following antigenic stimulation, including interferon- ⁇ , IL-4, and IL-5. Effector memory T cells are predominant in the CD8 compartment in blood, and in the human are proportionally enriched in the lung, liver, and gut. CD8+ effector memory T cells carry large amounts of perforin.
• closed system refers to a system that is closed to the outside
• Closed systems include, for example, but are not limited to closed G-containers. Once a tumor segment is added to the closed system, the system is no opened to the outside environment until the TILs are ready to be administered to the patient.
• peripheral blood mononuclear cells and "PBMCs” refers to a peripheral blood cell having a round nucleus, including lymphocytes (T cells, B cells, K cells) and monocytes.
• lymphocytes T cells, B cells, K cells
• monocytes preferably, monocytes.
• the peripheral blood mononuclear cells are irradiated allogeneic peripheral blood mononuclear cells.
• rapid expansion means an increase in the number of antigen-specific TILs of at least about 3 -fold (or 4-, 5-, 6-, 7-, 8-, or 9-fold) over a period of a week, more preferably at least about 10-fold (or 20-, 30-, 40-, 50-, 60-, 70-, 80-, or 90-fold) over a period of a week, or most preferably at least about 100-fold over a period of a week.
• rapid expansion protocols are described herein.
• methods of the present disclosure further include a "pre- REP" stage in which tumor tissue or cells from tumor tissue are grown in standard lab media (including without limitation RPMI) and treated the with reagents such as irradiated feeder cells and anti-CD3 antibodies to achieve a desired effect, such as increase in the number of TILS and/or an enrichment of the population for cells containing desired cell surface markers or other structural, biochemical or functional features.
• the pre-REP stage may utilize lab grade reagents (under the assumption that the lab grade reagents get diluted out during a later REP stage), making it easier to incorporate alternative strategies for improving TIL production. Therefore, in some embodiments, the disclosed TLR agonist and/or peptide or peptidomimetics can be included in the culture medium during the pre-REP stage.
• the pre- REP culture can in some embodiments, include IL-2.
• the present invention is directed in preferred aspects to novel methods of augmenting REPs with an additional restimulation protocol, sometimes referred to herein as a "restimulation Rapid Expansion Protocol” or "reREP", which leads surprisingly to expanded memory T cell subsets, including the memory effector T cell subset, and/or to marked enhancement in the glycolytic respiration as compared to freshly harvested TILs or thawed cryopreserved TILs for the restimulated TILs (sometimes referred to herein as "reTILs"). That is, by using a reREP procedure on cryopreserved TILs, patients can receive highly metabolically active, healthy TILs, leading to more favorable outcomes.
• Such restimulation protocols also referred to herein as additional “expansions" of the cell populations, are described in further detail herein.
• fragmenting includes mechanical fragmentation methods such as crushing, slicing, dividing, and morcellating tumor tissue as well as any other method for disrupting the physical structure of tumor tissue.
• in vivo refers to an event that takes place in a subject's body.
• in vitro refers to an event that takes places outside of a subject's body. In vitro assays encompass cell-based assays in which cells alive or dead are employed and may also encompass a cell-free assay in which no intact cells are employed.
• anti-CD3 antibody refers to an antibody or variant thereof, e.g., a monoclonal antibody and including human, humanized, chimeric or murine antibodies which are directed against the CD3 receptor in the T cell antigen receptor of mature T cells.
• Anti- CD3 antibodies include OKT-3, also known as muromonab, and UCHT-1.
• Other anti-CD3 antibodies include, for example, otelixizumab, teplizumab, and visilizumab.
• OKT-3 refers to a monoclonal antibody or biosimilar or variant thereof, including human, humanized, chimeric, or murine antibodies, directed against the CD3 receptor in the T cell antigen receptor of mature T cells, and includes commercially-available forms such as OKT-3 (30 ng/mL, MACS GMP CD3 pure, Miltenyi Biotech, Inc., San Diego, CA, USA) and muromonab or variants, conservative amino acid substitutions, glycoforms, or biosimilars thereof.
• the amino acid sequences of the heavy and light chains of muromonab are given in Table 1 (SEQ ID NO: l and SEQ ID NO: 2).
• a hybridoma capable of producing OKT-3 is deposited with the American Type Culture Collection and assigned the ATCC accession number CRL 8001.
• a hybridoma capable of producing OKT-3 is also deposited with European Collection of Authenticated Cell Cultures (ECACC) and assigned Catalogue No. 86022706.
• IL-2 refers to the T cell growth factor known as interleukin-2, and includes all forms of IL-2 including human and mammalian forms, conservative amino acid substitutions, glycoforms, biosimilars, and variants thereof.
• IL-2 is described, e.g., in Nelson, I. Immunol. 2004, 172, 3983-88 and Malek, Annu. Rev. Immunol. 2008, 26, 453-79, the disclosures of which are incorporated by reference herein.
• the amino acid sequence of recombinant human IL-2 suitable for use in the invention is given in Table 2 (SEQ ID NO:3).
• IL-2 encompasses human, recombinant forms of IL-2 such as aldesleukin (PROLEUKIN, available commercially from multiple suppliers in 22 million IU per single use vials), as well as the form of recombinant IL-2 commercially supplied by CellGenix, Inc., Portsmouth, NH, USA (CELLGRO GMP) or ProSpec-Tany TechnoGene Ltd., East Brunswick, NJ, USA (Cat No. CYT-209-b) and other commercial equivalents from other vendors.
• Aldesleukin (des-alanyl-1, serine-125 human IL- 2) is a nonglycosylated human recombinant form of IL-2 with a molecular weight of approximately 15 kDa.
• IL-2 also encompasses pegylated forms of IL-2, as described herein, including the pegylated IL2 prodrug NKTR-214, available from Nektar Therapeutics, South San Francisco, CA, USA.
• NKTR-214 and pegylated IL-2 suitable for use in the invention is described in U.S. Patent Application Publication No. US 2014/0328791 Al and International Patent Application Publication No. WO 2012/065086 Al, the disclosures of which are incorporated by reference herein.
• Alternative forms of conjugated IL-2 suitable for use in the invention are described in U. S. Patent Nos.
• IL-4" refers to the cytokine known as interleukin 4, which is produced by Th2 T cells and by eosinophils, basophils, and mast cells.
• IL-4 regulates the differentiation of naive helper T cells (ThO cells) to Th2 T cells. Steinke and Borish, Respir. Res. 2001, 2, 66-70.
• Th2 T cells Upon activation by IL-4, Th2 T cells subsequently produce additional IL-4 in a positive feedback loop.
• IL-4 also stimulates B cell proliferation and class II MHC expression, and induces class switching to IgE and IgGl expression from B cells.
• Recombinant human IL-4 suitable for use in the invention is commercially available from multiple suppliers, including ProSpec-Tany TechnoGene Ltd., East Brunswick, NJ, USA (Cat. No. CYT-211) and ThermoFisher Scientific, Inc., Waltham, MA, USA (human IL-15 recombinant protein, Cat. No. Gibco CTP0043).
• the amino acid sequence of recombinant human IL-4 suitable for use in the invention is given in Table 2 (SEQ ID NO:5).
• IL-7 refers to a glycosylated tissue- derived cytokine known as interleukin 7, which may be obtained from stromal and epithelial cells, as well as from dendritic cells. Fry and Mackall, Blood 2002, 99, 3892-904. IL-7 can stimulate the development of T cells. IL-7 binds to the IL-7 receptor, a heterodimer consisting of IL-7 receptor alpha and common gamma chain receptor, which in a series of signals important for T cell development within the thymus and survival within the periphery.
• Recombinant human IL-4 suitable for use in the invention is commercially available from multiple suppliers, including ProSpec-Tany TechnoGene Ltd., East Brunswick, NJ, USA (Cat. No. CYT-254) and ThermoFisher Scientific, Inc., Waltham, MA, USA (human IL-15 recombinant protein, Cat. No. Gibco PHC0071).
• the amino acid sequence of recombinant human IL-7 suitable for use in the invention is given in Table 2 (SEQ ID NO:6).
• IL-15 refers to the T cell growth factor known as interleukin- 15, and includes all forms of IL-2 including human and mammalian forms, conservative amino acid substitutions, glycoforms, biosimilars, and variants thereof.
• IL-15 is described, e.g., in Fehniger and Caligiuri, Blood 2001, 97, 14-32, the disclosure of which is incorporated by reference herein.
• IL-15 shares ⁇ and ⁇ signaling receptor subunits with IL-2.
• Recombinant human IL-15 is a single, non-glycosylated polypeptide chain containing 114 amino acids (and an N-terminal methionine) with a molecular mass of 12.8 kDa.
• Recombinant human IL-15 is commercially available from multiple suppliers, including ProSpec-Tany TechnoGene Ltd., East Brunswick, NJ, USA (Cat. No. CYT-230-b) and ThermoFisher Scientific, Inc., Waltham, MA, USA (human IL-15 recombinant protein, Cat. No. 34-8159-82).
• the amino acid sequence of recombinant human IL-15 suitable for use in the invention is given in Table 2 (SEQ ID NO:7).
• IL-21 refers to the pleiotropic cytokine protein known as interleukin-21, and includes all forms of IL-21 including human and mammalian forms, conservative amino acid substitutions, glycoforms, biosimilars, and variants thereof. IL-21 is described, e.g., in Spolski and Leonard, Nat. Rev. Drug. Disc. 2014, 13, 379-95, the disclosure of which is incorporated by reference herein.
• IL-21 is primarily produced by natural killer T cells and activated human CD4+ T cells
• Recombinant human IL-21 is a single, non-glycosylated polypeptide chain containing 132 amino acids with a molecular mass of 15.4 kDa.
• Recombinant human IL-21 is commercially available from multiple suppliers, including ProSpec-Tany TechnoGene Ltd., East Brunswick, NJ, USA (Cat. No. CYT-408-b) and ThermoFisher Scientific, Inc., Waltham, MA, USA (human IL-21 recombinant protein, Cat. No. 14-8219-80).
• the amino acid sequence of recombinant human IL-21 suitable for use in the invention is given in Table 2 (SEQ ID NO: 8).
• an anti-tumor effective amount When “an anti-tumor effective amount”, “an tumor-inhibiting effective amount”, or “therapeutic amount” is indicated, the precise amount of the compositions of the present invention to be administered can be determined by a physician with consideration of individual differences in age, weight, tumor size, extent of infection or metastasis, and condition of the patient (subject).
• a pharmaceutical composition comprising the genetically modified cytotoxic lymphocytes described herein may be administered at a dosage of 10 4 to 10 11 cells/kg body weight (e.g., 10 5 to 10 6 , 10 5 to 10 10 , 10 5 to 10 11 , 10 6 to 10 10 , 10 6 to 10 u , 10 7 to 10 11 , 10 7 to 10 10 , 10 8 to 10 11 , 10 8 to 10 10 , 10 9 to 10 11 , or 10 9 to 10 10 cells/kg body weight), including all integer values within those ranges.
• 10 4 to 10 11 cells/kg body weight e.g., 10 5 to 10 6 , 10 5 to 10 10 , 10 5 to 10 11 , 10 6 to 10 10 , 10 6 to 10 u , 10 7 to 10 11 , 10 7 to 10 10 , 10 8 to 10 11 , 10 8 to 10 10 , 10 9 to 10 11 , or 10 9 to 10 10 cells/kg body weight
• Genetically modified cytotoxic lymphocytes compositions may also be administered multiple times at these dosages.
• the genetically modified cytotoxic lymphocytes can be administered by using infusion techniques that are commonly known in immunotherapy (see, e.g., Rosenberg et al., New Eng. J. of Med. 319: 1676, 1988).
• the optimal dosage and treatment regime for a particular patient can readily be determined by one skilled in the art of medicine by monitoring the patient for signs of disease and adjusting the treatment accordingly.
• hematological malignancy refers to mammalian cancers and tumors of the hematopoietic and lymphoid tissues, including but not limited to tissues of the blood, bone marrow, lymph nodes, and lymphatic system.
• Hematological malignancies are also referred to as "liquid tumors.” Hematological malignancies include, but are not limited to, acute lymphoblastic leukemia (ALL), chronic lymphocytic lymphoma (CLL), small lymphocytic lymphoma (SLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute monocytic leukemia (AMoL), Hodgkin's lymphoma, and non- Hodgkin's lymphomas.
• ALL acute lymphoblastic leukemia
• CLL chronic lymphocytic lymphoma
• SLL small lymphocytic lymphoma
• AML acute myelogenous leukemia
• CML chronic myelogenous leukemia
• AoL acute monocytic leukemia
• Hodgkin's lymphoma and non- Hodgkin's lymphomas.
• B cell hematological malignancy refers to hematological
• Solid tumors may be benign or malignant.
• the term "solid tumor cancer” refers to malignant, neoplastic, or cancerous solid tumors.
• Solid tumor cancers include, but are not limited to, sarcomas, carcinomas, and lymphomas, such as cancers of the lung, breast, prostate, colon, rectum, and bladder.
• the tissue structure of solid tumors includes interdependent tissue compartments including the parenchyma (cancer cells) and the supporting stromal cells in which the cancer cells are dispersed and which may provide a supporting microenvironment.
• liquid tumor refers to an abnormal mass of cells that is fluid in nature.
• Liquid tumor cancers include, but are not limited to, leukemias, myelomas, and lymphomas, as well as other hematological malignancies.
• TILs obtained from liquid tumors may also be referred to herein as marrow infiltrating lymphocytes (MILs).
• MILs marrow infiltrating lymphocytes
• microenvironment may refer to the solid or
• the tumor microenvironment refers to a complex mixture of "cells, soluble factors, signaling molecules, extracellular matrices, and mechanical cues that promote neoplastic transformation, support tumor growth and invasion, protect the tumor from host immunity, foster therapeutic resistance, and provide niches for dominant metastases to thrive," as described in Swartz, et al, Cancer Res., 2012, 72, 2473.
• tumors express antigens that should be recognized by T cells, tumor clearance by the immune system is rare because of immune suppression by the microenvironment.
• the invention includes a method of treating a cancer with a population of rTILs, wherein a patient is pre-treated with non-myeloablative chemotherapy prior to an infusion of rTILs according to the invention.
• the population of rTILs may be provided with a population of eTils, wherein a patient is pre-treated with nonmyeloablative chemotherapy prior to an infusion of rTILs and eTils according to the invention.
• the non-myeloablative chemotherapy is cyclophosphamide 60 mg/kg/d for 2 days (days 27 and 26 prior to rTIL infusion) and fludarabine 25 mg/m2/d for 5 days (days 27 to 23 prior to rTIL infusion).
• the patient receives an intravenous infusion of IL-2 intravenously at 720,000 IU/kg every 8 hours to physiologic tolerance.
• some embodiments of the invention utilize a lymphodepletion step (sometimes also referred to as “immunosuppressive conditioning") on the patient prior to the introduction of the rTILs of the invention.
• a lymphodepletion step sometimes also referred to as “immunosuppressive conditioning”
• co-administration encompass administration of two or more active pharmaceutical ingredients (in a preferred embodiment of the present invention, for example, at least one potassium channel agonist in combination with a plurality of TILs) to a subject so that both active pharmaceutical ingredients (in a preferred embodiment of the present invention, for example, at least one potassium channel agonist in combination with a plurality of TILs) to a subject so that both active pharmaceutical ingredients (in a preferred embodiment of the present invention, for example, at least one potassium channel agonist in combination with a plurality of TILs) to a subject so that both active
• Co-administration includes simultaneous administration in separate compositions, administration at different times in separate compositions, or administration in a composition in which two or more active pharmaceutical ingredients are present. Simultaneous administration in separate compositions and administration in a composition in which both agents are present are preferred.
