Processes for production of tumor infiltrating lymphocytes and uses of same in immunotherapy
The present invention provides improved and/or shortened methods for expanding TILs and producing therapeutic populations of TILs, including novel methods for expanding TIL populations in a closed system that lead to improved efficacy, improved phenotype, and increased metabolic health of the TILs in a shorter time period, while allowing for reduced microbial contamination as well as decreased costs. Such TILs find use in therapeutic treatment regimens.
1. A method for expanding tumor infiltrating lymphocytes (TILs), the method 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 a subject with cancer, 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, wherein the first expansion is performed in a closed container providing a first gas-permeable surface area, wherein the first expansion is performed for about 3-11 days to obtain the 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 second expansion is performed for about 7-11 days to obtain the third population of TILs, wherein the second expansion is performed in a closed container providing a second gas-permeable surface area, and wherein the transition from step (a) to step (b) occurs without opening the system; and
(c) harvesting the third population of TILs obtained from step (b), wherein the transition from step (b) to step (c) occurs without opening the system.
2. The method according to claim 1 , further comprising:
(d) transferring the harvested third TIL population from step (c) to an infusion bag, wherein the transfer from step (c) to (d) occurs without opening the system.
3. The method according to claim 2 , further comprising:
(e) cryopreserving the infusion bag comprising the harvested TIL population from step (d) using a cryopreservation process.
4. The method according to claim 3 , further comprising:
(f) administering a therapeutically effective dosage of the third population of TILs from the infusion bag in step (e) to the subject.
5. 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.
6. The method according to claim 5 , further comprising disrupting the tumor sample mechanically so as to dissociate the tumor sample.
7. The method according to claim 6 , further comprising purifying the disassociated tumor sample using a density gradient separation.
8. The method according to claim 5 , wherein the enzymatic media comprises DNase.
9. The method according to claim 8 , wherein the enzymatic media comprises 30 units/mL of DNase.
10. The method according to claim 5 , wherein the enzymatic media comprises collagenase.
11. The method according to claim 10 , wherein the enzymatic media comprises 1.0 mg/mL of collagenase.
12. The method according to claim 1 , wherein the cell culture medium is CTS Optimizer.
13. The method according to claim 4 , wherein the third population of TILs harvested in step (c) comprises sufficient TILs for administering a therapeutically effective dosage of the TILs in step (f).
14. The method according to claim 13 , wherein the therapeutically effective dosage in step (f) comprises from about 1×10 9 to about 9×10 10 TILs.
15. The method according to claim 1 , wherein the APCs comprise peripheral blood mononuclear cells (PBMCs).
16. The method according to claim 4 , 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.
17. The method according to claim 16 , 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.
18. The method according to claim 4 , 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).
19. The method according to claim 18 , 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.
20. The method according to claim 4 , wherein the third population of TILs in step (c) provides for increased efficacy, increased interferon-gamma (IFN-γ) production, increased polyclonality, increased average IP-10, and/or increased average MCP-1 when administered to the subject.
21. 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.
22. The method according to claim 1 , wherein the cancer is a melanoma.
23. The method according to claim 1 , wherein the first expansion in step (a) and the second expansion in step (b) are each individually performed within a period of 11 days.
24. The method according to claim 1 , wherein steps (a) through (c) are performed in about 10 days to about 22 days.