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Nguyen LT, Yen PH, Nie J, Liadis N, Ghazarian D, Al-Habeeb A, Easson A, Leong W, Lipa J, McCready D, Reedijk M, Hogg D, Joshua AM, Quirt I, Messner H, Shaw P, Crump M, Sharon E, Ohashi PS. Expansion and characterization of human melanoma tumor-infiltrating lymphocytes (TILs). PLoS One 2010; 5:e13940. [PMID: 21085676 PMCID: PMC2978109 DOI: 10.1371/journal.pone.0013940] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 10/19/2010] [Indexed: 12/26/2022] Open
Abstract
Background Various immunotherapeutic strategies for cancer are aimed at augmenting the T cell response against tumor cells. Adoptive cell therapy (ACT), where T cells are manipulated ex vivo and subsequently re-infused in an autologous manner, has been performed using T cells from various sources. Some of the highest clinical response rates for metastatic melanoma have been reported in trials using tumor-infiltrating lymphocytes (TILs). These protocols still have room for improvement and furthermore are currently only performed at a limited number of institutions. The goal of this work was to develop TILs as a therapeutic product at our institution. Principal Findings TILs from 40 melanoma tissue specimens were expanded and characterized. Under optimized culture conditions, 72% of specimens yielded rapidly proliferating TILs as defined as at least one culture reaching ≥3×107 TILs within 4 weeks. Flow cytometric analyses showed that cultures were predominantly CD3+ T cells, with highly variable CD4+:CD8+ T cell ratios. In total, 148 independent bulk TIL cultures were assayed for tumor reactivity. Thirty-four percent (50/148) exhibited tumor reactivity based on IFN-γ production and/or cytotoxic activity. Thirteen percent (19/148) showed specific cytotoxic activity but not IFN-γ production and only 1% (2/148) showed specific IFN-γ production but not cytotoxic activity. Further expansion of TILs using a 14-day “rapid expansion protocol” (REP) is required to induce a 500- to 2000-fold expansion of TILs in order to generate sufficient numbers of cells for current ACT protocols. Thirty-eight consecutive test REPs were performed with an average 1865-fold expansion (+/− 1034-fold) after 14 days. Conclusions TILs generally expanded efficiently and tumor reactivity could be detected in vitro. These preclinical data from melanoma TILs lay the groundwork for clinical trials of ACT.
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Affiliation(s)
- Linh T. Nguyen
- Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, Canada
| | - Pei Hua Yen
- Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, Canada
| | - Jessica Nie
- Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, Canada
| | - Nicole Liadis
- Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, Canada
| | - Danny Ghazarian
- Department of Pathology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Ayman Al-Habeeb
- Department of Pathology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Alexandra Easson
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Wey Leong
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Joan Lipa
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - David McCready
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Michael Reedijk
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - David Hogg
- Department of Medical Oncology/Hematology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Anthony M. Joshua
- Department of Medical Oncology/Hematology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Ian Quirt
- Department of Medical Oncology/Hematology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Hans Messner
- Department of Medical Oncology/Hematology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Patricia Shaw
- Department of Pathology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Michael Crump
- Department of Medical Oncology/Hematology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Eran Sharon
- Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
| | - Pamela S. Ohashi
- Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, Canada
- Departments of Medical Biophysics and Immunology, University of Toronto, Toronto, Canada
- * E-mail:
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Westwood JA, Berry LJ, Wang LX, Duong CP, Pegram HJ, Darcy PK, Kershaw MH. Enhancing adoptive immunotherapy of cancer. Expert Opin Biol Ther 2010; 10:531-45. [PMID: 20132063 DOI: 10.1517/14712591003610622] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Conventional therapies, including surgery, chemotherapy and radiotherapy have contributed much to cancer treatment. However, these treatment modalities fail in a large proportion of patients, and there is a great need for effective alternate therapies. Adoptive immunotherapy can be effective against some cancers that have failed all other treatment options, even when disease burdens are massive. AREAS COVERED IN THIS REVIEW This review gives a brief introduction of the historical origins of adoptive immunotherapy and then provides details of strategies for increasing the potency of cell transfer. Approaches for enhancing adoptive immunotherapy include: selecting the right type of cell; providing cytokine support; preconditioning patients and tuning the tumor microenvironment. The review also provides insights into the safety, feasibility and costs of this form of therapy. WHAT THE READER WILL GAIN This article will give the reader an appreciation of the potential of adoptive immunotherapy, as well as an understanding of some limitations and current approaches for optimizing the effectiveness of this approach. TAKE HOME MESSAGE With recent developments in knowledge of the interactions between the immune system and tumors, the field of adoptive immunotherapy is now poised to make dramatic contributions to cancer therapy.
