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      Expansion of tumor infiltrating lymphocytes (TIL) from bladder cancer

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          ABSTRACT

          Advanced bladder cancer patients have limited therapeutic options resulting in a median overall survival (OS) between 12 and 15 months. Adoptive cell therapy (ACT) using tumor infiltrating lymphocytes (TIL) has been used successfully in treating patients with metastatic melanoma, resulting in a median OS of 52 months. In this study, we investigated the feasibility of expanding TIL from the tumors of bladder cancer patients. Primary bladder tumors and lymph node (LN) metastases were collected. Tumor specimens were minced into fragments, placed in individual wells of a 24-well plate, and propagated in high dose IL-2 for four weeks. Expanded TIL were phenotyped by flow cytometry and anti-tumor reactivity was assessed after co-culture with autologous tumor digest and IFN-gamma ELISA. Of the 28 transitional cell bladder or LN tumors collected, 14/20 (70%) primary tumors and all of the LN metastases demonstrated TIL expansion. Expanded TIL were predominantly CD3 + (median 63%, range 10–87%) with a median of 30% CD8 + T cells (range 5–70%). TIL secreted IFN-gamma in response to autologous tumor. Addition of agonisitic 4-1BB antibody improved TIL expansion from primary bladder tumors regardless of pre-treatment with chemotherapy. This study establishes the practical first step towards an autologous TIL therapy process for therapeutic testing in patients with bladder cancer.

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          Specific lymphocyte subsets predict response to adoptive cell therapy using expanded autologous tumor-infiltrating lymphocytes in metastatic melanoma patients.

          Adoptive cell therapy (ACT) using autologous tumor-infiltrating lymphocytes (TIL) is a promising treatment for metastatic melanoma unresponsive to conventional therapies. We report here on the results of an ongoing phase II clinical trial testing the efficacy of ACT using TIL in patients with metastatic melanoma and the association of specific patient clinical characteristics and the phenotypic attributes of the infused TIL with clinical response. Altogether, 31 transiently lymphodepleted patients were treated with their expanded TIL, followed by two cycles of high-dose interleukin (IL)-2 therapy. The effects of patient clinical features and the phenotypes of the T cells infused on the clinical response were determined. Overall, 15 of 31 (48.4%) patients had an objective clinical response using immune-related response criteria (irRC) with 2 patients (6.5%) having a complete response. Progression-free survival of more than 12 months was observed for 9 of 15 (60%) of the responding patients. Factors significantly associated with the objective tumor regression included a higher number of TIL infused, a higher proportion of CD8(+) T cells in the infusion product, a more differentiated effector phenotype of the CD8(+) population, and a higher frequency of CD8(+) T cells coexpressing the negative costimulation molecule "B- and T-lymphocyte attenuator" (BTLA). No significant difference in the telomere lengths of TIL between responders and nonresponders was identified. These results indicate that the immunotherapy with expanded autologous TIL is capable of achieving durable clinical responses in patients with metastatic melanoma and that CD8(+) T cells in the infused TIL, particularly differentiated effectors cells and cells expressing BTLA, are associated with tumor regression.
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            Clinical responses in a phase II study using adoptive transfer of short-term cultured tumor infiltration lymphocytes in metastatic melanoma patients.

            Adoptive cell therapy with autologous tumor-infiltrating lymphocytes (TIL) has shown promising results in metastatic melanoma patients. Although objective response rates of over 50% have been reported, disadvantages of this approach are the labor-intensive TIL production and a very high drop-out rate of enrolled patients, limiting its widespread applicability. Previous studies showed a clear correlation between short TIL culture periods and clinical response. Therefore, we used a new TIL production technique using unselected, minimally cultured, bulk TIL (Young-TIL). The use of Young-TIL is not restricted to human leukocyte antigen (HLA)-A2 patients. The purpose of this study is to explore the efficacy and toxicity of adoptively transferred Young-TIL following lympho-depleting chemotherapy in metastatic melanoma patients, refractory to interleukin-2 and chemotherapy. Young-TIL cultures for 90% of the patients were successfully generated, enabling the treatment of most enrolled patients. We report here the results of 20 evaluated patients. Fifty percent of the patients achieved an objective clinical response according to the Response Evaluation Criteria in Solid Tumors, including two ongoing complete remissions (20+, 4+ months) and eight partial responses (progression-free survival: 18+, 13+, 10+, 9, 6+, 4, 3+, and 3 months). All responders are currently alive. Four additional patients showed disease stabilization. Side effects were transient and manageable. We showed that lympho-depleting chemotherapy followed by transfer of short-term cultured TIL can mediate tumor regression in 50% of metastatic melanoma with manageable toxicity. The convincing clinical results combined with the simplification of the process may thus have a major effect on cell therapy of cancer. Copyright 2010 AACR.
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              Safety and activity of pembrolizumab in patients with locally advanced or metastatic urothelial cancer (KEYNOTE-012): a non-randomised, open-label, phase 1b study.

              PD-1 and its ligands are expressed in urothelial cancer, and findings have shown that inhibition of the PD-1 pathway has clinical benefit. We aimed to assess the safety and activity of an anti-PD-1 antibody pembrolizumab in patients with locally advanced or metastatic urothelial cancer.
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                Author and article information

                Journal
                Oncoimmunology
                Oncoimmunology
                KONI
                koni20
                Oncoimmunology
                Taylor & Francis
                2162-4011
                2162-402X
                2018
                23 July 2018
                23 July 2018
                : 7
                : 9
                : e1476816
                Affiliations
                [a ]Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute , Tampa, USA
                [b ]Immunology, Moffitt Cancer Center and Research Institute , Tampa, USA
                [c ]Pathology, Moffitt Cancer Center and Research Institute , Tampa, USA
                [d ]Cell Therapies, Moffitt Cancer Center and Research Institute , Tampa, USA
                [e ]Sarcoma, Moffitt Cancer Center and Research Institute , Tampa, USA
                [f ]Cutaneous Oncology, Moffitt Cancer Center and Research Institute , Tampa, USA
                Author notes
                CONTACT Shari Pilon-Thomas Shari.pilon-thomas@ 123456moffitt.org H. Lee Moffitt Cancer Center , 12902 Magnolia Drive, SRB-3, Tampa, FL 33612

                Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/koni.

                Author information
                http://orcid.org/0000-0002-4880-6981
                Article
                1476816
                10.1080/2162402X.2018.1476816
                6140546
                30228944
                e1774419-573a-4fa2-b387-e32dd1a58c15
                © 2018 Taylor & Francis Group, LLC

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

                History
                : 9 April 2018
                : 9 May 2018
                : 8 May 2018
                Page count
                Figures: 4, Tables: 2, References: 24, Pages: 7
                Funding
                Funded by: HHS | NIH | National Cancer Institute (NCI)
                Award ID: NCI-5K23CA178083
                Funded by: American Cancer Society (ACS)
                Award ID: RSG-16-117-01-LIB).
                This work was funded by Iovance Biotherapeutics, Swim Across America, and the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation. AAS was supported by NCI-5K23CA178083. SPT was supported by an American Cancer Society - Leo and Anne Albert Charitable Foundation Research Scholar Grant, (RSG-16-117-01-LIB).
                Categories
                Original Research

                Immunology
                t cells,bladder cancer,immunotherapy,tumor-infiltrating lymphocytes,4-1bb
                Immunology
                t cells, bladder cancer, immunotherapy, tumor-infiltrating lymphocytes, 4-1bb

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