• therapeutically effective amount may vary depending upon the intended application (in vitro or in vivo), or the subject and disease condition being treated (e.g., the weight, age and gender of the subject), the severity of the disease condition, or the manner of administration.
• the term also applies to a dose that will induce a particular response in target cells (e.g., the reduction of platelet adhesion and/or cell migration).
• the specific dose will vary depending on the particular compounds chosen, the dosing regimen to be followed, whether the compound is administered in combination with other compounds, timing of administration, the tissue to which it is administered, and the physical delivery system in which the compound is carried.
• treatment refers to obtaining a desired pharmacologic and/or physiologic effect.
• the effect may be prophylactic in terms of completely or partially preventing a disease or symptom thereof and/or may be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease.
• Treatment covers any treatment of a disease in a mammal, particularly in a human, and includes: (a) preventing the disease from occurring in a subject which may be predisposed to the disease but has not yet been diagnosed as having it;
• Treatment is also meant to encompass delivery of an agent in order to provide for a pharmacologic effect, even in the absence of a disease or condition.
• treatment encompasses delivery of a composition that can elicit an immune response or confer immunity in the absence of a disease condition, e.g., in the case of a vaccine.
• heterologous when used with reference to portions of a nucleic acid or protein indicates that the nucleic acid or protein comprises two or more subsequences that are not found in the same relationship to each other in nature.
• the nucleic acid is typically recombinantly produced, having two or more sequences from unrelated genes arranged to make a new functional nucleic acid, e.g., a promoter from one source and a coding region from another source, or coding regions from different sources.
• a heterologous protein indicates that the protein comprises two or more subsequences that are not found in the same relationship to each other in nature (e.g., a fusion protein).
• sequence identity refers to two or more sequences or subsequences that are the same or have a specified percentage of nucleotides or amino acid residues that are the same, when compared and aligned (introducing gaps, if necessary) for maximum correspondence, not considering any conservative amino acid substitutions as part of the sequence identity.
• the percent identity can be measured using sequence comparison software or algorithms or by visual inspection. Various algorithms and software are known in the art that can be used to obtain alignments of amino acid or nucleotide sequences. Suitable programs to determine percent sequence identity include for example the BLAST suite of programs available from the U. S. Government' s National Center for Biotechnology Information BLAST web site.
• Comparisons between two sequences can be carried using either the BLASTN or BLASTP algorithm.
• BLASTN is used to compare nucleic acid sequences
• BLASTP is used to compare amino acid sequences.
• ALIGN, ALIGN-2 (Genentech, South San Francisco, California) or MegAlign, available from DNASTAR, are additional publicly available software programs that can be used to align sequences.
• One skilled in the art can determine appropriate parameters for maximal alignment by particular alignment software. In certain embodiments, the default parameters of the alignment software are used.
• the term "variant" encompasses but is not limited to antibodies or fusion proteins which comprise an amino acid sequence which differs from the amino acid sequence of a reference antibody by way of one or more substitutions, deletions and/or additions at certain positions within or adjacent to the amino acid sequence of the reference antibody.
• the variant may comprise one or more conservative substitutions in its amino acid sequence as compared to the amino acid sequence of a reference antibody. Conservative substitutions may involve, e.g., the substitution of similarly charged or uncharged amino acids.
• the variant retains the ability to specifically bind to the antigen of the reference antibody.
• the term variant also includes pegylated antibodies or proteins.
• in vivo refers to an event that takes place in a subject's body.
• in vitro refers to an event that takes places outside of a subject's body.
• in vitro assays encompass cell-based assays in which cells alive or dead are employed and may also encompass a cell-free assay in which no intact cells are employed.
• rapid expansion means an increase in the number of antigen-specific TILs of at least about 3 -fold (or 4-, 5-, 6-, 7-, 8-, or 9-fold) over a period of a week, more preferably at least about 10-fold (or 20-, 30-, 40-, 50-, 60-, 70-, 80-, or 90-fold) over a period of a week, or most preferably at least about 100-fold over a period of a week.
• a number of rapid expansion protocols are outlined below.
• the present invention relates to the restimulation of cryopreserved TILs to increase their metabolic activity and thus relative health prior to transplant into a patient, and methods of testing said metabolic health.
• TILs are generally taken from a patient sample and manipulated to expand their number prior to transplant into a patient.
• the TILs may be optionally genetically manipulated as discussed below, and then cryopreserved. Once thawed, they are then restimulated to increase their metabolism prior to infusion into a patient.
• TILs are initially obtained from a patient tumor sample ("primary TILs") and then expanded into a larger population for further manipulation as described herein, optionally cryopreserved, restimulated as outlined herein and optionally evaluated for phenotype and metabolic parameters as an indication of TIL health.
• a patient tumor sample may be obtained using methods known in the art, generally via surgical resection, needle biopsy or other means for obtaining a sample that contains a mixture of tumor and TIL cells.
• the tumor sample may be from any solid tumor, including primary tumors, invasive tumors or metastatic tumors.
• the tumor sample may also be a liquid tumor, such as a tumor obtained from a hematological malignancy.
• the solid tumor may be of any cancer type, including, but not limited to, breast, pancreatic, prostate, colorectal, lung, brain, renal, stomach, and skin (including but not limited to squamous cell carcinoma, basal cell carcinoma, and melanoma).
• useful TILs are obtained from malignant melanoma tumors, as these have been reported to have particularly high levels of TILs.
• solid tumor refers to an abnormal mass of tissue that usually does not contain cysts or liquid areas. Solid tumors may be benign or malignant.
• solid tumor cancer refers to malignant, neoplastic, or cancerous solid tumors. Solid tumor cancers include, but are not limited to, sarcomas, carcinomas, and lymphomas, such as cancers of the lung, breast, triple negative breast cancer, prostate, colon, rectum, and bladder. In some embodiments, the cancer is selected from cervical cancer, head and neck cancer,
• tissue structure of solid tumors includes interdependent tissue compartments including the parenchyma (cancer cells) and the supporting stromal cells in which the cancer cells are dispersed and which may provide a supporting microenvironment.
• hematological malignancy refers to mammalian cancers and tumors of the hematopoietic and lymphoid tissues, including but not limited to tissues of the blood, bone marrow, lymph nodes, and lymphatic system.
• Hematological malignancies are also referred to as "liquid tumors.” Hematological malignancies include, but are not limited to, acute lymphoblastic leukemia (ALL), chronic lymphocytic lymphoma (CLL), small lymphocytic lymphoma (SLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute monocytic leukemia (AMoL), Hodgkin's lymphoma, and non- Hodgkin's lymphomas.
• ALL acute lymphoblastic leukemia
• CLL chronic lymphocytic lymphoma
• SLL small lymphocytic lymphoma
• AML acute myelogenous leukemia
• CML chronic myelogenous leukemia
• AoL acute monocytic leukemia
• Hodgkin's lymphoma and non- Hodgkin's lymphomas.
• B cell hematological malignancy refers to hematological
• the tumor sample is generally fragmented using sharp dissection into small pieces of between 1 to about 8 mm 3 , with from about 2-3 mm 3 being particularly useful.
• the TILs are cultured from these fragments using enzymatic tumor digests.
• Such tumor digests may be produced by incubation in enzymatic media (e.g., Roswell Park Memorial Institute (RPMI) 1640 buffer, 2 mM glutamate, 10 mcg/mL gentamicine, 30 units/mL of DNase and 1.0 mg/mL of collagenase) followed by mechanical dissociation (e.g., using a tissue dissociator).
• enzymatic media e.g., Roswell Park Memorial Institute (RPMI) 1640 buffer, 2 mM glutamate, 10 mcg/mL gentamicine, 30 units/mL of DNase and 1.0 mg/mL of collagenase
• Tumor digests may be produced by placing the tumor in enzymatic media and mechanically dissociating the tumor for approximately 1 minute, followed by incubation for 30 minutes at 37 °C in 5% CO2, followed by repeated cycles of mechanical dissociation and incubation under the foregoing conditions until only small tissue pieces are present.
• a density gradient separation using FICOLL branched hydrophilic polysaccharide may be performed to remove these cells.
• Alternative methods known in the art may be used, such as those described in U.S. Patent Application Publication No. 2012/0244133 Al, the disclosure of which is incorporated by reference herein. Any of the foregoing methods may be used in any of the embodiments described herein for methods of expanding TILs or methods treating a cancer.
• fragmentation includes physical fragmentation, including for example, dissection as well as digestion.
• the fragmentation is physical fragmentation.
• the fragmentation is dissection.
• the fragmentation is by digestion.
• TILs can be initially cultured from enzymatic tumor digests and tumor fragments obtained from patients.
• the tumor undergoes physical fragmentation after the tumor sample is obtained, for example such as in Step A of Figure 1 1
• the fragmentation occurs before cryopreservation.
• the fragmentation occurs after cryopreservation.
• the fragmentation occurs after obtaining the tumor and in the absence of any cryopreservation.
• the tumor is fragmented and 2, 3, or 4 fragments or pieces are placed in each container for the first expansion.
• the tumor is fragmented and 3 or 4 fragments or pieces are placed in each container for the first expansion.
• the tumor is fragmented and 4 fragments or pieces are placed in each container for the first expansion,
• the TILs are obtained from tumor fragments.
• the tumor fragment is obtained sharp dissection.
• the tumor fragment is between about 1 mm 3 and 10 mm 3 .
• the tumor fragment is between about 1 mm 3 and 8 mm 3 .
• the tumor fragment is about 1 mm 3 .
• the tumor fragment is about 2 mm 3 .
• the tumor fragment is about 3 mm 3 .
• the tumor fragment is about 4 mm 3 .
• the tumor fragment is about 5 mm 3 .
• the tumor fragment is about 6 mm 3 .
• the tumor fragment is about 7 mm 3 .
• the tumor fragment is about 8 mm 3 .
• the tumor fragment is about 9 mm 3 .
• the tumor fragment is about 10 mm 3 .
• the TILs are obtained from tumor digests.
• tumor digests were generated by incubation in enzyme media, for example but not limited to RPMI 1640, 2 mM GlutaMAX, 10 mg/mL gentamicin, 30 U/mL DNase, and 1.0 mg/mL collagenase, followed by mechanical dissociation (GentleMACS, Miltenyi Biotec, Auburn, CA). After placing the tumor in enzyme media, the tumor can be mechanically dissociated for approximately 1 minute. The solution can then be incubated for 30 minutes at 37°C in 5% CO2 and it then mechanically disrupted again for
• the tumor can be mechanically disrupted a third time for approximately 1 minute.
• 1 or 2 additional mechanical dissociations were applied to the sample, with or without 30 additional minutes of incubation at 37°C in 5% CO2.
• a density gradient separation using Ficoll can be performed to remove these cells.
• cells can be optionally frozen after sample harvest and stored frozen prior to entry into Step B, which is described in further detail below.
• a first expansion of TILs may be performed using an initial bulk TIL expansion step (for example, Step B as indicated in Figure 1 1 or a first expansion step; this can include an expansion step referred to as preREP) as described below and herein, followed by a second expansion step (for example, Step D as indicated in Figure 1 1 ; which can include as an example what is referred to as a rapid expansion protocol (REP) step) as described below and herein, followed by optional cryopreservation (for example, after Step D as indicated in Figure 1 1), and followed by an additional second expansion (for example, a second Step D, as indicated in Figure 1 1, which can include what is sometimes referred to as a restimulation REP step) as described below and herein.
• an initial bulk TIL expansion step for example, Step B as indicated in Figure 1 1 or a first expansion step; this can include an expansion step referred to as preREP) as described below and herein
• a second expansion step for example, Step D as indicated in Figure 1 1 ; which can include as an example
• the TILs obtained from this process may be optionally characterized for phenotypic characteristics and metabolic parameters as described herein.
• the TILs are frozen (i.e., cry opre served) after the first expansion (for example, Step B as indicated in Figure 11) and stored until phenotyped for selection then thawed prior to proceeding to one or more second expansion steps (for example, one or more expansion according to Step D as indicated in Figure 11).
• the cells are frozen after obtained from the tumor sample (such as, for example, during in Step A as indicated in Figure 11), the cells are thawed prior to the first expansion (for example, Step B as indicated in Figure 11).
• each well can be seeded with lxlO 6 tumor digest cells or one tumor fragment in 2 mL of complete medium (CM) with IL-2 (6000 KJ/mL; Chiron Corp., Emeryville, CA).
• CM complete medium
• IL-2 6000 KJ/mL
• the tumor fragment is between about 1mm 3 and 10 mm 3 .
• the resulting cells are cultured in serum containing IL-2 under conditions that favor the growth of TILs over tumor and other cells.
• the tumor digests are incubated in 2 mL wells in media comprising inactivated human AB serum (or, in some cases, as outlined herein, in the presence of aAPC cell population) with 6000 IU/mL of IL-2.
• This primary cell population is cultured for a period of days, generally from 10 to 14 days, resulting in a bulk TIL
• the growth media during the first expansion comprises IL-2 or a variant thereof.
• the IL is recombinant human IL-2 (rhIL-2).
• the IL-2 stock solution has a specific activity of 20-30xl0 6 IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 20-xlO 6 IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 25x10 s IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 30xl0 6 IU/mg for a 1 mg vial. In some embodiments, the IL- 2 stock solution has a final concentration of 4-8xl0 6 IU/mg of IL-2. In some embodiments, the IL- 2 stock solution has a final concentration of 5-7xl0 6 IU/mg of IL-2. In some embodiments, the IL- 2 stock solution has a final concentration of 6xl0 6 IU/mg of IL-2. In some embodiments, the IL-2 stock solution is prepare as described in Example 4.
• first expansion culture media comprises about 10,000 IU/mL of IL-2, about 9,000 IU/mL of IL-2, about 8,000 IU/mL of IL-2, about 7,000 IU/mL of IL-2, about 6000 IU/mL of IL-2 or about 5,000 IU/mL of IL-2. In some embodiments, first expansion culture media comprises about 9,000 IU/mL of IL-2, to about 5,000 IU/mL of IL- 2. In some embodiments, first expansion culture media comprises about 8,000 IU/mL of IL-2, to about 6,000 IU/mL of IL-2.
• first expansion culture media comprises about 7,000 IU/mL of IL-2, to about 6,000 IU/mL of IL-2. In some embodiments, first expansion culture media comprises about 6,000 IU/mL of IL-2. In an embodiment, the cell culture medium further comprises IL-2. In some embodiments, the cell culture medium comprises about 3000 IU/mL of IL-2.
• the cell culture medium comprises about 1000 IU/mL, about 1500 IU/mL, about 2000 IU/mL, about 2500 IU/mL, about 3000 IU/mL, about 3500 IU/mL, about 4000 IU/mL, about 4500 IU/mL, about 5000 IU/mL, about 5500 IU/mL, about 6000 IU/mL, about 6500 IU/mL, about 7000 IU/mL, about 7500 IU/mL, or about 8000 IU/mL of IL-2.
• the cell culture medium comprises between 1000 and 2000 IU/mL, between 2000 and 3000 IU/mL, between 3000 and 4000 IU/mL, between 4000 and 5000 IU/mL, between 5000 and 6000 IU/mL, between 6000 and 7000 IU/mL, between 7000 and 8000 IU/mL, or between 8000 IU/mL of IL-2.
• the first expansion culture medium is referred to as "CM", an abbreviation for culture media. In some embodiments, it is referred to as CM1 (culture medium 1). In some embodiments, CM consists of RPMI 1640 with GlutaMAX,
• each flask was loaded with 10-40x 10 6 viable tumor digest cells or 5-30 tumor fragments in 10-40mL of CM with IL-2.
• the CM is the CM1 described in the Examples, see, Example 5.
• the first expansion occurs in an initial cell culture medium or a first cell culture medium.