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Affiliation(s)
- Jennifer A Westwood
- Peter MacCallum Cancer Centre, Cancer Immunology Research Program, St. Andrews Place, Melbourne, Victoria 3002, Australia
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Klatte T, Ittenson A, Röhl FW, Ecke M, Allhoff EP, Böhm M. Pretreatment with interferon-alpha2a modulates perioperative immunodysfunction in patients with renal cell carcinoma. ACTA ACUST UNITED AC 2008; 31:28-34. [PMID: 18268396 DOI: 10.1159/000112214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Complex perioperative immunodysfunction occurs in patients with renal cell carcinoma undergoing surgery. Here, we report on the effect of preoperative treatment with interferon-alpha2a (IFN-alpha2a). MATERIALS AND METHODS 30 patients with a renal tumour received preoperative IFN-alpha2a for 6 days beginning 1 week before nephrectomy, 30 did not. Parameters of cellular and humoral immunity were measured in venous blood at various intervals using flow cytometry and ELISA. Endpoints included effects on immune parameters, toxicity, and survival. RESULTS Toxicity was grade 1 in 52%, 2 in 30%, and 3 in 4%. During IFN-alpha2a administration, leukocytes, monocytes, granulocytes, B-cell marker CD19, activation markers, CD4+CD25+ regulatory T-cells, and vascular endothelial growth factor (VEGF) dropped significantly, but no difference was observed in T-cell and natural killer (NK)-cell markers, and IL-10. Postoperatively, T-cell and activation markers decreased in both groups, but CD4, CD28, IL-6, IL-10, and HLA-DR alterations were significantly less accentuated in patients who had been treated with IFN-alpha2a. After a median follow-up of 23 months, survival did not differ between the groups (p = 0.54). CONCLUSIONS Perioperative immunodysfunction can be modulated by preoperative administration of IFN- alpha2a. IFN-alpha2a decreased the level of VEGF and CD4+CD25+ regulatory T-cells implicating a potential combination with tyrosine kinase inhibitors and vaccines.
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Affiliation(s)
- Tobias Klatte
- Department of Urology, Otto-von-Guericke University, Magdeburg, Germany
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4
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Abstract
During the past 20 years, there has been considerable interest in lymphocyte therapy as a treatment for renal cell carcinoma. There is no therapeutic role for B-lymphocyte therapy, but their products, monoclonal antibodies, now have widespread clinical applications. The major types of autologous lymphocyte therapy that have been explored in clinical trials are cytotoxic lymphokine-activated killer cells, which are natural killer cells and T-cells that have been stimulated in vitro by interleukin-2 or other similar cytokines; cytotoxic and noncytotoxic tumor infiltrating lymphocytes, which are T-cells derived from tumor tissue; other tumor antigen-stimulated T-lymphocytes derived from regional lymph nodes or peripheral blood; and noncytotoxic lymphocytes of the memory/helper phenotype. More recently, allogeneic immune therapy using nonmyeloablative hematopoietic stem cell transplant and/or donor lymphocyte therapy has also shown promise.
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van Spronsen DJ, Mulders PFA, De Mulder PHM. Novel treatments for metastatic renal cell carcinoma. Crit Rev Oncol Hematol 2005; 55:177-91. [PMID: 15979888 DOI: 10.1016/j.critrevonc.2005.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2005] [Revised: 03/30/2005] [Accepted: 04/18/2005] [Indexed: 10/25/2022] Open
Abstract
The mainstay of any curative treatment in renal cell carcinoma (RCC) is surgery. In case of metastatic disease at presentation a radical nephrectomy is recommended to good performance status patients prior to start of interferon-alfa treatment. Interferon-alpha (IFN-alpha) offers in a small but significant percentage of patients advantage in overall survival; interleukin-2 (IL-2) based therapy gives similar survival rates. To date hormonal and chemotherapy do not have a proven impact on survival. The recent new insights in the molecular biology of clear RCC has revealed a key-role for vascular endothelial growth factor (VEGF) in the stimulation of angiogenesis in this highly vascularized tumour. This opens interesting new treatment strategies including: blockage of VEGF with the monoclonal antibody bevacizumab and inhibition of VEGF receptor tyrosine kinases (with small oral molecules such as SU11248 or PTK787). Likewise, inhibition of the Raf kinase pathway (with oral Bay 43-9006) or inhibition of the mTOR pathway (with i.v. CCI-779) are under investigation. Preliminary clinical results with all these compounds are interesting and the results of ongoing phase III studies will become available in the next years.
