Remnant tumor infiltrating lymphocytes and methods of preparing and using the same
In some embodiments, methods of delivering a therapeutically effective amount of an expanded number of tumor infiltrating lymphocytes obtained from tumor remnants to a patient in need thereof, for the treatment of a cancer, are disclosed.
1. A method of treating a cancer in a patient in need of such treatment, the method comprising:
obtaining a therapeutically effective amount of remnant tumor infiltrating lymphocytes (rTILs), by enzymatically digesting tumor remnants separated from emergent tumor infiltrating lymphocytes (eTILs) using a digest mixture comprising a deoxyribonuclease, a collagenase, a hyaluronidase, or a combination thereof, and expanding the rTILs with a second cell culture medium comprising cell culture media, irradiated feeder cells, OKT-3 antibody, and interleukin 2 (IL-2), wherein the tumor remnants and the eTILs are derived from tumor tissue that was obtained from the patient, fragmented and treated with a first cell culture medium comprising IL-2,
and administering the therapeutically effective amount of rTILs to the patient.
2. The method of claim 1 , wherein the tumor tissue is selected from the group consisting of melanoma tumor tissue, head and neck tumor tissue, breast tumor tissue, renal tumor tissue, pancreatic tumor tissue, glioblastoma tumor tissue, lung tumor tissue, colorectal tumor tissue, sarcoma tumor tissue, triple negative breast tumor tissue, cervical tumor tissue, ovarian tumor tissue, and acute myeloid leukemia bone marrow or tumor tissue.
3. The method of claim 1 , wherein the irradiated feeder cells comprise irradiated allogeneic peripheral blood mononuclear cells.
4. The method of claim 1 , wherein IL-2 is present in the second cell culture medium at an initial concentration of about 3000 IU/mL and OKT-3 antibody is present in the second cell culture medium at an initial concentration of about 30 ng/mL.
5. The method of claim 1 , wherein CD56 + expression in the rTILs is reduced by at least 3-fold relative to CD56 + expression in the eTILs.
6. The method of claim 1 , wherein CD69 + expression in the rTILs is increased by at least 2-fold relative to CD69 + expression in the eTILs.
7. The method of claim 1 , wherein the first cell culture medium further comprises a cytokine selected from the group consisting of IL-4, IL-7, IL-15, IL-21, and combinations thereof.
8. The method of claim 1 , wherein the second cell culture medium further comprises a cytokine selected from the group consisting of IL-4, IL-7, IL-15, IL-21, and combinations thereof.
9. The method of claim 1 , wherein the rTILs are cryopreserved prior to obtaining the rTILs.
10. The method of claim 9 , further comprising the step of thawing the cryopreserved rTILs prior to obtaining the rTILs.
11. The method of claim 1 , further comprising the steps of:
administering a non-myeloablative lymphodepletion regimen to the patient prior to administering of the therapeutically effective amount of rTILs to the patient; and
administering a high-dose IL-2 regimen to the patient starting on the day after administering of the therapeutically effective amount of rTILs to the patient.
12. The method of claim 11 , wherein a therapeutically effective amount of eTILs is simultaneously obtained in a mixture with the therapeutically effective amount of rTILs.
13. The method of claim 11 , wherein the non-myeloablative lymphodepletion regimen comprises the steps of administering cyclophosphamide to the patient at a dose of 60 mg/m2/day for two days followed by administering fludarabine to the patient at a dose of 25 mg/m2/day for five days.
14. The method of claim 11 , wherein the high-dose IL-2 regimen comprises 600,000 or 720,000 IU/kg of aldesleukin, or a biosimilar or variant thereof, administered to the patient as a 15-minute bolus intravenous infusion every eight hours until tolerance.
15. The method of claim 1 , wherein the cancer is selected from the group consisting of melanoma, double-refractory melanoma, uveal melanoma, ovarian cancer, cervical cancer, lung cancer, bladder cancer, breast cancer, head and neck cancer, renal cell carcinoma, acute myeloid leukemia, colorectal cancer, and sarcoma.
16. The method of claim 15 , wherein the cancer is breast cancer, and wherein the breast cancer is selected from the group consisting of triple negative breast cancer, estrogen receptor-positive breast cancer, progesterone receptor-positive breast cancer, and estrogen receptor-positive/progesterone receptor-positive breast cancer.
17. The method of claim 15 , wherein the cancer is lung cancer, and the lung cancer is selected from the group consisting of non-small cell lung cancer and small cell lung cancer.
18. The method of claim 1 , wherein the therapeutically effective amount of rTILs is provided in a pharmaceutical composition, wherein the concentration of the rTILs in the pharmaceutical composition is greater than 50%.