• the initial cell culture medium or the first cell culture medium comprises IL-2.
• the first TIL expansion can proceed for 11 days, 12 days, 13 days, 14 days, 15 days, 16 days, 17 days, 18 days, 19 days, 20 days, or 21 days. In some embodiments, the first TIL expansion can proceed for 11 days to 21 days. In some embodiments, the first TIL expansion can proceed for 12 days to 21 days. In some embodiments, the first TIL expansion can proceed for 13 days to 21 days. In some embodiments, the first TIL expansion can proceed for 14 days to 21 days. In some embodiments, the first TIL expansion can proceed for 15 days to 21 days. In some embodiments, the first TIL expansion can proceed for 16 days to 21 days. In some embodiments, the first TIL expansion can proceed for 17 days to 21 days.
• the first TIL expansion can proceed for 18 days to 21 days. In some embodiments, the first TIL expansion can proceed for 19 days to 21 days. In some embodiments, the first TIL expansion can proceed for 20 days to 21 days. In some embodiments, the first TIL expansion can proceed for 21 days
• the TILs obtained from the first expansion are stored until phenotyped for selection.
• the TILs obtained from the first expansion are cryopreserved after the first expansion and prior to the second expansion.
• the TILs are cryopreserved after the first expansion and prior to the second expansion.
• the TILs are cryopreserved as part of the first expansion to second expansion transition.
• the TILs are cryopreserved after Step B and before Step D as indicated in Figure 1 1.
• the TILs are cryopreserved and thawed as part of the first expansion to second expansion transition.
• the TILs are cryopreserved after Step B then thawed prior to proceeding to Step D (as provided in Figure 11).
• the transition from the first expansion to the second expansion occurs at about 22 days, 23, days, 24 days, 25 days, 26 days, 27 days, 28 days, 29 days, or 30 days from when fragmentation occurs.
• the transition from the first expansion to the second expansion occurs at about 22 days to 30 days from when
• the transition from the first expansion to the second expansion occurs at about 24 days to 30 days from when fragmentation occurs. In some embodiments, the transition from the first expansion to the second expansion occurs at about 26 days to 30 days from when fragmentation occurs. In some embodiments, the transition from the first expansion to the second expansion occurs at about 28 days to 30 days from when fragmentation occurs. In some embodiments, the transition from the first expansion to the second expansion occurs at about 30 days from when fragmentation occurs.
• the second expansion or second TIL expansion (which can include expansions sometimes referred to as REP) of TIL can be performed using any TIL flasks or containers known by those of skill in the art.
• the second TIL expansion can proceed for 14 days, 15 days, 16 days, 17 days, 18 days, 19 days, 20 days, 21 days, or 22 days.
• the second TIL expansion can proceed for about 14 days to about 22 days.
• the second TIL expansion can proceed for about 14 days to about 20 days.
• the second TIL expansion can proceed for about 14 days to about 18 days.
• the second TIL expansion can proceed for about 14 days to about 16 days.
• the second TIL expansion can proceed for about 14 days.
• the second expansion occurs in a supplemented cell culture medium.
• the supplemented cell culture medium comprises IL-2, OKT- 3, and antigen-presenting feeder cells.
• the second cell culture medium comprises IL-2, OKT-3, and antigen-presenting cells (APCs; also referred to as antigen- presenting feeder cells).
• the second expansion (which can include expansions referred to as REP) of TILs can be performed using T-175 flasks and gas-permeable bags as previously described (Tran KQ, Zhou J, Durflinger KH, et al., 2008, J Immunother.
• the second expansion is performed using flasks. In some embodiments, the second expansion is performed using gas-permeable G-Rex flasks.
• TIL the second expansion in T-175 flasks, about 1 x 10 6 TIL are suspended in about 150 mL of media and this is added to each T-175 flask.
• the TIL are cultured with irradiated (50 Gy) allogeneic PBMC as "feeder" cells at a ratio of 1 to 100 and the cells were cultured in a 1 to 1 mixture of CM and AIM-V medium (50/50 medium), supplemented with 3000 IU/mL of IL-2 and 30 ng/mL of anti-CD3.
• CM and AIM-V medium 50/50 medium
• the T-175 flasks are incubated at 37°C in 5% CO2. In some embodiments, half the media is changed 5 days into the second expansion using 50/50 medium with 3000 IU/mL of IL-2.
• cells from 2 T-175 flasks are combined in a 3 L bag and 300 mL of AIM-V with 5% human AB serum and 3000 IU/mL of IL-2 is added to the 300 mL of TIL suspension.
• the number of cells in each bag can be counted every day or two and fresh media can be added to keep the cell count between about 0.5 and about 2.0 x 10 6 cells/mL.
• the second expansion (which can include expansions referred to as REP) of TIL can be performed in 500 mL capacity gas permeable flasks with 100 cm 2 gas-permeable silicon bottoms (G-Rex 100, commercially available from Wilson Wolf Manufacturing Corporation, New Brighton, MN, USA) (Fig. 1), about 5 x 10 6 or 10 x 10 6 TIL are cultured with irradiated allogeneic PBMC at a ratio of 1 to 100 in 400 mL of 50/50 medium, supplemented with 3000 IU/mL of IL-2 and 30 ng/ mL of anti- CD3 (OKT3).
• the G-Rex 100 flasks can be incubated at 37°C in 5% CO2.
• 250 mL of supernatant is removed and placed into centrifuge bottles and centrifuged at 1500 rpm (491 x g) for 10 minutes.
• the TIL pellets can then be resuspended with 150 mL of fresh medium with 5% human AB serum, 3000 IU per mL of IL-2 and added back to the original G-Rex 100 flasks.
• TILs are expanded serially in G-Rex 100 flasks
• the TIL in each G-RexlOO are suspended in the 300 mL of media present in each flask and the cell suspension was divided into three 100 mL aliquots that can be used to seed three G-RexlOO flasks. Then 150 mL of AIM-V with 5% human AB serum and 3000 IU per mL of IL-2 can be added to each flask.
• the G-Rex 100 flasks can be incubated at 37°C in 5% CO2 and after 4 days in to the second expansion, 150 mL of AIM-V with 3000 IU per mL of IL-2 can be added to each G-RexlOO flask. In some embodiments, the cells are harvested on day 14 of culture.
• the second expansion (which can include expansions referred to as REP) of TIL can be performed in a gas permeable container.
• TILs can be rapidly expanded using non-specific T-cell receptor stimulation in the presence of interleukin-2 (IL-2) or interleukin-15 (IL-15).
• expansion of the number of TILs uses about 1 x 10 9 to about 1 x 10 11 antigen-presenting feeder cells.
• the non-specific T- cell receptor stimulus can include, for example, about 30 ng/ml of OKT3, a mouse monoclonal anti-CD3 antibody (commercially available from Ortho-McNeil, Raritan, NJ or Miltenyi Biotech, Auburn, CA).
• TILs can be rapidly expanded further stimulation of the TILs in vitro with one or more antigens, including antigenic portions thereof, such as epitope(s), of the cancer, which can be optionally expressed from a vector, such as a human leukocyte antigen A2 (HLA-A2) binding peptide, e.g., 0.3 ⁇ MART-1 :26-35 (27 L) or gpl 00:209- 217 (210M), optionally in the presence of a T-cell growth factor, such as 300 IU/mL IL-2 or IL-15.
• HLA-A2 human leukocyte antigen A2
• TIL may include, e.g., NY-ESO-1, TRP-1, TRP-2, tyrosinase cancer antigen, MAGE-A3, SSX-2, and VEGFR2, or antigenic portions thereof.
• TIL may also be rapidly expanded by re-stimulation with the same antigen(s) of the cancer pulsed onto HLA-A2-expressing antigen-presenting cells.
• the TILs can be further re- stimulated with, e.g., example, irradiated, autologous lymphocytes or with irradiated HLA- A2+ allogeneic lymphocytes and IL-2.
• the second expansion (which can include expansions referred to as REP) of TIL can be performed in 500 mL capacity gas permeable flasks with 100 cm gas-permeable silicon bottoms (G-Rex 100, commercially available from Wilson Wolf Manufacturing Corporation, New Brighton, MN, USA), 5 ⁇ 10 6 or 10 ⁇ 10 6 TIL may be cultured with aAPCs at a ratio of 1 to 100 in 400 mL of 50/50 medium, supplemented with 5% human AB serum, 3000 IU per mL of IL-2 and 30 ng per ml of anti-CD3 (OKT3).
• the G-Rex 100 flasks may be incubated at 37°C in 5% CO2.
• TIL may be removed and placed into centrifuge bottles and centrifuged at 1500 rpm (491 ⁇ g) for 10 minutes.
• the TIL pellets may be re-suspended with 150 mL of fresh medium with 5% human AB serum, 3000 IU per mL of IL-2, and added back to the original G-Rex 100 flasks.
• the TIL in each G-Rex 100 may be suspended in the 300 mL of media present in each flask and the cell suspension may be divided into 3 100 mL aliquots that may be used to seed 3 G-Rex 100 flasks.
• AIM- V with 5% human AB serum and 3000 IU per mL of IL-2 may be added to each flask.
• the G-Rex 100 flasks may be incubated at 37° C in 5% CO2 and after 4 days 150 mL of AIM-V with 3000 IU per mL of IL-2 may be added to each G-RexlOO flask
• the cells may be harvested on day 14 of culture.
• the second expansion (including expansions referred to as REP) is performed in flasks with the bulk TILs being mixed with a 100- or 200-fold excess of inactivated feeder cells, 30 mg/mL OKT3 anti-CD3 antibody and 3000 IU/mL IL-2 in 150 ml media.
• Media replacement is done (generally 2/3 media replacement via respiration with fresh media) until the cells are transferred to an alternative growth chamber.
• Alternative growth chambers include GRex flasks and gas permeable containers as more fully discussed below.
• the second expansion (including expansions referred to as REP) is performed and further comprises a step wherein TILs are selected for superior tumor reactivity.
• Any selection method known in the art may be used.
• the methods described in U.S. Patent Application Publication No. 2016/0010058 Al, the disclosures of which are incorporated herein by reference, may be used for selection of TILs for superior tumor reactivity.
• a cell viability assay can be performed after the second expansion (including expansions referred to as the REP expansion), using standard assays known in the art.
• a trypan blue exclusion assay can be done on a sample of the bulk TILs, which selectively labels dead cells and allows a viability assessment.
• TIL samples can be counted and viability determined using a Cellometer K2 automated cell counter (Nexcelom Bioscience, Lawrence, MA).
• viability is determined according to the Cellometer K2 Image Cytometer Automatic Cell Counter protocol described, for example, in Example 2.
• cells are grown for 7 days, 8 days, 9 days, 10 days, or 1 1 days of the total second expansion time before being split into more than one container or flask.
• the second expansion culture medium (e.g., sometimes referred to as CM2 or the second cell culture medium), comprises IL-2, OKT-3, as well as the antigen-presenting feeder cells (APCs), as discussed in more detail below.
• the antigen-presenting feeder cells are PBMCs.
• the antigen-presenting feeder cells are artificial antigen-presenting feeder cells.
• the ratio of TILs to antigen-presenting feeder cells in the second expansion is about 1 to 25, about 1 to 50, about 1 to 100, about 1 to 125, about 1 to 150, about 1 to 175, about 1 to 200, about 1 to 225, about 1 to 250, about 1 to 275, about 1 to 300, about 1 to 325, about 1 to 350, about 1 to 375, about 1 to 400, or about 1 to 500.
• the ratio of TILs to antigen-presenting feeder cells in the second expansion is between 1 to 50 and 1 to 300.
• the ratio of TILs to antigen-presenting feeder cells in the second expansion is between 1 to 100 and 1 to 200.
• the TIL expansion procedures described herein require an excess of feeder cells during the second expansion (including for example, expansions referred to as REP TIL expansions).
• the feeder cells are peripheral blood mononuclear cells (PBMCs) obtained from standard whole blood units from healthy blood donors.
• PBMCs are obtained using standard methods such as Ficoll-Paque gradient separation.
• aAPC artificial antigen-presenting cells are used in place of PBMCs.
• the allogenic PBMCs are inactivated, either via irradiation or heat treatment, and used in the REP procedures.
• the growth media during the first expansion comprises IL-2 or a variant thereof.
• the IL is recombinant human IL-2 (rhIL-2).
• the IL-2 stock solution has a specific activity of 20-3 Ox 10 6 IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 20-xlO 5 IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 25xl0 6 IU/mg for a 1 mg vial.
• the IL-2 stock solution has a specific activity of 30xl0 6 IU/mg for a 1 mg vial.
• the IL- 2 stock solution has a final concentration of 4-8xl0 6 IU/mg of IL-2. In some embodiments, the IL- 2 stock solution has a final concentration of 5-7xl0 6 IU/mg of IL-2. In some embodiments, the IL- 2 stock solution has a final concentration of 6xl0 6 IU/mg of IL-2. In some embodiments, the IL-2 stock solution is prepare as described in Example 4.
• first expansion culture media comprises about 10,000 IU/mL of IL-2, about 9,000 IU/mL of IL-2, about 8,000 IU/mL of IL-2, about 7,000 IU/mL of IL-2, about 6000 IU/mL of IL-2 or about 5,000 IU/mL of IL-2. In some embodiments, first expansion culture media comprises about 9,000 IU/mL of IL-2, to about 5,000 IU/mL of IL-2. In some embodiments, first expansion culture media comprises about 8,000 IU/mL of IL-2, to about 6,000 IU/mL of IL-2.
• first expansion culture media comprises about 7,000 IU/mL of IL-2, to about 6,000 IU/mL of IL-2. In some embodiments, first expansion culture media comprises about 6,000 IU/mL of IL-2. In an embodiment, the cell culture medium further comprises IL-2. In some embodiments, the cell culture medium comprises about 3000 IU/mL of IL-2.
• the cell culture medium comprises about 1000 IU/mL, about 1500 IU/mL, about 2000 IU/mL, about 2500 IU/mL, about 3000 IU/mL, about 3500 IU/mL, about 4000 IU/mL, about 4500 IU/mL, about 5000 IU/mL, about 5500 IU/mL, about 6000 IU/mL, about 6500 IU/mL, about 7000 IU/mL, about 7500 IU/mL, or about 8000 IU/mL of IL-2.
• the cell culture medium comprises between 1000 and 2000 IU/mL, between 2000 and 3000 IU/mL, between 3000 and 4000 IU/mL, between 4000 and 5000 IU/mL, between 5000 and 6000 IU/mL, between 6000 and 7000 IU/mL, between 7000 and 8000 IU/mL, or between 8000 IU/mL of IL-2.
• the second expansion cell culture media also includes an anti-CD3 antibody.
• the cell culture medium comprises OKT3 antibody.
• the cell culture medium comprises about 30 ng/mL of OKT3 antibody.
• the cell culture medium comprises about 0.1 ng/mL, about 0.5 ng/mL, about 1 ng/mL, about 2.5 ng/mL, about 5 ng/mL, about 7.5 ng/mL, about 10 ng/mL, about 15 ng/mL, about 20 ng/mL, about 25 ng/mL, about 30 ng/mL, about 35 ng/mL, about 40 ng/mL, about 50 ng/mL, about 60 ng/mL, about 70 ng/mL, about 80 ng/mL, about 90 ng/mL, about 100 ng/mL, about 200 ng/mL, about 500 ng/mL, and about 1 ⁇ g/mL of OKT3 antibody
• the cell culture medium comprises between 0.1 ng/mL and 1 ng/mL, between 1 ng/mL and 5 ng/mL, between 5 ng/mL and 10 ng/mL, between 10 ng/mL and 20 ng/mL, between 20 ng/mL and 30 ng/mL, between 30 ng/mL and 40 ng/mL, between 40 ng/mL and 50 ng/mL, and between 50 ng/mL and 100 ng/mL of OKT3 antibody.