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Affiliation(s)
- D J van Spronsen
- Department of Medical Oncology 550, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Dillman R, Schiltz P, DePriest C, Barth N, Beutel L, de Leon C, O'Connor A, Nayak S. Tumor-infiltrating lymphocytes and interleukin-2: dose and schedules of administration in the treatment of metastatic cancer. Cancer Biother Radiopharm 2005; 19:730-7. [PMID: 15665620 DOI: 10.1089/cbr.2004.19.730] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The potential for therapeutic use of tumor-infiltrating lymphocytes (TIL), as adoptive cellular therapy has been touted for many years with some encouraging reports in patients with metastatic melanoma. MATERIALS AND METHODS We previously described methodologies for TIL production and phenotypic characterization of TIL generated in our laboratory between 1991 and 1995 in semipermeable bags and between 1996 and 2000 in bioreactors. Patients treated in the earlier era were to have received a hybrid bolus and a 12-hour continuous infusion of interleukin (IL)-2 (total, 48 MIU), while in the latter era 4 days of interferon- alpha preceded the TIL and IL-2; which was given by a hybrid schedule that included bolus and 72- hour continuous IL-2 (total, 96 MIU). There were 55 patients, including 23 patients with melanoma, 9 patients with renal cell carcinoma, and 8 patients with colorectal cancer. There was only 1 objective tumor response, which was noted in a patient with renal cell carcinoma. The 55 patients who received these products were grouped in cohorts by treatment era, quantity of TIL received, amount of IL-2 intended, and different combinations of TIL and IL-2. RESULTS There was no difference in survival by production method (treatment era), or amount of IL-2 given with TIL, but 33 patients who received an intermediate or higher dose of TIL (mean = 54.4 x 10(9)) had a median survival of 11.8 months, compared to 6.4 months for 22 patients who received 1 low-dose TIL (mean = 6.48 x 10(9)) (p = 0.059, log rank test). The objective response rate in this heterogeneous group of patients was not encouraging. The data suggest there may be a dose/benefit relationship between the total number of TIL infused and survival.
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De Mulder PHM, van Herpen CML, Mulders PAF. Current treatment of renal cell carcinoma. Ann Oncol 2005; 15 Suppl 4:iv319-28. [PMID: 15477330 DOI: 10.1093/annonc/mdh946] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- P H M De Mulder
- Department of Medical Oncology, University Medical Center Nijmegen, The Netherlands
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8
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Abstract
Renal cell carcinoma evokes an immune response, which investigators have attempted to augment by administering cytokines in doses above physiological levels. In 1992, high-dose (HD) bolus interleukin-2 (IL-2) received US Food and Drug Administration approval for metastatic renal cell carcinoma based on data that revealed durable responses in a small percentage of patients. However, this regimen is associated with significant toxicity and cost, which has limited its application to highly selected patients treated at specialised centres. Several investigators have evaluated regimens with lower doses of IL-2 in an attempt to decrease toxicity. Attempts were also made to improve treatment efficacy by adding interferon (IFN)-alpha followed by 5-fluorouracil to low-dose IL-2 regimens. These regimens were reported to produce response rates and survival comparable to HD IL-2 with much less toxicity, but possibly fewer durable responses. Based on positive preclinical data, other cytokines (e.g., IFN-gamma, IL-12) have also been given to patients with metastatic renal cell carcinoma with limited success. This review examines the clinical trials that have described the efficacy and toxicity of IL-2 and other cytokines in patients with renal cancer, with a particular focus on the Phase III trials that have helped to define the proper use of these agents.
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Shimabukuro T, Ohmoto Y, Naito K. Transforming growth factor-beta1 and renal cell cancer: cell growth, mRNA expression and protein production of cytokines. J Urol 2003; 169:1865-9. [PMID: 12686863 DOI: 10.1097/01.ju.0000053394.59680.78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE We evaluated the effects of transforming growth factor-beta1 (TGF-beta1) on growth activity, cytokine mRNA expression and cytokine protein production by renal cancer cells. MATERIALS AND METHODS Exogenous continuous exposure of biologically active TGF-beta1 was performed on ACHN cells at various concentrations of 0.1 to 30 ng./ml. and the number of cells was counted each culture day. To determine the index of S-phase cells the bromodeoxyuridine pulse labeling method was used. Reverse transcriptase-polymerase chain reaction (PCR) was done and PCR products were quantified. Each supernatant cytokine level was measured using an enzyme-linked immunosorbent assay. RESULTS TGF-beta1 significantly inhibited the growth activities of ACHN cells compared with controls. Bromodeoxyuridine labeling indexes after treating ACHN cells with TGF-beta1 (10 ng./ml.) showed that it began to decrease gradually after 24 hours and after 72 hours it was inhibited to approximately 40% compared with controls. The mRNA of TGF-beta1, TGF-beta types 1 and 2 receptors, interleukin-6 (IL-6) and granulocyte-macrophage colony-stimulating factor (GM-CSF) from ACHN cells was detected by reverse transcriptase-PCR assay. IL-6 and GM-CSF proteins were produced constitutively from ACHN cells but other cytokines were not. Adding TGF-beta1 to the cell culture medium did not influence mRNA expression, or the protein production of IL-6 or GM-CSF. CONCLUSIONS The inhibition of growth activities of ACHN cells by TGF-beta1 are mediated by its direct binding to specific receptors on ACHN cells followed by cell cycle inhibition, while TGF-beta1 seems to have no effect on the production of the cytokines studied.
