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 melanoma comprising administering expanded tumor infiltrating lymphocytes (TILs) comprising:
(a) performing a first expansion by (i) thawing cryopreserved dissociated tumor materials comprising a first population of TILs obtained from a tumor that was resected from the subject, 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 14 to 22 days in order to obtain the third population of TILs;
(c) harvesting the third population of TILs obtained from step (b);
(d) transferring the harvested third population of TILs from step (c) into an infusion bag;
(e) cryopreserving the infusion bag comprising the harvested TIL population from step (d) using a cryopreservation process; 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 dissociated tumor materials comprise a tumor digest.
3. The method according to claim 1 , wherein obtaining the dissociated tumor materials comprises fragmenting the tumor resected from the subject into one or more tumor fragments.
4. The method according to claim 1 , wherein obtaining the dissociated tumor materials comprises mechanically disrupting the tumor resected from the subject.
5. The method according to claim 1 , wherein obtaining the dissociated tumor materials comprises enzymatically disrupting the tumor resected from the subject.
6. 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.
7. The method according to claim 1 , wherein the APCs comprise peripheral blood mononuclear cells (PBMCs).
8. 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.
9. The method according to claim 8 , 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.
10. 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).
11. The method according to claim 10 , 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.
12. The method according to claim 1 , wherein step (a) further comprises adding the thawed dissociated tumor materials into a closed system prior to culturing the first population of TILs.
13. The method according to claim 12 , wherein the transition from step (a) to step (b), the transition from step (b) to step (c), or the transition from step (c) to step (d) occurs without opening the system.
14. The method according to claim 1 , wherein step (a) further comprises adding the thawed dissociated tumor materials into a closed system prior to culturing the first population of TILs, wherein the transition from step (a) to step (b) occurs without opening the system, wherein the transition from step (b) to step (c) occurs without opening the system, and wherein the transition from step (c) to step (d) occurs without opening the system.
15. The method according to claim 1 , wherein the first expansion is performed within from about 11 to 21 days.
16. The method according to claim 1 , wherein the first expansion is performed within about 11 days, 12 days, 13 days or 14 days.
17. The method according to claim 1 , wherein the second expansion is performed within about 14 days, 15 days, 16 days, 17 days, 18 days, 19 days, 20 days, 21 days or 22 days.
18. The method according to claim 1 , wherein the second expansion is performed within about 14 days, 15 days, 16 days or 17 days.
19. The method according to claim 1 , wherein the second expansion is performed within about 14 days or 15 days.
20. The method according to claim 1 , wherein steps (a) through (e) are performed within about 24 days.
21. The method according to claim 1 , wherein the cryopreserved dissociated tumor materials were obtained by cryopreserving dissociated tumor materials in a cryopreservation media comprising DMSO.
22. The method according to claim 21 , wherein the cryopreservation media comprises 5% DMSO.