Restimulation of cryopreserved tumor infiltrating lymphocytes
The present disclosure provides methods for re-stimulating TIL populations that lead to improved phenotype and increased metabolic health of the TILs and provides methods of assaying for TIL populations to determine suitability for more efficacious infusion after re-stimulation.
1. A method for treating a subject with a cancer comprising administering expanded tumor infiltrating lymphocytes (TILs) comprising:
(a) performing a first expansion by (i) thawing a cryopreserved tumor digest comprising a first population of TILs from a tumor that was resected from the subject, digested after the resection, and cryopreserved after the digestion, and (ii) culturing the first population of TILs in a cell culture medium comprising IL-2 to produce a second population of TILs;
(b) performing a second expansion by supplementing the cell culture medium of the second population of TILs with additional IL-2, OKT-3, and antigen presenting cells (APCs), to produce a third population of TILs, wherein the third population of TILs is a therapeutic population of TILs, and wherein the second expansion is performed for about 7 to 14 days in order to obtain the therapeutic population of TILs;
(c) harvesting the therapeutic population of TILs obtained from step (b);
(d) admixing the harvested therapeutic population of TILs from step (c) with a cryopreservation media to form an admixture;
(e) cryopreserving the admixture from step (d) using a cryopreservation process to produce a cryopreserved TIL composition; and
(f) administering a therapeutically effective dosage of the third population of TILs to the subject.
2. The method according to claim 1 , wherein the tumor digest in step (a) was prepared by incubating a sample of the tumor that was resected from the subject in an enzymatic media.
3. The method according to claim 2 , further comprising disrupting the tumor sample mechanically so as to dissociate the tumor sample.
4. The method according to claim 3 , further comprising purifying the dissociated tumor sample using a density gradient separation.
5. The method according to claim 2 , wherein the enzymatic media comprises DNase.
6. The method according to claim 5 , wherein the enzymatic media comprises 30 units/mL of DNase.
7. The method according to claim 2 , wherein the enzymatic media comprises collagenase.
8. The method according to claim 7 , wherein the enzymatic media comprises 1.0 mg/mL of collagenase.
9. The method according to claim 1 , wherein the cell culture medium is CTS Optimizer.
10. The method according to claim 1 , wherein the therapeutically effective dosage in step (f) comprises from about 1×10 9 to about 9×10 10 TILs.
11. The method according to claim 1 , wherein the APCs comprise peripheral blood mononuclear cells (PBMCs).
12. The method according to claim 1 , wherein prior to administering a therapeutically effective dosage of TIL cells in step (f), a non-myeloablative lymphodepletion regimen has been administered to the subject.
13. The method according to claim 12 , where the non-myeloablative lymphodepletion regimen comprises the steps of administration of cyclophosphamide at a dose of 60 mg/m 2 /day for two days followed by administration of fludarabine at a dose of 25 mg/m 2 /day for five days.
14. The method according to claim 1 , further comprising the step of treating the subject with a high-dose IL-2 regimen starting on the day after administration of the TIL cells to the subject in step (f).
15. The method according to claim 14 , wherein the high-dose IL-2 regimen comprises 600,000 or 720,000 IU/kg administered as a 15-minute bolus intravenous infusion every eight hours until tolerance.
16. The method according to claim 1 , wherein step (a) further comprises adding the thawed tumor digest into a closed system prior to culturing the first population of TILs, and wherein the transition from step (a) to step (b), the transition from step (b) to step (c), and the transition from step (c) to step (d) occurs without opening the system.
17. The method according to claim 1 , wherein the cancer is selected from the group consisting of melanoma (including metastatic 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 (including head and neck squamous cell carcinoma (HNSCC)), renal cancer, and renal cell carcinoma.
18. The method according to claim 1 , wherein the first expansion is performed within from about 3 to 11 days.
19. The method according to claim 1 , wherein steps (a) through (e) are performed within about 24 days.
20. The method according to claim 1 , wherein the cryopreservation media comprises DMSO.