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Affiliation(s)
- Barbara J Gitlitz
- University of California @ Los Angeles, 10945 Le Conte Avenue, Suite 2333, Los Angeles, CA 90095, USA
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11
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Siemens DR, Ratliff TL. Are Vaccinations for Prostate Cancer Realistic? Prostate Cancer 2003. [DOI: 10.1016/b978-012286981-5/50060-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Abstract
Interferons are agents with antiviral, antiproliferative, and immunomodulatory properties. Interferon-alfa (IFN-alpha) is used in the treatment of hematologic malignancies and solid tumors. IFN-alpha has shown antitumor and antiviral efficacy that are not correlated, one with another. Approval by the US Food and Drug Administration was granted early for the treatment of patients with hairy cell leukemia, acquired immune deficiency syndrome-related Kaposi's sarcoma, and condylomata acuminata. Although IFNs are effective as single agents in certain clinical pathologic entities, increasing experience with these cytokines suggests that their greatest therapeutic potential may be realized in combination with other biological response modifiers, cytotoxics, or antiviral agents. For example, trials combining IFN-alpha with 5-fluorouracil to treat colorectal carcinoma or IFN-alpha with zidovudine to treat acquired immune deficiency disorder showed increased efficacy over IFN-alpha alone. While IFN-alpha appears to be moderately effective in certain diseases, the flu-like syndrome associated with its use is a major limiting factor for its clinical application. Further studies are needed to determine the underlying mechanism of action for IFNs and the most effective combinations and appropriate preclinical models, or intermediate endpoints that will then facilitate the rational use of this agent in combinations based on the mechanisms of action of IFN-alpha.
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Affiliation(s)
- John Kirkwood
- University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213-2582, USA
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13
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van Herpen CML, De Mulder PHM. Prognostic and predictive factors of immunotherapy in metastatic renal cell carcinoma. Crit Rev Oncol Hematol 2002; 41:327-34. [PMID: 11880208 DOI: 10.1016/s1040-8428(01)00173-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Metastatic renal cell carcinoma has a poor prognosis. The value of immunotherapy with IFN-alpha and IL-2 both as single agent or as the combination is extensively investigated. The optimal dose and schedule is not known. In various studies response rates vary between 10 and 40%. The duration of response is variable. For a partial response a median duration between 10 and 12 months is given. Complete responses are sometimes long-lasting (a couple of years). The toxicity is drug, dose and schedule dependent. On the basis of a number of prognostic factors, such as performance score, time between the initial diagnosis and the treatment of metastases and the number of metastatic sites, patients can be divided in different prognostic groups. Patients who are classified in the good or intermediate prognostic group may have an improvement of their survival after immunotherapy and therefore they are candidates for immunotherapy.
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Affiliation(s)
- C M L van Herpen
- Department of Medical Oncology, Universal Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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14
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Abstract
Immunotherapy is receiving interest as an alternative or adjuvant approach to the treatment of many malignancies. The potential for immune modulation as a treatment of solid tumors is the focus of cancer researchers throughout the world. Though not a novel idea, increasing technological sophistication and continued advancement in the understanding of the immune system have increased the number of novel therapeutic approaches. In urology, BCG is an excellent example of how modulation of the immune system can be used to treat malignancy, and we are only now beginning to understand its immune mechanisms. Numerous other immunotherapeutic approaches have been and are being developed and evaluated. We provide a brief overview of immunology and its relation to tumor development and growth, and focus on some of the immunotherapeutic approaches to renal cell carcinoma, prostate adenocarcinoma, and transitional cell carcinoma of the bladder.