• an anti-CD3 antibody in combination with IL-2 induces T cell activation and cell division in the TIL population. This effect can be seen with full length antibodies as well as Fab and F(ab')2 fragments, with the former being generally preferred; see, e.g., Tsoukas et al., J. Immunol. 1985, 135, 1719, hereby incorporated by reference in its entirety.
• suitable anti-human CD3 antibodies that find use in the invention, including anti-human CD3 polyclonal and monoclonal antibodies from various mammals, including, but not limited to, murine, human, primate, rat, and canine antibodies.
• the OKT3 anti-CD3 antibody is used (commercially available from Ortho-McNeil, Raritan, NJ or Miltenyi Biotech, Auburn, CA).
• the cells in the second expansion are grown in a culture media with high doses of a cytokine, in particular IL-2, as is known in the art.
• a cytokine in particular IL-2
• cytokines for the second expansion of TILS is additionally possible, with combinations of two or more of IL-2, IL-15 and IL-21 as is generally outlined in International Publication No. WO 2015/189356 and International Publication No. WO 2015/189357, hereby expressly incorporated by reference in their entirety.
• possible combinations include IL-2 and IL-15, IL-2 and IL-21, IL-15 and IL- 21 and IL-2, IL-15 and IL-21, with the latter finding particular use in many embodiments.
• the use of combinations of cytokines specifically favors the generation of lymphocytes, and in particular T-cells as described therein.
• Step D Second Expansion
• the second expansion is performed one or more times, i.e., the second expansion is repeated.
• the Step D second expansion as indicated in Figure 11 is repeated one or more times.
• the second expansion is referred to as an additional second expansion.
• this can include procedures referred to as a TIL Rapid Expansion Protocol.
• the TIL cell population is expanded in number after harvest and first expansion. This process is generally referred to in the art as a rapid expansion process (REP) and the repeated second expansion can include expansion referred to as reREP.
• REP rapid expansion process
• This overall protocol can be generally accomplished using culture media comprising a number of components, including feeder cells, a cytokine source, and an anti-CD3 antibody, in a gas- permeable container.
• one or more subsequent second expansion(s) are performed as described above.
• one or more subsequent second expansions are performed as provided in under Step D in Figure 11 and prior to Step E as provide in Figure 11.
• one, two, three, four or more second expansions are performed as described above.
• one, two, three, four or more second expansions are performed as provided in Step D of Figure 1 1 before Step E of Figure 11.
• two second expansions are performed as described above.
• two second expansions are performed as provided in Step D of Figure 1 1 before Step E of Figure 1 1. In some embodiments, three second expansions are performed as described above. In some embodiments, three second expansions are performed as provided in Step D of Figure 11 before Step E of Figure 1 1. In some embodiments, four second expansions are performed as described above. In some embodiments, four second expansions are performed as provided in Step D of Figure 11 before Step E of Figure 1 1.
• the repeat of the second expansion of the TILS can be referred to as a restimulation of TTLs.
• the present invention includes a restimulation step, i.e., a repeat of the second expansion (for example, a repeat of the second expansion from Step D of Figure 11).
• the repeated second expansion (which can include an expansion referred to as a restimulation step ("reREP")) is performed on cells that have been cryopreserved.
• the TILs are cryopreserved after Step D.
• the cells may be cultured in regular media, e.g.
• the resting media comprises IL-2. In some embodiments, the resting media does not comprise IL-2. In some embodiments, the resting media is a standard cell culture media known in the art. In some embodiments, the resting media is AEVI-V, DMEM, DMEM/F12, MEM, RPMI, OptiMEM, IMDM, or any other standard media that is known in art, including commercially available media. In some embodiments, the resting media is AIM-V.
• the TILs are initially prepared by obtaining a primary population of TILs from a tumor resected from a patient as discussed herein (the "primary cell population” or “first cell population”). This is followed with an initial bulk expansion utilizing a culturing of the cells with IL-2, forming a second population of cells (sometimes referred to herein as the “bulk TIL population” or “second population”). In some embodiments, this is also referred to as the initial or first expansion.
• the bulk TIL population (for example, the population obtained from for example Step A in Figure 1 1) is then subjected to a REP step, sometimes referred to as a first expansion (for example, the first expansion as described in Step B of Figure 11) in a cell culture media comprising IL-2, OKT-3, and antigen presenting feeder cells (APCs), wherein the APCs generally comprise peripheral blood mononuclear cells (PBMCs; or, alternatively as discussed herein, using antigen presenting cells), wherein the rapid expansion (for example, the second expansion as provide in Step D of Figure 11) is performed for at least 14 days.
• the media may also contain combinations of IL-2, IL-15 and/or IL- 23 rather than IL-2 alone.
• this post second expansion (for example, post Step D of Figure 1 1) expanded TIL population is at least 50 -fold or 100-fold greater in number than the second population of TILs (for example, the population of TILs obtained from Step B of Figure 11).
• the population of TILs obtained after the second expansion in Step D of Figure 1 1 are 50-fold or 100-fold greater in number than the TILs obtained from the first expansion in Step B of Figure 1 1.
• TILs are measured by cell counting methods known in the art, including those methods described in the Examples provided herewith, including Examples 1, 2, and 3.
• a K2 cell counter is employed to count the TILs.
• a Cellometer IC2 Image cytometer is employed to count the TILs.
• the TIL population obtained after the second expansion (sometimes referred to as a third TIL population or a REP cell population) is removed from the supplemented cell culture media (for example, the culture media used in Step D of Figure 1 1 or the media referred to as CM2 in the Examples) and optionally cryopreserved in a storage media (for example, media containing 5% DMSO) prior to performing and additional second expansion step.
• the supplemented cell culture media for example, the culture media used in Step D of Figure 1 1 or the media referred to as CM2 in the Examples
• a storage media for example, media containing 5% DMSO
• the TILs can be cryopreserved after a second expansion and before an additional second expansion.
• the TILs are cryopreserved after performing Step D of Figure 1 1 and before performing an additional Step D of Figure 11.
• the cryopreserved TILs are thawed prior to performing the additional second expansion.
• the cryopreserved TILs are thawed prior to performing the additional Step D as provided in Figure 11.
• the TILs are cryopreserved in 5% DMSO.
• the TILs are cryopreserved in cell culture media plus 5% DMSO.
• the cells are removed from the supplemented cell culture media (for example, the culture media used in Step D of Figure 11) and cultured in a resting media.
• a resting media Such media include those that are described in Examples 1 and 5, as well as the other Examples provided herewith.
• resting media can include media with IL-2.
• the resting media can be the media referred to as CM1 in the examples.
• the additional second expansion (including expansions referred to as reREP) is done on either the thawed cells or resting cells, using a supplemented cell culture medium (for example, a medium as provide in Step D of Figure 11) comprising IL-2, OKT-3, and feeder cells (for example, antigen presenting cells), generally comprising peripheral blood mononuclear cells (PBMCs; or, alternatively as discussed herein, using antigen presenting cells), wherein the additional second expansion is performed for at least 14 days.
• a supplemented cell culture medium for example, a medium as provide in Step D of Figure 11
• feeder cells for example, antigen presenting cells
• PBMCs peripheral blood mononuclear cells
• the media may also contain combinations of IL-2, IL-15 and/or IL-23 rather than IL-2 alone.
• these expanded TILs exhibits an increased subpopulation of effector T cells and/or central memory T cells relative to the second population of TILs (e.g., the bulk starting TILs).
• these expanded TILs are the TILs obtained from Step D of Figure 1 1.
• the memory T cells are those cells that constitutively CCR7 and CD62L. See, Sallusto, et al, Annu. Rev. Immunol , 2004, 22:745-763; incorporated by reference herein in its entirety.
• the present invention provides methods for the restimulation of cryopreserved TILs upon thawing, based on post-thaw methods that result in increases of metabolic health such as glycolysis and respiration.
• method comprises providing a population of thawed cryopreserved TILs that are then treated to increase their metabolic health to allow for optimal treatment upon infusion into patients.
• cells can be harvested.
• the TILs are harvested after one, two, three, four or more second expansion steps.
• the TILs are harvested after one, two, three, four or more second expansion steps according to Step D as provided in Figure 1 1.
• TILs can be harvested in any appropriate and sterile manner, including for example by centrifugation. Methods for TIL harvesting are well known in the art and any such know methods can be employed with the present process.
• Steps A through E as provided in an exemplary order in Figure 11 and as outlined in detailed above and herein are complete, cells are transferred to a container for use in administration to a patient.
• cells are transferred to a container for use in administration to a patient.
• a therapeutically sufficient number of TILs are obtained using the expansion methods described above, they are transferred to a container for use in administration to a patient.
• TILs expanded using APCs of the present disclosure are administered to a patient as a pharmaceutical composition.
• the pharmaceutical composition is a suspension of TILs in a sterile buffer.
• TILs expanded using PBMCs of the present disclosure may be administered by any suitable route as known in the art.
• the T-cells are administered as a single intra-arterial or intravenous infusion, which preferably lasts approximately 30 to 60 minutes.
• Other suitable routes of administration include intraperitoneal, intrathecal, and intralymphatic.
• TILs expanded using APCs of the present disclosure are administered to a patient as a pharmaceutical composition.
• the pharmaceutical composition is a suspension of TILs in a sterile buffer.
• TILs expanded using PBMCs of the present disclosure may be administered by any suitable route as known in the art.
• the T-cells are administered as a single intra-arterial or intravenous infusion, which preferably lasts approximately 30 to 60 minutes.
• Other suitable routes of administration include intraperitoneal, intrathecal, and intralymphatic
• any suitable dose of TILs can be administered.
• a therapeutically sufficient number of TILs are needed for a suitable dosage.
• from about 2.3 > ⁇ 10 10 to about 13.7> ⁇ 10 10 TILs are administered, with an average of around 7.8 x l0 10 TILs, particularly if the cancer is melanoma.
• about 1.2 l 0 10 to about 4.3 l 0 10 of TILs are administered.
• about 3 l 0 10 to about 12x 10 10 TILs are administered.
• about 4x 10 10 to about 10x 10 10 TILs are administered.
• the therapeutically effective dosage is about 2.3 x l0 10 to about 13.7 ⁇ 10 10 . In some embodiments, the therapeutically effective dosage is about 7.8 l0 10 TILs, particularly of the cancer is melanoma. In some embodiments, the therapeutically effective dosage is about 1.2x l0 10 to about 4.3 x l 0 10 of TILs.
• the therapeutically effective dosage is about 3 x l0 10 to about 12x l0 10 TILs. In some embodiments, the therapeutically effective dosage is about 4 ⁇ 10 10 to about 10 ⁇ 10 10 TILs. In some embodiments, the therapeutically effective dosage is about 5 l0 10 to about 8 l0 10 TILs. In some embodiments, the therapeutically effective dosage is about 6 ⁇ 10 10 to about 8 ⁇ 10 10 TILs. In some embodiments, the therapeutically effective dosage is about 7xl0 10 to about 8xl0 10 TILs.
• the number of the TILs provided in the pharmaceutical compositions of the invention is about l lO 6 , 2 ⁇ 10 6 , 3 ⁇ 10 6 , 4 ⁇ 10 5 , 5 10 6 , 6 ⁇ 10 6 , 7xl0 6 , 8xl0 6 , 9xl0 6 , lxlO 7 , 2xl0 7 , 3xl0 7 , 4xl0 7 , 5xl0 7 , 6xl0 7 , 7xl0 7 , 8xl0 7 , 9xl0 7 , lxlO 8 , 2xl0 8 , 3xl0 8 , 4xl0 8 , 5xl0 8 , 6 ⁇ 10 8 , 7 ⁇ 10 8 , 8 ⁇ 10 8 , 9 ⁇ 10 8 , ⁇ ⁇ ⁇ 9 , 2 ⁇ 10 9 , 3 ⁇ 10 9 , 4 ⁇ 10 9 , 5 ⁇ 10 9 , 6 , 6 ⁇ 10 8
• the number of the TILs provided in the pharmaceutical compositions of the invention is in the range of 1 ⁇ 10 6 to 5xl0 6 , 5xl0 6 to lxlO 7 , lxl0 7 to 5xl0 7 , 5xl0 7 to lxlO 8 , lxl0 8 to 5xl0 8 , 5xl0 8 to lxlO 9 , lxlO 9 to5xl0 9 , 5xl0 9 to ⁇ ⁇ ⁇ 10 , 1 ⁇ 10 10 ⁇ 5 ⁇ 10 10 , 5xl0 10 to lxlO 11 , 5xl0 u to lxlO 12 , lxlO 12 to 5xl0 12 , and 5xl0 12 to lxlO 13 .
• the therapeutically effective dosage is about lxlO 6 , 2 ⁇ 10 6 , 3 ⁇ 10 6 , 4 ⁇ 10 6 , 5 ⁇ 10 6 , 6 ⁇ 10 6 , 7 ⁇ 10 6 , 8 ⁇ 10 6 , 9 ⁇ 10 6 , ⁇ ⁇ ⁇ 7 , 2 ⁇ 10 7 , 3 ⁇ 10 7 , 4 ⁇ 10 7 , 5 ⁇ 10 7 , 6 ⁇ 10 7 , 7 ⁇ 10 7 , 8 ⁇ 10 7 , 9 ⁇ 10 7 , ⁇ ⁇ ⁇ 8 , 2 ⁇ 10 8 , 3 ⁇ 10 8 , 4 ⁇ 10 8 , 5 ⁇ 10 8 , 6 ⁇ 10 8 , 7 ⁇ 10 8 , 8 ⁇ 10 8 , 9 ⁇ 10 8 , ⁇ ⁇ ⁇ 9 , 2 ⁇ 10 9 , 3 ⁇ 10 9 , 4 ⁇ 10 9 , 5 ⁇ 10 9 , 6 ⁇ 10 6 , 7 ⁇ 10 8 , 8
• the concentration of the TILs provided in the pharmaceutical compositions of the invention is less than, for example, 100%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002% or 0.0001% w/w, w/v or v/v of the pharmaceutical composition.
• the concentration of the TILs provided in the pharmaceutical compositions of the invention is greater than 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19.75%, 19.50%, 19.25% 19%, 18.75%, 18.50%, 18.25% 18%, 17.75%, 17.50%, 17.25% 17%, 16.75%, 16.50%, 16.25% 16%, 15.75%, 15.50%, 15.25% 15%, 14.75%, 14.50%, 14.25% 14%, 13.75%, 13.50%, 13.25% 13%, 12.75%, 12.50%, 12.25% 12%, 1 1.75%, 1 1.50%, 1 1.25% 1 1%, 10.75%, 10.50%, 10.25% 10%, 9.75%, 9.50%, 9.25% 9%, 8.75%, 8.50%, 8.25% 8%, 7.75%, 7.50%, 7.25% 7%, 6.75%, 6.50%, 6.25% 6%, 5.75%, 5.50%, 5.25%
• the concentration of the TILs provided in the pharmaceutical compositions of the invention is in the range from about 0.0001% to about 50%, about 0.001% to about 40%, about 0.01% to about 30%, about 0.02% to about 29%, about 0.03% to about 28%, about 0.04% to about 27%, about 0.05% to about 26%, about 0.06% to about 25%, about 0.07% to about 24%, about 0.08% to about 23%, about 0.09% to about 22%, about 0.1% to about 21%, about 0.2% to about 20%, about 0.3% to about 19%, about 0.4% to about 18%, about 0.5% to about 17%, about 0.6% to about 16%, about 0.7% to about 15%, about 0.8% to about 14%, about 0.9% to about 12% or about 1% to about 10% w/w, w/v or v/v of the pharmaceutical composition.