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Affiliation(s)
- Elizabeth L Broghammer
- University of Iowa Department of Urology, 200 Hawkins Drive, 3 RCP, Iowa City, IA 52242, USA
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15
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Malone CC, Schiltz PM, Mackintosh AD, Beutel LD, Heinemann FS, Dillman RO. Characterization of human tumor-infiltrating lymphocytes expanded in hollow-fiber bioreactors for immunotherapy of cancer. Cancer Biother Radiopharm 2001; 16:381-90. [PMID: 11776755 DOI: 10.1089/108497801753354285] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We attempted to grow tumor-infiltrating lymphocytes (TIL) from 34 fresh tumors of eight different histologies using flasks for the initiation phase and hollow fiber bioreactors to expand TIL to therapeutic numbers. Overall success rate was 76% (26/34) including melanoma (9/14, 64%) and renal cell carcinoma (11/11, 100%). The mean number of days required to reach successful initiation (1 x 10(9) TIL) for all tumor types was 29 +/- 16 days (mean +/- S.D.). Therapeutic doses of TIL required an average of 88 +/- 23 days (initiation plus expansion) with an average TIL number of 3.2 x 10(10) +/- 2.8 x 10(10). TIL phenotype was predominantly CD4+ in 53% (16/30) and CD8+ in 47% (14/30), renal cell carcinoma samples accounted for 12/14 of the predominantly CD8+ TIL. Cells bearing the natural killer (NK) phenotype represented only 0-7% of TIL while LAK phenotype represented 0-68% (mean 11 +/- 15%); LAK was the predominant phenotype in one patient with kidney cancer. Cytotoxicity tests showed consistent NK and LAK activity in addition to cytolysis of autologous tumor. Autologous tumor cell restricted cytolysis was noted for three TIL cultures. The overall success rate and characteristics of TIL were similar to our results with TIL expanded in semi-permeable plastic bags. This work confirms that hollow-fiber bioreactors are a suitable alternative to semi-permeable bags and roller bottle systems for the expansion of human TIL for therapeutic use in cancer patients.
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MESH Headings
- Bioreactors
- CD4-Positive T-Lymphocytes/cytology
- CD4-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/cytology
- CD8-Positive T-Lymphocytes/immunology
- Carcinoma, Renal Cell/immunology
- Cell Culture Techniques/instrumentation
- Cell Culture Techniques/methods
- Cells, Cultured/cytology
- Cells, Cultured/immunology
- Culture Media
- Cytotoxicity, Immunologic
- Equipment Design
- Humans
- Immunophenotyping
- Immunotherapy, Adoptive
- Kidney Neoplasms/immunology
- Killer Cells, Lymphokine-Activated/cytology
- Killer Cells, Lymphokine-Activated/immunology
- Killer Cells, Natural/cytology
- Killer Cells, Natural/immunology
- Lymphocyte Activation/drug effects
- Lymphocytes, Tumor-Infiltrating/cytology
- Lymphocytes, Tumor-Infiltrating/immunology
- Melanoma/immunology
- Muromonab-CD3/pharmacology
- Neoplasms/immunology
- Tissue Preservation
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Affiliation(s)
- C C Malone
- Patty and George Hoag Cancer Center, One Hoag Drive, Building 41, Newport Beach, CA 92658, USA
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Stassar MJ, Raddrizzani L, Hammer J, Zöller M. T-helper cell-response to MHC class II-binding peptides of the renal cell carcinoma-associated antigen RAGE-1. Immunobiology 2001; 203:743-55. [PMID: 11563674 DOI: 10.1016/s0171-2985(01)80003-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recently, epitope prediction software for HLA-DR binding sequences has become available. In view of the importance of T helper (Th) cell activation in immunotherapy of cancer and evidences supporting immunogenicity of renal cell carcinoma (RCC), we have tested 4 peptides of RAGE-1 binding promiscuously to HLA-DR molecules for induction of an immune response. The peptides predicted by the TEPITOPE program using a stringent threshold were derived from the open reading frame 2 and 5 of RAGE-1. Induction of response was evaluated by culturing peripheral blood mononuclear cells (PBMC) in the presence of peptide-loaded dendritic cells (DC) to determine proliferative activity and cytokine expression. Two out of 5 donors did not respond to any of the 4 peptides, 2 donors responded to one peptide and one donor responded to two other peptides. Notably, as revealed by blocking studies and T cell subtype definition, peptides bound to MHC class II molecules and peptide pulsed DC exclusively activated CD4+ T cells, which were of the Th1 subtype. With respect to clinical application it is important that (un)responsiveness of individual donors' PBMC was a very consistent feature. Though we have not tested explicitly whether these peptides correspond to naturally processed peptides, the possibility to define those patients whose Th might respond to in silico predicted peptides of RAGE-1, by an in vitro assay, could well be a helpful step towards setting up a RAGE-1 based immunotherapeutic protocol.
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Affiliation(s)
- M J Stassar
- Department of Tumor Progression and Immune Defense, German Cancer Research Center (DKFZ), Heidelberg
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Abstract
Despite extensive investigations with many different treatment modalities, metastatic renal cell carcinoma (RCC) remains a disease highly resistant to systemic therapy. The outlook for patients with metastatic RCC is poor, with a 5-year survival rate of less than 10%. Late relapses after nephrectomy, prolonged stable disease in the absence of systemic therapy, and rare spontaneous regression are clinical observations that suggest host immune mechanisms could be important in regulating tumor growth. Interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) have been extensively studied in advanced RCC with responses in the 10 to 20% range. Two randomized trials suggest that treatment with IFN-alpha compared with vinblastine or medroxyprogesterone results in a small improvement in survival. Prolonged responses with high-dose IL-2 is significant but is accompanied by formidable toxicity. Although the combination of IFN-alpha and IL-2 compared with monotherapy with IFN-alpha or IL-2 increases the response proportion, no improvement in survival could be demonstrated in a recent randomized trial. In addition, three randomized trials showed no survival benefit associated with IFN-alpha therapy given as adjuvant therapy following complete resection of locally advanced RCC. Small numbers of patients exhibit complete or partial responses to IFN-alpha and/or IL-2, but most patients do not respond and there are few long-term survivors. Clinical investigation of new agents and treatment programs to identify improved antitumor activity against metastases remain the highest priorities in this refractory disease.
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Affiliation(s)
- J Vuky
- Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, 10021, New York, NY, USA
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Bartholeyns J, Bardot V, Chokri M, Romet-Lemonne JL. [Adoptive immunotherapy: evaluation and perspectives in the treatment of certain cancers]. Rev Med Interne 2000; 21:863-71. [PMID: 11075395 DOI: 10.1016/s0248-8663(00)00237-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Adoptive immunotherapy was first introduced in the 1980s. This new anticancer therapeutic approach has already demonstrated promising results in both animal models and humans affected by various tumors. CURRENT KNOWLEDGE AND KEY POINTS This review summarizes the requirements of such therapies involving either activated lymphocytes, tumor-infiltrating lymphocytes or activated macrophages. It focuses more particularly on the promising approaches that represent antigen presenting cells such as macrophages and antigen-loaded dendritic cells in the development of safe and effective cancer vaccines. FUTURE PROSPECTS AND PROJECTS Standardized procedures for macrophages and dendritic cell generation, as well as preliminary results of clinical applications in patients with either prostate cancer or melanoma, are also discussed.
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Sawczuk IS, Pollard JC. Renal cell carcinoma: should radical nephrectomy be performed in the presence of metastatic disease? Curr Opin Urol 1999; 9:377-81. [PMID: 10579074 DOI: 10.1097/00042307-199909000-00002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Metastatic renal cell carcinoma is associated with an unfavorable prognosis and the treatment options are limited. Adjunctive radical nephrectomy, performed either before or after the administration of systemic immunotherapy, has been proposed as a means of improving outcome. The role of nephrectomy for patients with metastatic disease remains controversial. This article reviews the role of nephrectomy in metastatic renal cell carcinoma and the optimal timing for surgery relative to immunotherapy.
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Affiliation(s)
- I S Sawczuk
- Department of Urology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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Figlin RA, Thompson JA, Bukowski RM, Vogelzang NJ, Novick AC, Lange P, Steinberg GD, Belldegrun AS. Multicenter, randomized, phase III trial of CD8(+) tumor-infiltrating lymphocytes in combination with recombinant interleukin-2 in metastatic renal cell carcinoma. J Clin Oncol 1999; 17:2521-9. [PMID: 10561318 DOI: 10.1200/jco.1999.17.8.2521] [Citation(s) in RCA: 161] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To prospectively evaluate in a multicenter randomized trial the antitumor activity of CD8(+) tumor-infiltrating lymphocytes (TILs) in combination with low-dose recombinant interleukin-2 (rIL-2), compared with rIL-2 alone, after radical nephrectomy in metastatic renal cell carcinoma patients. PATIENTS AND METHODS Between December 1994 and March 1997, 178 patients with resectable primary tumors were enrolled at 29 centers in the United States and Europe. Patients underwent total nephrectomy, recovered, and were randomized to receive either CD8(+) TILs (5 x 10(7) to 3 x 10(10) cells intravenously, day 1) plus rIL-2 (one to four cycles: 5 x 10(6) IU/m(2) by continuous infusion daily for 4 days per week for 4 weeks) (TIL/rIL-2 group) or placebo cell infusion plus rIL-2 (identical regimen) (rIL-2 control group). Primary tumor specimens were cultured at a central cell-processing center in serum-free medium containing rIL-2 to generate TILs. RESULTS Of 178 enrolled patients, 160 were randomized (TIL/rIL-2 group, n = 81; rIL-2 control group, n = 79). Twenty randomized patients received no treatment after nephrectomy because of surgical complications (four patients), operative mortality (two patients), or ineligibility for rIL-2 therapy (14 patients). Among 72 patients eligible for TIL/rIL-2 therapy, 33 (41%) received no TIL therapy because of an insufficient number of viable cells. Intent-to-treat analysis demonstrated objective response rates of 9.9% v 11.4% and 1-year survival rates of 55% v 47% in the TIL/rIL-2 and rIL-2 control groups, respectively. The study was terminated early for lack of efficacy as determined by the Data Safety Monitoring Board. CONCLUSION Treatment with CD8(+) TILs did not improve response rate or survival in patients treated with low-dose rIL-2 after nephrectomy.