• the concentration of the TILs provided in the pharmaceutical compositions of the invention is in the range from about 0.001% to about 10%, about 0.01% to about 5%, about 0.02% to about 4.5%, about 0.03% to about 4%, about 0.04% to about 3.5%, about 0.05% to about 3%, about 0.06% to about 2.5%, about 0.07% to about 2%, about 0.08% to about 1.5%, about 0.09% to about 1%, about 0.1% to about 0.9% w/w, w/v or v/v of the pharmaceutical composition.
• the amount of the TILs provided in the pharmaceutical compositions of the invention is equal to or less than 10 g, 9.5 g, 9.0 g, 8.5 g, 8.0 g, 7.5 g, 7.0 g, 6.5 g, 6.0 g, 5.5 g, 5.0 g, 4.5 g, 4.0 g, 3.5 g, 3.0 g, 2.5 g, 2.0 g, 1.5 g, 1.0 g, 0.95 g, 0.9 g, 0.85 g, 0.8 g, 0.75 g, 0.7 g, 0.65 g, 0.6 g, 0.55 g, 0.5 g, 0.45 g, 0.4 g, 0.35 g, 0.3 g, 0.25 g, 0.2 g, 0.
• the amount of the TILs provided in the pharmaceutical compositions of the invention is more than 0.0001 g, 0.0002 g, 0.0003 g, 0.0004 g, 0.0005 g, 0.0006 g, 0.0007 g, 0.0008 g, 0.0009 g, 0.001 g, 0.0015 g, 0.002 g, 0.0025 g, 0.003 g, 0.0035 g, 0.004 g, 0.0045 g, 0.005 g, 0.0055 g, 0.006 g, 0.0065 g, 0.007 g, 0.0075 g, 0.008 g, 0.0085 g, 0.009 g, 0.0095 g, 0.01 g, 0.015 g, 0.02 g, 0.025 g, 0.03 g, 0.035 g, 0.04 g, 0.045 g, 0.05 g, 0.055 g, 0.06 g, 0.065
• the TILs provided in the pharmaceutical compositions of the invention are effective over a wide dosage range.
• the exact dosage will depend upon the route of administration, the form in which the compound is administered, the gender and age of the subject to be treated, the body weight of the subject to be treated, and the preference and experience of the attending physician.
• the clinically-established dosages of the TILs may also be used if appropriate.
• the amounts of the pharmaceutical compositions administered using the methods herein, such as the dosages of TILs, will be dependent on the human or mammal being treated, the severity of the disorder or condition, the rate of administration, the disposition of the active pharmaceutical ingredients and the discretion of the prescribing physician.
• TILs may be administered in a single dose.
• TILs may be administered in multiple doses. Dosing may be once, twice, three times, four times, five times, six times, or more than six times per year. Dosing may be once a month, once every two weeks, once a week, or once every other day. Administration of TILs may continue as long as necessary.
• an effective dosage of TILs is about lxlO 6 , 2xl0 6 , 3xl0 6 , 4xl0 6 , 5xl0 6 , 6xl0 6 , 7 ⁇ 10 6 , 8 ⁇ 10 ⁇ , 9 ⁇ 10 6 , ⁇ ⁇ ⁇ 7 , 2 ⁇ 10 7 , 3 ⁇ 10 7 , 4 ⁇ 10 7 , 5 ⁇ 10 7 , 6 ⁇ 10 7 , 7 ⁇ 10 7 , 8 ⁇ 10 7 , 9 ⁇ 10 7 , ⁇ ⁇ ⁇ 8 , 2 ⁇ 10 8 , 3 ⁇ 10 8 , 4 ⁇ 10 8 , 5 ⁇ 10 8 , 6 ⁇ 10 8 , 7 ⁇ 10 8 , 8 ⁇ 10 8 , 9 ⁇ 10 8 , ⁇ ⁇ ⁇ 9 , 2 ⁇ 10 9 , 3 ⁇ 10 9 , 4 ⁇ 10 9 , 5 ⁇ 10 9 , 6 ⁇ 10 8 , 6 ⁇ 10 8
• an effective dosage of TILs is in the range of 1 ⁇ 10 6 to 5 ⁇ 10 6 , 5 ⁇ 10 6 to lxlO 7 , I x l0 7 to 5 x l0 7 , 5 x l0 7 to l x lO 8 , l x lO 8 to 5 x l0 8 , 5 x l0 8 to l x lO 9 , l x lO 9 to 5 x l0 9 , 5 x l0 9 to l x lO 10 , I x l0 10 to 5 x l0 10 , 5 x l0 10 to l x lO 11 , 5 x lO u to l x lO 12 , l x lO 12 to 5 ⁇ 10 12 , and 5x l0 12 to l x lO 13 .
• an effective dosage of TILs is in the range of about 0.01 mg/kg to about 4.3 mg/kg, about 0.15 mg/kg to about 3.6 mg/kg, about 0.3 mg/kg to about 3.2 mg/kg, about 0.35 mg/kg to about 2.85 mg/kg, about 0.15 mg/kg to about 2.85 mg/kg, about 0.3 mg to about 2.15 mg/kg, about 0.45 mg/kg to about 1.7 mg/kg, about 0.15 mg/kg to about 1.3 mg/kg, about 0.3 mg/kg to about 1.15 mg/kg, about 0.45 mg/kg to about 1 mg/kg, about 0.55 mg/kg to about 0.85 mg/kg, about 0.65 mg/kg to about 0.8 mg/kg, about 0.7 mg/kg to about 0.75 mg/kg, about 0.7 mg/kg to about 2.15 mg/kg, about 0.85 mg/kg to about 2 mg/kg, about 1 mg/kg to about 1.85 mg/kg, about 1.15 mg/kg to about 1.7 mg/kg, about
• an effective dosage of TILs is in the range of about 1 mg to about 500 mg, about 10 mg to about 300 mg, about 20 mg to about 250 mg, about 25 mg to about 200 mg, about 1 mg to about 50 mg, about 5 mg to about 45 mg, about 10 mg to about 40 mg, about 15 mg to about 35 mg, about 20 mg to about 30 mg, about 23 mg to about 28 mg, about 50 mg to about 150 mg, about 60 mg to about 140 mg, about 70 mg to about 130 mg, about 80 mg to about 120 mg, about 90 mg to about 110 mg, or about 95 mg to about 105 mg, about 98 mg to about 102 mg, about 150 mg to about 250 mg, about 160 mg to about 240 mg, about 170 mg to about 230 mg, about 180 mg to about 220 mg, about 190 mg to about 210 mg, about 195 mg to about 205 mg, or about 198 to about 207 mg.
• An effective amount of the TILs may be administered in either single or multiple doses by any of the accepted modes of administration of agents having similar utilities, including intranasal and transdermal routes, by intra-arterial injection, intravenously, intraperitoneally, parenterally, intramuscularly, subcutaneously, topically, by transplantation, or by inhalation.
• a cell viability assay can be performed after the Step B first expansion, using standard assays known in the art.
• a trypan blue exclusion assay can be done on a sample of the bulk TILs, which selectively labels dead cells and allows a viability assessment.
• Other assays for use in testing viability can include but are not limited to the Alamar blue assay; and the MTT assay.
• cell counts and/or viability are measured.
• the expression of markers such as but not limited CD3, CD4, CD8, and CD56, as well as any other disclosed or described herein, can be measured by flow cytometry with antibodies, for example but not limited to those commercially available from BD Bio-sciences (BD Biosciences, San Jose, CA) using a FACSCantoTM flow cytometer (BD Biosciences).
• the cells can be counted manually using a disposable c-chip hemocytometer (VWR, Batavia, IL) and viability can be assessed using any method known in the art, including but not limited to trypan blue staining.
• the bulk TIL population can be cryopreserved immediately, using the protocols discussed below.
• the bulk TIL population can be subjected to REP and then cryopreserved as discussed below.
• the bulk or REP TIL populations can be subjected to genetic modifications for suitable treatments.
• a method for expanding TILs may include using about 5,000 mL to about 25,000 mL of cell medium, about 5,000 mL to about 10,000 mL of cell medium, or about 5,800 mL to about 8,700 mL of cell medium.
• expanding the number of TILs uses no more than one type of cell culture medium. Any suitable cell culture medium may be used, e.g., AIM-V cell medium (L-glutamine, 50 ⁇ streptomycin sulfate, and 10 uM gentamicin sulfate) cell culture medium (Invitrogen, Carlsbad CA).
• AIM-V cell medium L-glutamine, 50 ⁇ streptomycin sulfate, and 10 uM gentamicin sulfate
• expanding the number of TIL may comprise adding fresh cell culture media to the cells (also referred to as feeding the cells) no more frequently than every third or fourth day. Expanding the number of cells in a gas permeable container simplifies the procedures necessary to expand the number of cells by reducing the feeding frequency necessary to expand the cells.
• the cell medium in the first and/or second gas permeable container is unfiltered.
• the use of unfiltered cell medium may simplify the procedures necessary to expand the number of cells.
• the cell medium in the first and/or second gas permeable container lacks beta-mercaptoethanol (BME).
• the duration of the method comprising obtaining a tumor tissue sample from the mammal; culturing the tumor tissue sample in a first gas permeable container containing cell medium therein; obtaining TILs from the tumor tissue sample; expanding the number of TILs in a second gas permeable container containing cell medium therein using aAPCs for a duration of about 14 to about 42 days, e.g. , about 28 days.
• TILs are expanded in gas-permeable containers.
• Gas-permeable containers have been used to expand TILs using PBMCs using methods, compositions, and devices known in the art, including those described in U.S. Patent Application Publication No. 2005/0106717 Al, the disclosures of which are incorporated herein by reference.
• TILs are expanded in gas-permeable bags.
• TILs are expanded using a cell expansion system that expands TILs in gas permeable bags, such as the Xuri Cell Expansion System W25 (GE Healthcare).
• TILs are expanded using a cell expansion system that expands TILs in gas permeable bags, such as the WAVE Bioreactor System, also known as the Xuri Cell Expansion System W5 (GE Healthcare).
• the cell expansion system includes a gas permeable cell bag with a volume selected from the group consisting of about 100 mL, about 200 mL, about 300 mL, about 400 mL, about 500 mL, about 600 mL, about 700 mL, about 800 mL, about 900 mL, about 1 L, about 2 L, about 3 L, about 4 L, about 5 L, about 6 L, about 7 L, about 8 L, about 9 L, and about 10 L.
• TILs can be expanded in G-Rex flasks (commercially available from Wilson Wolf Manufacturing). Such embodiments allow for cell populations to expand from about 5xl0 5 cells/cm 2 to between lOxlO 6 and 30xl0 6 cells/cm 2 . In an embodiment this expansion is conducted without adding fresh cell culture media to the cells (also referred to as feeding the cells). In an embodiment, this is without feeding so long as medium resides at a height of about 10 cm in the GRex flask. In an embodiment this is without feeding but with the addition of one or more cytokines. In an embodiment, the cytokine can be added as a bolus without any need to mix the cytokine with the medium. Such containers, devices, and methods are known in the art and have been used to expand TILs, and include those described in U.S. Patent Application Publication No. US
• the TILs are optionally genetically engineered to include additional functionalities, including, but not limited to, a high-affinity T cell receptor (TCR), e.g., a TCR targeted at a tumor-associated antigen such as MAGE-1, HER2, or NY-ESO-1, or a chimeric antigen receptor (CAR) which binds to a tumor-associated cell surface molecule (e.g., mesothelin) or lineage-restricted cell surface molecule (e.g., CD19).
• TCR high-affinity T cell receptor
• CAR chimeric antigen receptor
• cryopreservation can occur at numerous points throughout the TIL expansion process.
• the bulk TIL population after the first expansion according to Step B or the expanded population of TILs after the one or more second expansions according to Step D can be cryopreserved.
• Cryopreservation can be generally accomplished by placing the TIL population into a freezing solution, e.g., 85% complement inactivated AB serum and 15% dimethyl sulfoxide (DMSO). The cells in solution are placed into cryogenic vials and stored for 24 hours at -80 °C, with optional transfer to gaseous nitrogen freezers for cryopreservation. See, Sadeghi, et al, Acta
• the TILs are cryopreserved in 5% DMSO. In some embodiments, the TILs are cryopreserved in cell culture media plus 5% DMSO. In some embodiments, the TILs are cryopreserved according to the methods provided in Examples 8 and 9.
• the cells are removed from the freezer and thawed in a 37 °C water bath until approximately 4/5 of the solution is thawed.
• the cells are generally resuspended in complete media and optionally washed one or more times.
• the thawed TILs can be counted and assessed for viability as is known in the art.
• the TILs are analyzed for expression of numerous phenotype markers after expansion, including those described herein and in the Examples. In an embodiment, expression of one or more phenotypic markers is examined. In some embodiments, the phenotypic characteristics of the TILs are analyzed after the first expansion in Step B. In some embodiments, the phenotypic characteristics of the TILs are analyzed during the transition in Step C. In some embodiments, the phenotypic characteristics of the TILs are analyzed during the transition according to Step C and after cryopreservation. In some embodiments, the phenotypic characteristics of the TILs are analyzed after the second expansion according to Step D.
• the phenotypic characteristics of the TILs are analyzed after two or more expansions according to Step D.
• the marker is selected from the group consisting of TCRab, CD57, CD28, CD4, CD27, CD56, CD8a, CD45RA, CD8a, CCR7, CD4, CD3, CD38, and HLA-DR.
• the marker is selected from the group consisting of TCRab, CD57, CD28, CD4, CD27, CD56, and CD8a.
• the marker is selected from the group consisting of CD45RA, CD8a, CCR7, CD4, CD3, CD38, and HLA-DR.
• expression of one, two, three, four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, or fourteen markers is examined. In some embodiments, the expression from one or more markers from each group is examined. In some embodiments, one or more of HLA-DR, CD38, and CD69 expression is maintained ⁇ i.e., does not exhibit a statistically significant difference) in fresh TILs as compared to thawed TILs. In some embodiments, the activation status of TILs is maintained in the thawed TILs.
• expression of one or more regulatory markers is measured.
• the regulatory marker is selected from the group consisting of CD 137, CD8a, Lag3, CD4, CD3, PD1, ⁇ -3, CD69, CD8a, TIGIT, CD4, CD3, KLRG1, and CD 154.
• the regulatory marker is selected from the group consisting of CD137, CD8a, Lag3, CD4, CD3, PD1, and TEV1-3.
• the regulatory marker is selected from the group consisting of CD69, CD8a, TIGIT, CD4, CD3, KLRG1, and CD154.
• regulatory molecule expression is decreased in thawed TILs as compared to fresh TILs.
• expression of regulatory molecules LAG-3 and TIM-3 is decreased in thawed TILs as compared to fresh TILs.
• the memory marker is selected from the group consisting of CCR7 and CD62L
• the viability of the fresh TILs as compared to the thawed TILs is at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or at least 98%. In some embodiments, the viability of both the fresh and thawed TILs is greater than 70%, greater than 75%, greater than 80%, greater than 85%, greater than 90%, greater than 95%), or greater than 98%.
• the viability of both the fresh and thawed product is greater than 80%, greater than 81%, greater than 82%, greater than 83%, greater than 84%, greater than 85%, greater than 86%, greater than 87%, greater than 88%, greater than 89%, or greater than 90%. In some embodiments, the viability of both the fresh and thawed product is greater than 86%.
• restimulated TILs can also be evaluated for cytokine release, using cytokine release assays.
• TILs can be evaluated for interferon-7 (IFN-7) secretion in response to stimulation either with OKT3 or co-culture with autologous tumor digest.