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Affiliation(s)
- R A Figlin
- University of California, Los Angeles, Los Angeles, CA, USA.
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Kerrebijn JD, Balm AJ, Freeman JL, Dosch HM, Drexhage HA. Who is in control of the immune system in head and neck cancer? Crit Rev Oncol Hematol 1999; 31:31-53. [PMID: 10532189 DOI: 10.1016/s1040-8428(99)00011-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- J D Kerrebijn
- Department of Otolaryngology/Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ont., Canada
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Ravaud A, Debled M. Present achievements in the medical treatment of metastatic renal cell carcinoma. Crit Rev Oncol Hematol 1999; 31:77-87. [PMID: 10532192 DOI: 10.1016/s1040-8428(99)00005-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- A Ravaud
- Department of Medicine, Institut Bergonié, Regional Cancer Centre, Bordeaux, France.
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Abstract
Vaccine therapy may provide an alternative for prostate cancer patients whose disease no longer responds to hormone therapy. Administration of dendritic cells pulsed with prostate-specific membrane antigen (PSMA) induces cellular immune responses against the tumor with virtually no adverse effects. About 30% of the evaluable patients were identified as partial responders, based on the National Prostate Cancer Project (NPCP) criteria. In addition, there was a 50% decrease of serum prostate-specific antigen or resolution of previously measurable lesions on imaging. Dendritic cell vaccine therapy may have a synergistic effect, when combined with other therapies.
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Affiliation(s)
- B A Tjoa
- Cancer Research Division, Pacific Northwest Cancer Foundation, Northwest Hospital, Seattle, Washington, USA
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24
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Bolhuis RL, Willemsen RA, Lamers CH, Stam K, Gratama JW, Weijtens ME. Preparation for a phase I/II study using autologous gene modified T lymphocytes for treatment of metastatic renal cancer patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1999; 451:547-55. [PMID: 10026926 DOI: 10.1007/978-1-4615-5357-1_85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- R L Bolhuis
- Department of Clinical and Tumor Immunology, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
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25
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Abstract
Cellular and cytokine adjuvants, often immune effector cells and soluble factors, respectively, are supplemental and/or follow-up treatments of human origin for cancer patients who have unsatisfactory clinical responses to conventional chemotherapy, radiotherapy, and surgery. Since many human studies with these reagents are in their infancy, extensive data collection is only now being performed to determine which strategy provides the greatest therapeutic benefit. Research published in the literature since the genesis of this approach to cancer treatment is summarized in this report. Methodologies attempting to generate anticancer responses by provoking or enhancing the patient's own immune system are new compared with the other standard types of cancer treatment. Although a few encouraging human studies can be discussed, many of the most promising techniques are only now being transferred from the laboratory to the clinic. The administration of immune effector cells in combination with immunomodulators, such as interferons or interleukins, often enhances clinical outcome. The literature cited in this report indicate that immune-cell- and cytokine-based therapies hold promise in our attempts to improve the quality and duration of life in those with cancer. With each report reaching the literature, more effective clinical trials are being designed and implemented.
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Affiliation(s)
- M L Salgaller
- Pacific Northwest Cancer Foundation and Immunotherapeutics Division, Northwest Biotherapeutics, L.L.C., Seattle, Washington 98125, USA.
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Nouri AM, Symes MO. Relevance of the immune system in human urological malignancies: prospective for future clinical treatments. Urology 1998; 51:41-9. [PMID: 9610557 DOI: 10.1016/s0090-4295(98)00073-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The possible role of the immune system in resisting human malignancies has long been debated. Several recent findings from animal and human studies have restimulated interest in the immune surveillance hypothesis for tumor control. These findings have been complied from various disciplines including cytokine therapy, adoptive immunotherapy, and gene therapy. Following the initial euphoria, it is now clear that immunotherapy of selected cancer cases in the early stages of tumor development may make an important contribution to tumor control, particularly in dealing with minimal residual disease after tumor debulking. This review discusses some of these issues and proposes approaches that could pave the way for better selection of the patients best suited for immunotherapy. We would argue that therapies directed at the re-expression of major histocompatibility complex (MHC) class I antigens might improve outcomes in immune-therapy-based treatments.