• IFN-7 interferon-7
• TILs are washed extensively, and duplicate wells are prepared with 1 x 10 5 cells in 0.2 mL CM in 96-well flat- bottom plates precoated with 0.1 or 1.0 ⁇ g/mL of OKT3 diluted in phosphate-buffered saline.
• the TILs are being evaluated for various regulatory markers.
• the regulatory marker is selected from the group consisting of TCR ⁇ / ⁇ , CD56, CD27, CD28, CD57, CD45RA, CD45RO, CD25, CD127, CD95, IL-2R-, CCR7, CD62L, KLRG1, and CD122.
• the regulatory marker is TCR ⁇ / ⁇ .
• the regulatory marker is CD56.
• the regulatory marker is CD27.
• the regulatory marker is CD28.
• the regulatory marker is CD57. In some embodiments, the regulatory marker is CD45RA. In some embodiments, the regulatory marker is CD45RO. In some embodiments, the regulatory marker is CD25. In some embodiments, the regulatory marker is CD 127. In some embodiments, the regulatory marker is CD95. In some embodiments, the regulatory marker is IL-2R-. In some embodiments, the regulatory marker is CCR7. In some embodiments, the regulatory marker is CD62L. In some embodiments, the regulatory marker is KLRG1. In some embodiments, the regulatory marker is CD122.
• the restimulated TILs are characterized by significant enhancement of basal glycolysis as compared to either freshly harvested TILs and/or post-thawed TILs.
• Spare respiratory capacity (SRC) and glycolytic reserve can be evaluated for TILs expanded with aEM3 aAPCs in comparison to PBMC feeders.
• the Seahorse XF Cell Mito Stress Test measures mitochondrial function by directly measuring the oxygen consumption rate (OCR) of cells, using modulators of respiration that target components of the electron transport chain in the mitochondria.
• OCR oxygen consumption rate
• the test compounds oligomycin, FCCP, and a mix of rotenone and antimycin A, described below
• Proton leak and spare respiratory capacity are then calculated using these parameters and basal respiration.
• Each modulator targets a specific component of the electron transport chain.
• Oligomycin inhibits ATP synthase (complex V) and the decrease in OCR following injection of oligomycin correlates to the mitochondrial respiration associated with cellular ATP production.
• Carbonyl cyanide-4 (trifluoromethoxy) phenylhydrazone (FCCP) is an uncoupling agent that collapses the proton gradient and disrupts the mitochondrial membrane potential. As a result, electron flow through the electron transport chain is uninhibited and oxygen is maximally consumed by complex IV.
• FCCP-stimulated OCR can then be used to calculate spare respiratory capacity, defined as the difference between maximal respiration and basal respiration.
• Spare respiratory capacity (SRC) is a measure of the ability of the cell to respond to increased energy demand.
• the third injection is a mix of rotenone, a complex I inhibitor, and antimycin A, a complex III inhibitor. This combination shuts down mitochondrial respiration and enables the calculation of nonmitochondrial respiration driven by processes outside the mitochondria.
• the metabolic assay is basal respiration.
• second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 11, including TILs referred to as reREP TILs) have a basal respiration rate that is at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 97%, at least 98%, or at least 99% of the basal respiration rate of freshly harvested TILs.
• the basal respiration rate is from about 50% to about 99% of the basal respiration rate of freshly harvested TILs.
• the basal respiration rate is from about 60% to about 99%) of the basal respiration rate of freshly harvested TILs. In some embodiments, the basal respiration rate is from about 70% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the basal respiration rate is from about 80% to about 99%) of the basal respiration rate of freshly harvested TILs. In some embodiments, the basal respiration rate is from about 90% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the basal respiration rate is from about 95% to about 99% of the basal respiration rate of freshly harvested TILs.
• the second expansion or second additional expansion TILs (such as, for example, those described in Step D of Figure 1 1, including TILs referred to as reREP TILs) have a basal respiration rate that is not statistically significantly different than the basal respiration rate of freshly harvested TILs.
• second expansion TILs or additional second expansion TILs such as those in Step D (including, for example, TILs referred to as reREP which have undergone an additional second expansion) TILs have a spare respiratory capacity that is at least is at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 97%, at least 98%, or at least 99% of the basal respiration rate of freshly harvested TILs.
• the spare respiratory capacity is from about 50% to about 99% of the basal respiration rate of freshly harvested TILs.
• the spare respiratory capacity is from about 50% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the spare respiratory capacity is from about 60% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the spare respiratory capacity is from about 70% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the spare respiratory capacity is from about 80% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the spare respiratory capacity is from about 90%) to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the spare respiratory capacity is from about 95% to about 99% of the basal respiration rate of freshly harvested TILs.
• the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 1 1, including TILs referred to as reREP TILs) have a spare respiratory capacity that is not statistically significantly different than the basal respiration rate of freshly harvested TILs.
• the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 11, including TILs referred to as reREP TILs) have a spare respiratory capacity that is at least is at least is at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 97%, at least 98%, or at least 99% of the basal respiration rate of freshly harvested TILs.
• the metabolic assay measured is glycolytic reserve.
• the metabolic assay is glycolytic reserve.
• the metabolic assay is spare respiratory capacity.
• cellular (respiratory) metabolism cells were treated with inhibitors of mitochondrial respiration and glycolysis to determine a metabolic profile for the TIL consisting of the following measures: baseline oxidative phosphorylation (as measured by OCR), spare respiratory capacity, baseline glycolytic activity (as measured by ECAR), and glycolytic reserve. Metabolic profiles were performed using the Seahorse Combination Mitochondrial/Glycolysis Stress Test Assay (including the kit commercially available from Agilent®), which allows for determining a cells' capacity to perform glycolysis upon blockage of mitochondrial ATP production. In some embodiments, cells are starved of glucose, then glucose is injected, followed by a stress agent.
• the stress agent is selected from the group consisting of oligomycin, FCCP, rotenone, antimycin A and/or 2-deoxyglucose (2-DG), as well as combinations thereof.
• oligomycin is added at 10 mM.
• FCCP is added at 10 mM.
• rotenone is added at 2.5 mM.
• antimycin A is added at 2.5 mM.
• 2-deoxyglucose (2-DG) is added at 500 mM.
• glycolytic capacity, glycolytic reserve, and/or non-glycolytic acidification are measured.
• TILs have a glycolytic reserve that is at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 97%, at least 98%, or at least 99% of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 50%) to about 99%) of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 60%> to about 99% of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 70% to about 99% of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 80% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 90%) to about 99%) of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 95% to about 99% of the basal respiration rate of freshly harvested TILs.
• the metabolic assay is basal glycolysis. In some embodiments, the metabolic assay is basal glycolysis.
• second expansion TILs or additional second expansion TILs such as those in Step D (including, for example, TILs referred to as reREP which have undergone an additional second expansion) have an increase in basal glycolysis of at least two-fold, at least three-fold, at least four-fold, at least five-fold, at least six-fold, at least 7-fold, at least eightfold, at least nine-fold, or at least ten-fold.
• the second expansion TILs or additional second expansion such as those in Step D (including TILs referred to as reREP TILs) have an increase in basal glycolysis of about two-fold to about ten-fold.
• the second expansion TILs or additional second expansion such as those in Step D (including TILs referred to as reREP TILs) have an increase in basal glycolysis of about two-fold to about eight-fold. In some embodiments, the second expansion TILs or additional second expansion, such as those in Step D (including TILs referred to as reREP TILs) have an increase in basal glycolysis of about three-fold to about seven-fold. In some embodiments, the second expansion TILs or additional second expansion, such as those in Step D (including TILs referred to as reREP TILs) have an increase in basal glycolysis of about two-fold to about four-fold. In some embodiments, the second expansion TILs or additional second expansion, such as those in Step D (including TILs referred to as reREP TILs) have an increase in basal glycolysis of about two-fold to about three-fold.
• second expansion TILs or additional second expansion such as those in Step D (including, for example, TILs referred to as reREP which have undergone an additional second expansion) TILs have a glycolytic reserve that is at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%), at least 95%, at least 97%, at least 98%, or at least 99% of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 50% to about 99% of the basal respiration rate of freshly harvested TILs.
• the glycolytic reserve is from about 60% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 70% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 80% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 90% to about 99% of the basal respiration rate of freshly harvested TILs. In some embodiments, the glycolytic reserve is from about 95% to about 99% of the basal respiration rate of freshly harvested TILs.
• the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 11, including TILs referred to as reREP TILs) have a spare respiratory capacity that is not statistically significantly different than the basal respiration rate of freshly harvested TILs.
• Granzyme B is another measure of the ability of TIL to kill target cells. Media supernatants restimulated as described above using antibodies to CD3, CD28, and CD137/4-1BB were also evaluated for their levels of Granzyme B using the Human Granzyme B DuoSet ELISA Kit (R & D Systems, Minneapolis, MN) according to the manufacturer's instructions.
• the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 11, including TILs referred to as reREP TILs) have increased Granzyme B production.
• the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 11, including TILs referred to as reREP TILs) have increased cytotoxic activity.
• the present methods include an assay for assessing TIL viability, using the methods as described above.
• the TILs are expanded as discussed above, including for example as provided in Figure 11.
• the TILs are cryopreserved prior to being assessed for viability.
• the viability assessment includes thawing the TILs prior to performing a first expansion, a second expansion, and an additional second expansion.
• the present methods provide an assay for assessing cell proliferation, cell toxicity, cell death, and/or other terms related to viability of the TIL population. Viability can be measured by any of the TIL metabolic assays described above as well as any methods know for assessing cell viability that are known in the art.
• the present methods provide as assay for assessment of cell proliferation, cell toxicity, cell death, and/or other terms related to viability of the TILs expanded using the methods described herein, including those exemplified in Figure 1 1.
• the present invention also provides assay methods for determining TIL viability.
• the present disclosure provides methods for assaying TILs for viability by expanding tumor infiltrating lymphocytes (TILs) into a larger population of TILs comprising:
• the method further comprises:
• step (iv) performing an additional second expansion by supplementing the cell culture medium of the third population of TILs with additional IL-2, additional OKT-3, and additional APCs, wherein the additional second expansion is performed for at least 14 days to obtain a larger population of TILs than obtained in step (iii), wherein the larger population of TILs comprises an increased subpopulation of effector T cells and/or central memory T cells relative to the third population of TILs, and wherein the third population is further assayed for viability.
• the cells prior to step (i), the cells are cryopreserved.
• the cells are thawed prior to performing step (i).
• step (iv) is repeated one to four times in order to obtain sufficient TILs for analysis.
• steps (i) through (iii) or (iv) are performed within a period of about 40 days to about 50 days.
• steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 48 days. [00271] In some embodiments, steps (i) through (iii) or (iv) are performed within a period of about 42 days to about 45 days.
• steps (i) through (iii) or (iv) are performed within about 44 days.
• the cells from steps (iii) or (iv) express CD4, CD8, and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the antigen presenting cells are peripheral blood
• PBMCs mononuclear cells
• the PBMCs are added to the cell culture on any of days 9 through 17 in step (iii).
• the effector T cells and/or central memory T cells in the larger population of TILs in step (iv) exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells, and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the APCs are artificial APCs (aAPCs).
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high- affinity T cell receptor.
• step of transducing occurs before step (i).
• the method further comprises the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising a single chain variable fragment antibody fused with at least one endodomain of a T-cell signaling molecule.
• CAR chimeric antigen receptor
• step of transducing occurs before step (i).
• the TILs are assayed for viability.
• the TILs are assayed for viability after cryopreservation. [00285] In some embodiments, the TILs are assayed for viability after cryopreservation and after step (iv).
• a method for assaying TILs for viability and/or further use in administration to a subject comprises:
• step (viii) determining based on the ratio in step (vii) whether the thawed population of TILs is suitable for administration to a patient;
• step (ix) administering a therapeutically effective dosage of the thawed third population of TILs to the patient when the ratio of the number of TILs in the fourth population of TILs to the number of TILs in the third population of TILs is determined to be greater than 5 : 1 in step (viii).
• the reREP period is performed until the ratio of the number of TILs in the fourth population of TILs to the number of TILs in the third population of TILs is greater than 50: 1.
• the number of TILs sufficient for a therapeutically effective dosage is from about 2.3 x 10 10 to about 13.7* 10 10 .
• steps (i) through (vii) are performed within a period of about 40 days to about 50 days. In some embodiments, steps (i) through (vii) are performed within a period of about 42 days to about 48 days. In some embodiments, steps (i) through (vii) are performed within a period of about 42 days to about 45 days. In some embodiments, steps (i) through (vii) are performed within about 44 days.
• the cells from steps (iii) or (vii) express CD4, CDS, and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the cells are TILs.
• the antigen presenting cells are peripheral blood
• PBMCs mononuclear cells
• the PBMCs are added to the cell culture on any of days 9 through 17 in step (iii).
• the effector T cells and/or central memory T cells in the larger population of TILs in steps (iii) or (vii) exhibit one or more characteristics selected from the group consisting of expression of CD27, expression of CD28, longer telomeres, increased CD57 expression, and decreased CD56 expression, relative to effector T cells, and/or central memory T cells in the third population of cells.
• the effector T cells and/or central memory T cells exhibit increased CD57 expression and decreased CD56 expression.
• the APCs are artificial APCs (aAPCs).
• the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high-affinity T cell receptor is a step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a high-affinity T cell receptor.
• step of transducing occurs before step (i).
• the step of transducing the first population of TILs with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising a single chain variable fragment antibody fused with at least one endodomain of a T-cell signaling molecule.
• CAR chimeric antigen receptor
• step of transducing occurs before step (i).
• the TILs are assayed for viability after step (vii).
• the present disclosure also provides further methods for assaying TILs.
• the disclosure provides a method for assaying TILs comprising:
• step (iv) determining based on the ratio in step (iii) whether the first population of TILs is suitable for use in therapeutic administration to a patient;
• step (v) determining the first population of TILs is suitable for use in therapeutic administration when the ratio of the number of TILs in the second population of TILs to the number of TILs in the first population of TILs is determined to be greater than 5: 1 in step (iv).
• the ratio of the number of TILs in the second population of TILs to the number of TILs in the portion of the first population of TILs is greater than 50: 1.
• the method further comprises performing expansion of the entire first population of cryopreserved TILs from step (i) according to the methods as described in any of the embodiments provided herein.
• the method further comprises administering the entire first population of cryopreserved TILs from step (i) to the patient.
• the cryopreserved TILs are thawed and a second expansion performed to determine if the cells expand sufficiently. If the cells expand to a ratio of at least 5 : 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 10: 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 15: 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 20: 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 25: 1, the TILs are sufficiently viably for administration to the patient.
• the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 35: 1, the TILs are sufficiently viably for administration to the patient If the cells expand to a ratio of at least 40: 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 45: 1, the TILs are sufficiently viably for administration to the patient. If the cells expand to a ratio of at least 5 : 1, the TILs are sufficiently viably for administration to the patient.
• the present disclosure also provides further methods for assaying TILs.
• the disclosure provides a method for assaying TILs comprising:
• step (iv) determining based on the ratio in step (iii) whether the first population of TILs is suitable for use in therapeutic administration to a patient;
• step (v) therapeutically administering the remainder of the first population of TILs to the patient when the ratio of the number of TILs in the second population of TILs to the number of TILs in the first population of TILs is determined to be greater than 5: 1 in step (iv).
• the ratio of the number of TILs in the second population of TILs to the number of TILs in the portion of the first population of TILs is greater than 50: 1.
• the method further comprises performing expansion of the entire first population of cryopreserved TILs from step (i) according to the methods of any of the preceding claims.
• the method further comprises administering the entire first population of cryopreserved TILs from step (i) to the patient. [00309] In some embodiments, the method further comprised the step of assessing the metabolic health of the second population of TILs.
• the method further comprises the step of assessing the phenotype of the second population of TILs.
• the antigen presenting cells are allogeneic peripherial blood mononuclear cells.
• Methods of treatment begin with the initial TIL collection and culture of TILs. Such methods have been both described in the art by, for example, Jin et al. (J. Immunotherapy, 2012, 35(3):283-292), incorporated by reference herein in its entirety. As well as described throughout the Examples section below.
• the present invention provides novel methods for TIL generation that have not been previously described, e.g., TILs produced according to Steps A through F.
• TILs produced according to Steps A through F above or as otherwise produced as described herein find particular use in the treatment of patients with cancer.
• General methods of using TILs for the treatment of cancer have been described in Goff, et al., J. Clinical Oncology, 2016, 34(20):2389-239, as well as the supplemental content; incorporated by reference herein in its entirety.
• the TILs produced according to the present invention can also be used for the treatment of cancer.
• TIL were grown from resected deposits of metastatic melanoma as previously described (see, Dudley, et al ., J Immunother ., 2003, 26:332-342; incorporated by reference herein in its entirety). Fresh tumor can be dissected under sterile conditions. A representative sample can be collected for formal pathologic analysis. Single fragments of 2 mm 3 to 3 mm 3 . In some embodiments, 5, 10, 15, 20, 25 or 30 samples per patient are obtained. In some embodiments, 20, 25, or 30 samples per patient are obtained. In some embodiments, 20, 22, 24, 26, or 28 samples per patient are obtained. In some embodiments, 24 samples per patient are obtained.
• TILs can be placed in individual wells of a 24-well plate, maintained in growth media with high-dose IL-2 (6,000 IU/mL), and monitored for destruction of tumor and/or proliferation of TIL. Any tumor with viable cells remaining after processing can be enzymatically digested into a single cell suspension and cry opre served, as described herein.
• expanded TILs can be sampled for phenotype analysis (CD3, CD4, CD8, and CD56) and tested against autologous tumor when available. TILs can be considered reactive if overnight co-culture yielded interferon-gamma (IFN- ⁇ ) levels > 200 pg/mL and twice background.
• IFN- ⁇ interferon-gamma
• cultures with evidence of autologous reactivity or sufficient growth patterns can be selected for a second expansion (for example, a second expansion as provided in according to Step D of Figure 11), including second expansions that are sometimes referred to as rapid expansion (REP).
• expanded TILs with high autologous reactivity for example, high proliferation during a second expansion
• TILs with high autologous reactivity for example, high proliferation during second expansion as provided in Step D of Figure 11
• the patient is not moved directly to ACT (adoptive cell transfer), for example, in some embodiments, after tumor harvesting and/or a first expansion, the cells are not utilized immediately.
• TILs can be cryopreserved and thawed 2 days before the second expansion step (for example, in some embodiments, 2 days before a step referred to as a REP step).
• TILs can be cryopreserved and thawed 2 days before the second expansion step (for example, in some embodiments, 2 days before a Step D as provided in Figure 1 1).
• the second expansion (including processes referred to as REP) used OKT3 (anti-CD3) antibody (Miltenyi Biotech, San Diego, CA) and IL-2 (3,000 IU/mL; Prometheus, San Diego, CA) in the presence of irradiated feeder cells, autologous when possible, at a 100: 1 ratio (see, Dudley, et al., J Immunother ., 2003, 26:332-342; incorporated by reference herein in its entirety).
• the TILs can be cryopreserved and thawed 5 days before the second expansion step.
• the TILs can be cryopreserved and thawed 4 days before the second expansion step. In some embodiments, the TILs can be cryopreserved and thawed 3 days before the second expansion step. In some embodiments, the TILs can be cryopreserved and thawed 2 days before the second expansion step. In some embodiments, the TILs can be cryopreserved and thawed 1 day before the second expansion step. In some embodiments, the TILs can be cryopreserved and thawed immediately before the second expansion step.
• Cell phenotypes of cryopreserved samples of infusion bag TIL can be analyzed by flow cytometry (FlowJo) for surface markers CD3, CD4, CD8, CCR7, and CD45RA (BD Biosciences), as well as by any of the methods described herein.
• Serum cytokines were measured by using standard enzyme-linked immunosorbent assay techniques. A rise in serum IFN-g was defined as >100 pg/mL and greater than 4 3 baseline levels.
• some embodiments of the invention utilize a lymphodepletion step (sometimes also referred to as "immunosuppressive conditioning") on the patient prior to the introduction of the second expansion TILs or second additional expansion TILs (such as, for example, those described in Step D of Figure 1 1 , including TILs referred to as reREP TILs) of the invention.
• a lymphodepletion step sometimes also referred to as “immunosuppressive conditioning”
• second expansion TILs or second additional expansion TILs such as, for example, those described in Step D of Figure 1 1 , including TILs referred to as reREP TILs
• lymphodepletion is done using fludarabine and/or cyclophosphamide (the active form being referred to as mafosfamide) and combinations thereof.
• fludarabine and/or cyclophosphamide the active form being referred to as mafosfamide
• mafosfamide the active form being referred to as mafosfamide
• Such methods are described in Gassner et al. (Cancer Immunol Immunother . 201 1 , 60(l):75-85, Muranski, et al, Nat Clin Pract Oncol, 2006 3(12):668-681, Dudley, et al., J Clin Oncol 2008, 26:5233-5239, and Dudley, et al., J Clin Oncol. 2005, 23(10):2346-2357, all of which are incorporated by reference herein in their entireties.
• the fludarabine is at a concentration of 0.5 -10 ⁇ g/ml fludarabine (Sigma-Aldrich, MO, USA). In some embodiments, the fludarabine is at a concentration of 1 ⁇ g/ml fludarabine (Sigma-Aldrich, MO, USA). In some embodiments, the fludarabine treatment is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days or more.
• the fludarabine is administered at a dosage of 10 mg/kg/day,
• the fludarabine treatment is for 2-7 days at
• the fludarabine treatment is for 4-5 days at
• the fludarabine treatment is for 4-5 days at
• the mafosfamide, the active form of cyclophosphamide is at a concentration of 0.5 ⁇ g/ml -10 ⁇ g/ml. In some embodiments, the mafosfamide, the active form of cyclophosphamide, is at a concentration of 1 ⁇ g/ml. In some embodiments, the cyclophosphamide treatment is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days or more. In some embodiments, the cyclophosphamide is administered at a dosage of
• the cyclophosphamide is administered intravenously (i.e., i.v.)
• the cyclophosphamide treatment is for 2-7 days at 35 mg/kg/day.
• the cyclophosphamide treatment is for 4-5 days at 250 mg/m 2 /day i.v.
• the cyclophosphamide treatment is for 4 days at 250 mg/m 2 /day i.v.
• the fludarabine and the cyclophosphamide are administered together to a patient.
• fludarabine is administered at 25 mg/m 2 /day i.v. and cyclophosphamide is administered at 250 mg/m 2 /day i.v. over 4 days.
• This protocol includes administration of fludarabine (25 mg/m 2 /day i.v.) and cyclophosphamide (250 mg/m /day i.v.) over 4 days.
• the present disclosure provides a method of treating a cancer with a population of tumor infiltrating lymphocytes (TILs) comprising the steps of (a) obtaining a first population of TILs from a tumor resected from a patient; (b) performing an initial expansion of the first population of TILs in a first cell culture medium to obtain a second population of TILs, wherein the second population of TILs is at least 5-fold greater in number than the first population of TILs, and wherein the first cell culture medium comprises IL-2; (c) performing a rapid expansion of the second population of TILs using a population of myeloid artificial antigen presenting cells (myeloid aAPCs) in a second cell culture medium to obtain a third population of TILs, wherein the third population of TILs is at least 50-fold greater in number than the second population of TILs after 7 days from the start of the rapid expansion; and wherein the second cell culture medium comprises IL-2 and OKT-3;
• TILs tumor infiltra
• the IL-2 is present at an initial concentration of about 3000 IU/mL and OKT-3 antibody is present at an initial concentration of about 30 ng/mL in the second cell culture medium.
• first expansion is performed over a period not greater than 14 days.
• the first expansion is performed using a gas permeable container.
• the second expansion is performed using a gas permeable container.
• the ratio of the second population of TILs to the population of aAPCs in the rapid expansion is between 1 to 80 and 1 to 400. In some embodiments, the ratio of the second population of TILs to the population of aAPCs in the rapid expansion is about 1 to 300.
• the cancer for treatment is selected from the group consisting of melanoma, ovarian cancer, cervical cancer, non-small-cell lung cancer (NSCLC), lung cancer, bladder cancer, breast cancer, cancer caused by human papilloma virus, head and neck cancer, renal cancer, and renal cell carcinoma.
• the cancer for treatment is selected from the group consisting of melanoma, ovarian cancer, and cervical cancer.
• the cancer for treatment is melanoma.
• the cancer for treatment is ovarian cancer.
• the cancer for treatment is cervical cancer.
• the method of treating cancer further comprises the step of treating the patient with a non-myeloablative lymphodepletion regimen prior to administering the third population of TILs to the patient.
• the non-myeloablative lymphodepletion regimen comprises the steps of administration of cyclophosphamide at a dose of 60 mg/m2/day for two days followed by administration of fludarabine at a dose of 25 mg/m2/day for five days.
• the high dose IL-2 regimen comprises 600,000 or 720,000 IU/kg of aldesleukin, or a biosimilar or variant thereof, administered as a 15-minute bolus intravenous infusion every eight hours until tolerance.
• the TILs produced as described herein in Steps A through F can be administered in combination with one or more immune checkpoint regulators, such as the antibodies described below.
• immune checkpoint regulators such as the antibodies described below.
• antibodies that target PD-1 and which can be co-administered with the TILs of the present invention include, e.g.
• nivolumab BMS-936558, Bristol-Myers Squibb; Opdivo®
• pembrolizumab lambrolizumab, MK03475 or MK-3475, Merck; Keytruda®
• humanized anti-PD-1 antibody JS001 ShangHai JunShi
• monoclonal anti-PD-1 antibody TSR-042 TSR-042 (Tesaro, Inc.)
• Pidilizumab (anti-PD-1 mAb CT-011, Medivation), anti-PD-1 monoclonal Antibody BGB- A317 (BeiGene), and/or anti-PD-1 antibody SHR-1210 (ShangHai HengRui), human monoclonal antibody REGN2810 (Regeneron), human monoclonal antibody MDX-1106 (Bristol-Myers Squibb), and/or humanized anti-PD-1 IgG4 antibody PDR001 (Novartis).
• the PD-1 antibody is from clone: RMPl-14 (rat IgG) - BioXcell cat# BP0146.
• anti-PD-1 antibodies suitable for use in co-administration methods with TILs produced according to Steps A through F as described herein are anti-PD-1 antibodies disclosed in U.S. Patent No. 8,008,449, herein incorporated by reference.
• the antibody or antigen-binding portion thereof binds specifically to PD-Ll and inhibits its interaction with PD-1, thereby increasing immune activity.
• Any antibodies known in the art which bind to PD-Ll and disrupt the interaction between the PD-1 and PD- Ll, and stimulates an anti- tumor immune response are suitable for use in co-administration methods with TILs produced according to Steps A through F as described herein.
• antibodies that target PD-Ll and are in clinical trials include BMS-936559 (Bristol-Myers Squibb) and MPDL3280A (Genentech).
• BMS-936559 Bristol-Myers Squibb
• MPDL3280A Genetech
• Other suitable antibodies that target PD-Ll are disclosed in U. S. Patent No. 7,943,743, herein incorporated by reference. It will be understood by one of ordinary skill that any antibody which binds to PD-1 or PD-Ll, disrupts the PD-1/PD-L1 interaction, and stimulates an anti-tumor immune response, are suitable for use in co-administration methods with TILs produced according to Steps A through F as described herein.
• the subject administered the combination of TILs produced according to Steps A through F is co-administered with a and anti-PD-1 antibody when the patient has a cancer type that is refractory to administration of the anti-PD-1 antibody alone.
• the patient is administered TILs in combination with and anti-PD-1 when the patient has refactory melanoma.
• the patient is administered TILs in combination with and anti-PD-1 when the patient has non-small cell lung carcinoma (NSCLC).
• NSCLC non-small cell lung carcinoma
• Adoptive cell transfer is a very effective form of immunotherapy and involves the transfer of immune cells with antitumor activity into cancer patients.
• ACT is a treatment approach that involves the identification, in vitro, of lymphocytes with antitumor activity, the in vitro expansion of these cells to large numbers and their infusion into the cancer-bearing host.
• Lymphocytes used for adoptive transfer can be derived from the stroma of resected tumors (tumor infiltrating lymphocytes or TILs).
• TILs for ACT can be prepared as described herein. In some embodiments, the TILs are prepared, for example, according to a method as described in Figure 11.
• TCRs antitumor T-cell receptors
• CARs chimeric antigen receptors
• MLTCs mixed lymphocyte tumor cell cultures
• ACT in which the lymphocytes originate from the cancer-bearing host to be infused is termed autologous ACT.
• U. S. Publication No. 2011/0052530 relates to a method for performing adoptive cell therapy to promote cancer regression, primarily for treatment of patients suffering from metastatic melanoma, which is incorporated by reference in its entirety for these methods.
• TILs can be administered as described herein.
• TILs can be administered in a single dose. Such administration may be by injection, e.g., intravenous injection.
• TILs and/or cytotoxic lymphocytes may be administered in multiple doses. Dosing may be once, twice, three times, four times, five times, six times, or more than six times per year. Dosing may be once a month, once every two weeks, once a week, or once every other day. Administration of TILs and/or cytotoxic lymphocytes may continue as long as necessary.
• the invention provides a method for expanding tumor infiltrating lymphocytes (TILs) comprising:
• step f) performing a second rapid expansion of the third population of TILs in a third cell culture medium, wherein the third cell culture medium comprises IL-2, OKT-3, and peripheral blood mononuclear cells (PBMCs), wherein the second rapid expansion is performed for at least 14 days, to obtain a fourth population of TILs, wherein the fourth population of cells exhibits an increased subpopulation of effector T cells and/or central memory T cells relative to the second population of TILs; and g) optionally, repeating step f) one or more times.
• the third cell culture medium comprises IL-2, OKT-3, and peripheral blood mononuclear cells (PBMCs)
• PBMCs peripheral blood mononuclear cells
• the invention provides that said restimulated cells express CD4, CD8 and TCR ⁇ ⁇ at levels similar to freshly harvested cells.
• the invention provides that said reREP medium comprises peripheral blood mononuclear cells (PBMCs).
• PBMCs peripheral blood mononuclear cells
• the invention provides that said PBMCs are added to the TILs on any of days 9 through 17. In some embodiments, the invention provides that said PBMCs are added to the TILs on days 9, 10, 1 1, 12, 13, 14, 15, 16, and/or 17.
• the invention provides that said reREP medium comprises aAPCs.
• the invention provides that the cryopreserved TILs were transduced with an expression vector comprising a nucleic acid encoding a high-affinity T cell receptor.
• the invention provides that the cryopreserved TILs were transduced with an expression vector comprising a nucleic acid encoding a chimeric antigen receptor (CAR) comprising an immunoglobulin light chain fused with an endodomain of a T- cell signaling molecule.
• CAR chimeric antigen receptor
• the invention provides that restimulated TILs are infused into a patient.
• step d) further comprises removing the cells from the second cell culture medium.
• step f) is repeated a sufficient number of times in order to obtain sufficient TILs for a therapeutic dosage of said TILs.
• the invention provides a population of restimulated TILs made according to the methods described above and herein.
• the invention provides a population of restimulated TILs made according to the method of claim 1 wherein said restimulated TILs have at least a twofold increase in basal glycolysis as compared to said thawed cryopreserved TILs.
• the invention provides a method for assessing the metabolic activity of a TIL cell population comprising measuring the basal glycolysis of said cells.
• the invention provides a method for assessing the metabolic activity of a TIL cell population comprising measuring the basal respiration of said cells.
• the invention provides a method for assessing the metabolic activity of a TIL cell population comprising measuring the spare respiratory capacity (SRC) of said cells.
• SRC spare respiratory capacity
• the invention provides a method for assessing the metabolic activity of a TIL cell population comprising measuring the glycolytic reserve of said cells.
• the invention provides a method of treating cancer in a patient with a population of tumor infiltrating lymphocytes (TILs) comprising the steps of: a) obtaining a primary TIL population from said patient;
• cryopreserving said expanded population to form a cryopreserved TIL population; d) thawing said cryopreserved TIL population;
• the invention provides a method for expanding tumor infiltrating lymphocytes (TILs) comprising:
• step d) further comprises removing the cells from the second cell culture medium.
• step f) is repeated a sufficient number of times in order to obtain sufficient TILs for a therapeutic dosage of said TILs.
• Post REP TIL post Step D TIL according to Figure 1 1
• Allogeneic PBMC feeder cells anti-CD3 (clone OKT3) antibody
• IL-2 interleukin-2
• the post REP TIL (post Step D TIL according to Figure 1 1) were infused into the patients who were previously lymphodepleted to facilitate TIL survival and expansion in vivo. Once the TIL were re-infused into the patient, they encountered antigen, resulting in the activation of the TIL, but the TIL were ultimately short-lived. Re-stimulation of the TIL through antigen contact together with exposure to IL-2 during ACT may result in TIL proliferation and tumor control or may lead to deletion through apoptosis (activation induced cell death) or induction of a non-proliferative (anergic) state due to lack of appropriate co- stimulation.
• restimulation of post REP TIL may mimic the in vivo process by providing antigen stimulation and necessary cytokines for TIL expansion.
• Post REP TIL post Step D TIL according to Figure 11
• Post Step D TIL were activated through membrane receptors on the feeder MNCs that bind to anti-CD3 (clone OKT3) antibody and crosslink to TIL in the REP flask, stimulating the TIL to expand.
• TIL post Step D TIL according to Figure 1
• TIL were restimulated with allogeneic PBMC feeder cells, anti-CD3 (clone OKT3) antibody, and interleukin-2 (IL-2). Viable cells were counted on Day 7 and recorded.
• this procedure can also be applied to test or validate the current REP protocol.
• TIL post Step D TIL according to Figure 11
• TIL were infused into the patients who were prior lymphodepleted to facilitate TIL survival and expansion in vivo. Once the TIL were re-infused into the patient, they encountered antigen, resulting in the activation of the TIL, but the TIL were ultimately short-lived. Re-stimulation of the TIL through antigen contact together with exposure to IL-2 during ACT may result in TIL proliferation and tumor control or may lead to deletion through apoptosis (activation induced cell death) or induction of a non-proliferative (anergic) state due to lack of appropriate co- stimulation.
• apoptosis activation induced cell death
• anergic non-proliferative
• Post REP TIL were activated through membrane receptors on the feeder MNCs that bind to anti-CD3 (clone OKT3) antibody and crosslink to TIL in the REP flask, stimulating the TIL to expand.
• the Re-REP (repeat of Step D according to Figure 11) was set up in a 24 well tissue culture plate with 2 x 10 6 MNC feeder cells, 30 ng/ml OKT3, 1 x 10 4 post-REP TIL plus 3,000 IU/ml rhIL-2 in CM2. The cultures were incubated for seven days in a 5% C0 2 , 37°C humidified incubator at which point viable cell recovery and viability was determined. The fold expansion of TIL was calculated based on the viable cell counts.
• TIL TILs were obtained from fresh post REP or frozen post REP. TIL cultures were removed from the incubator and transferred to the BSC. Next, 200 ⁇ 1 was removed for a cell count using the Cellometer K2. Counts were recorded
• Vials were transferred to BSC and sprayed or wiped with 70% EtOH or IPA. Using a transfer pipette, the contents of feeder vials was immediately transferred into 50 mL of warm CM2 in a 50-mL conical tube. 200 ⁇ 1 was removed for cell counting using the Cellometer K2. Counts were recorded. Cells were centrifuged at 350 x g for 10 minutes. The supernatant and resuspended cells were aspirated in a desired volume at 2 x 10 6 cells/ml in warm CM2 plus 3000 IU/ml rhIL-2.
• CM2 A sufficient amount of CM2 was prepared for the conditions needed. Each well contained 2 ml of CM2. Each well was supplemented the CM2 with 3000 IU/mL of rhIL-2. From the stock of 6 xlO 6 IU/mL, 50 ⁇ was needed for each 100 ml of CM2.
• Each plate was labeled with Experiment Name, Feeder Lot #, post-REP TIL designation, date, and operator initials. Each plate was filled with components as listed in Table 8. Each component was added and each well filled with a total of 2 ml and place the plates into 37°C incubator. Plates were mixed carefully 3 times using 1 ml pipette.
• CM2 was prepared with 3000 IU/ml rhIL-2. 10ml was needed. 1 ml of the media was removed from each well and discarded. With a 1 ml pipette, 1 ml warm CM2 with 3000 IU/mL rhIL-2 was transferred to each well . The plates were returned to the incubator.
• EXAMPLE 2 DETERMINATION OF CELL COUNT AND VIABILITY OF TIL CULTURES USING THE CELLOMETER K2 CELL COUNTER
• This example provides exemplary instructions for how the operation of the Cellometer K2 Image Cytometer automatic cell counter was carried out.
• Scope Determination of the total cell count and viability of cell cultures.
• the final Trypan blue concentration was 0.1%.
• the Trypan blue was filtered with a 0.2-0.4 micron filter and aliquoted in small volumes into labeled, capped tubes.
• the cell suspension was mixed at 1 : 1 with 0.2 % trypan blue.
• sample ID was clicked to open another screen to input operator's information for specimen. "User ID” was entered. This consisted of the user's three letter initials. Enter “Sample ID”. The sample ID was derived from incoming specimen information.
• the dilution factor was 2.
• the dilution factor was 2 times of the prior dilution. The dilution factor was updated according to the mixture used.
• the plastic backing was removed from both sides of a Cellometer counting chamber slide (SD100) and placed on top of a clean, lint-free wipe. After preparing the cell suspension, a small aliquot of the sample was removed and transferred into a well of a multiwell cell culture plate or tube. When diluting the sample, the dilution was performed using cell culture medium. 20 ⁇ of cell suspension was added into a well of the multiwell cell culture plate or tube. 20 1 of 0.2% trypan blue or the AOPI solution was added to the 20 ⁇ 1 of cell suspension and the sample mixed thoroughly. 20 ⁇ 1 of the 1 : 1 solution was measured and transferred it into one side of the counting chamber. NOTE: Touching the clear area of the slide was avoided.
• the final Trypan blue concentration was 0.1%.
• the cell suspension was mixed at 1 : 1 with 0.2 % trypan blue.
• sample ID was entered.
• the sample ID was derived from incoming specimen information.
• the dilution factor was updated according to the mixture used in the dilution section of the screen.
• the pencil icon was selected to bring up the dialog screens.
• the chamber was inserted into the slot on the front of the Cellometer.
• Preview Fl was selected on the main screen to preview the green fluorescent image (live cell) image.
• Preview Brightfield was selected.
• the focusing wheel was used to bring image into optimal focus. Cells had a bright center and a clearly-defined edge.
• This example describes an exemplary preparation procedure for an IL-2 stock solution.
• ⁇ L microliter or ⁇
• D-PBS Dulbecco's Phosphate Buffered Saline
• HSA Human Serum Albumin
• PPE Personal Protective Equipment
• IL-2 Recombinant human Interleukin-2
• the specific activity for the 1 mg vial was 25x10 6 IU/mg. It recommends reconstituting the rhIL-2 in 2mL
• Rh-IL-2 labels included vendor and catalog number, lot number, expiration date, operator initials, concentration and volume of aliquot.
• This Example describes the procedure for the preparation of tissue culture media for use in protocols involving the culture of tumor infiltrating lymphocytes (TIL) derived from various tumor types including, but not limited to, metastatic melanoma, head and neck squamous cell carcinoma, ovarian carcinoma, triple-negative breast carcinoma, and lung adenocarcinoma. In many cases, this media was used for preparation of any of the TILs described in the present application and Examples.
• TIL tumor infiltrating lymphocytes
• AIM-V® serum-free tissue culture medium (Thermo Fisher Scientific)
• preparation of serum e.g., 100ml or 500ml volumes.
• CMl was discarded no more than two weeks after preparation, or as the phenol red pH indicator showed an extreme shift in pH (bright red to pink coloration).
• CM 1 was prepared by sub stituting 2mM
• CMl formulations required additional antibiotic or antimycotic to prevent contamination of pre-REP TIL grown from
• CM2 8.1.3 Prepared the amount of CM2 needed by mixing prepared CMl with an equal volume of AIM-V® in a sterile media bottle.
• CM3 was the same as AEVI-V® medium, supplemented with 3000 IU/ml IL-2 on the day of use.
• IL-2 stock solution directly to the bottle or bag of AIM-V. Mixed well by gentle shaking. Labeled bottle with "3000 IU/ml IL-2" immediately after adding to the AIM-V. When there was excess CM3, it was stored in bottles at 4°C labeled with the media name, the initials of the preparer, the date the media was prepared, and its expiration date (7 days after preparation).
• CM4 was the same as CM3, with the additional supplement of 2mM GlutaMAXTM (final concentration).
• CM4 8.3.4 If there was excess CM4, it was stored in bottles at 4°C labeled with the media name, "GlutaMAX", the initials of the preparer, the date the media was prepared, and its expiration date (7 days after preparation).
• This Example describes a novel abbreviated procedure for qualifying individual lots of gamma-irradiated peripheral mononuclear cells (PBMCs, also known as MNC) for use as allogeneic feeder cells in the exemplary methods described herein.
• PBMCs peripheral mononuclear cells
• Each irradiated MNC feeder lot was prepared from an individual donor. Each lot or donor was screened individually for its ability to expand TIL in the REP in the presence of purified anti-CD3 (clone OKT3) antibody and interleukin-2 (IL-2). In addition, each lot of feeder cells was tested without the addition of TIL to verify that the received dose of gamma radiation was sufficient to render them replication incompetent.
• clone OKT3 purified anti-CD3
• IL-2 interleukin-2
• Feeder lots were evaluated on two criteria: 1) their ability to expand TIL in co- culture >100-fold and 2) their replication incompetency.
• Feeder lots were tested in mini-REP format utilizing two primary pre-REP TIL lines grown in upright T25 tissue culture flasks. Feeder lots were tested against two distinct TIL lines, as each TIL line was unique in its ability to proliferate in response to activation in a REP. As a control, a lot of irradiated MNC feeder cells which was historically been shown to meet the criteria of 1) and 2): (1) their ability to expand TIL in co-culture >100-fold and (2) their replication incompetency was run alongside the test lots.
• Flasks containing TIL lines #1 and #2 evaluated the ability of the feeder lot to expand TIL.
• the feeder control flasks evaluated the replication
• CM2 medium as per Example 5, Pre-REP and REP Media Preparation. Warmed CM2 in 37°C water bath. Prepared 40 ml of CM2 supplemented with 3000IU/ml IL- 2. Kept warm until use. Placed 20ml of pre-warmed CM2 without IL-2 into each of two 50ml conical tubes labeled with names of the TIL lines used. Removed the two designated pre-REP TIL lines from LN2 storage and transfer the vials to the tissue culture room. Recorded TIL line identification form. Thawed vials by placing them inside a sealed zipper storage bag in a 37°C water bath until a small amount of ice remains.
• CM2 medium for the number of feeder lots to be tested, (e.g., for testing 4 feeder lots at one time, prepare 800ml of CM2 medium). Aliquoted a portion of the CM2 prepared in Example 5 and supplemented it with 3000 IU/ml IL-2 for the culturing of the cells, (e.g., for testing 4 feeder lots at one time, prepare 500ml of CM2 medium with 3000 IU/ml IL-2). The remainder of the CM2 with no IL-2 was used for washing of cells as described below. Prepared TIL
• TIL were diluted 1 : 10 for a final concentration of 1.3 x 10 5 cells/ml as per step 7.3.2.35 below.
• Each 1ml vial frozen by SDBB had 100 x 10 6 viable cells upon freezing.
• TIL cells Diluted TIL cells from 1.3 x 10 6 cells/ml to 1.3 x 10 5 cells/ml. Worked with each TIL line independently to prevent cross-contamination.
• CM2 medium Added 4.5ml of CM2 medium to a 15ml conical tube. .36.2. Removed TIL cells from incubator and resuspended well using a 10ml serological pipet.
• Feeder control flasks were evaluated for replication incompetence and flasks containing TIL were evaluated for fold expansion from Day 0 according to the criteria listed in Figure 2.
• Acceptance was two-fold, as follows (outlined in Figure 2. Acceptance Criteria): [00388] Whether the dose of radiation was sufficient to render the MNC feeder cells replication incompetent when cultured in the presence of 30ng/ml OKT3 antibody and 3000 IU/ml JL-2 was evaluated.
• Replication incompetence was evaluated by total viable cell count (TVC) as determined by automated cell counting on Day 7 and Day 14 of the REP.
• TVC total viable cell count
• Acceptance criteria is "No Growth,” meaning the total viable cell number had not increased on Day 7 and Day 14 from the initial viable cell number put into culture on Day 0 of the REP.
• TIL growth was measured in terms of fold expansion of viable cells from the onset of culture on Day 0 of the REP to Day 7 of the REP.
• TIL cultures achieved a minimum of 100-fold expansion, (i.e., greater than 100 times the number of total viable TIL cells put into culture on REP Day 0), as evaluated by automated cell counting.
• Acceptance criteria was "No Growth,” meaning the total viable cell number was not increased on Day 7 and Day 14 from the initial viable cell number put into culture on Day 0 of the REP.
• TIL growth was measured in terms of fold expansion of viable cells from the onset of culture on Day 0 of the REP to Day 7 of the REP.
• TIL cultures achieved a minimum of 100-fold expansion, (i.e., greater than 100 times the number of total viable TIL cells put into culture on REP Day 0), as evaluated by automated cell counting.
• Two trained personnel include the original person who evaluated the lot in question, had to both test the lot at the same time.
• Section 7.2 - 7.3 was done to re-evaluate the lot in question. Each person would test the lot in question as well as a control lot (as defined in Section 7.2.4 above).
• EXAMPLE 7 PROCEDURE FOR QUALIFYING INDIVIDUAL LOTS OF GAMMA- IRRADIATED PERIPHERAL BLOOD MONONUCLEAR CELLS
• This Example describes a novel abbreviated procedure for qualifying individual lots of gamma-irradiated peripheral blood mononuclear cells (PBMC) for use as allogeneic feeder cells in the exemplary methods described herein.
• PBMC peripheral blood mononuclear cells
• This example provides a protocol for the evaluation of irradiated PBMC cell lots for use in the production of clinical lots of TIL.
• Each irradiated PBMC lot was prepared from an individual donor. Over the course of more than 100 qualification protocols, it has been shown that, in all cases, irradiated PBMC lots from SDBB (San Diego Blood Bank) can expand TILs >100-fold on Day 7 of a REP.
• SDBB San Diego Blood Bank
• This modified qualification protocol is intended to apply to irradiated donor PBMC lots from SDBB which must still be tested to verify that the received dose of gamma radiation was sufficient to render them replication incompetent. Once demonstrated that they maintain replication incompetence over the course of 14 days, donor PBMC lots were considered "qualified" for usage to produce clinical lots of TIL.

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