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Affiliation(s)
- A M Nouri
- Department of Medical Oncology, The Royal London Hospital, England
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27
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The contribution of dendritic cells to immune responses against urological cancers. Urol Oncol 1998; 4:17-23. [DOI: 10.1016/s1078-1439(98)00027-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/1998] [Indexed: 11/22/2022]
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Gohji K, Ueno K, Gotoh A, Hara I, Okada H, Arakawa S, Kamidono S. Surgical treatment of renal cell carcinoma with tumor thrombi in the inferior vena cava. Int J Clin Oncol 1997. [DOI: 10.1007/bf02488994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Troy AJ, Hart DN. Dendritic cells and cancer: progress toward a new cellular therapy. JOURNAL OF HEMATOTHERAPY 1997; 6:523-33. [PMID: 9483187 DOI: 10.1089/scd.1.1997.6.523] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A J Troy
- Department of Urology, Christchurch Hospital, New Zealand
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30
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Walther MM, Yang JC, Pass HI, Linehan WM, Rosenberg SA. Cytoreductive surgery before high dose interleukin-2 based therapy in patients with metastatic renal cell carcinoma. J Urol 1997; 158:1675-8. [PMID: 9334576 DOI: 10.1016/s0022-5347(01)64091-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE We defined the outcome of a strategy using cytoreductive surgery before high dose interleukin-2 (IL-2) therapy in patients with metastatic renal cell carcinoma. MATERIALS AND METHODS During an 11-year period, 195 patients underwent cytoreductive surgery as preparation for high dose IL-2 based therapy. The renal primary and locoregional metastatic disease that could be safely resected was removed. RESULTS Because of the large size 176 of 195 renal tumors (90%) were resected through transabdominal incision and in 45 patients (23%) a second additional significant procedure was performed. Five cases (2.6%) were unresectable and 2 (1%) perioperative deaths occurred. After surgery 121 of 195 patients (62%) were eligible for treatment with high dose IL-2 based protocols. Overall response rate to IL-2 based protocols was 18%. CONCLUSIONS Cytoreductive surgery can be performed safely in patients with metastatic renal cell carcinoma. Although the impact of cytoreductive surgery on response to immunotherapy remains undefined, this combination of primary debulking and systemic IL-2 can result in durable complete tumor regression in some patients with metastatic renal cell carcinoma.
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Affiliation(s)
- M M Walther
- Urologic Oncology Branche, National Cancer Institute, Bethesda, Maryland, USA
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31
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Abstract
BACKGROUND Despite significant advances in understanding the biology of renal cell carcinoma (RCC) during the past decade, metastatic disease remains nearly incurable and a major medical challenge. Because RCC is known to be immunogenic, immunotherapeutic agents such as recombinant human interleukin-2 (rIL-2) and interferon-alpha (IFN-alpha) have represented encouraging treatment modalities. METHODS A review of the natural history of and therapeutic approaches to RCC was examined. Studies involving rIL-2 alone and in combination with other adjuvant therapies were critically evaluated. RESULTS Overall response rates for metastatic RCC patients treated with rIL-2 were similar (i.e., in the range of 15-20%), regardless of whether rIL-2 was administered as monotherapy or in combination with IFN-alpha. Recombinant IL-2 monotherapy response rates were similar to those of IFN-alpha, but with an increased frequency of complete responses and enhanced response duration. Subcutaneous administration generally resulted in lower toxicity than intravenous administration. The roles of chemotherapy or adoptive immunotherapy in combination with rIL-2 and IFN-alpha therapy remain unclear and require further study. The importance of patient performance status as a predictor of response and survival in rIL-2 therapy was demonstrated. CONCLUSIONS The use of rIL-2 with or without IFN-alpha may represent the most useful therapeutic approach currently available for patients with good performance status. In patients with borderline performance status or severe comorbid disease, therapeutic approaches depend on patient factors and outcome expectation and may involve cytokine therapy. However, regardless of performance status, palliative measures and/or observation are important choices, because the majority of patients with metastatic RCC are incurable.
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Affiliation(s)
- R M Bukowski
- Experimental Therapeutics Program, Cleveland Clinic Cancer Center, Ohio 44195, USA
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34
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Litwin MS, Fine JT, Dorey F, Figlin RA, Belldegrun AS. Health Related Quality of Life Outcomes in Patients Treated for Metastatic Kidney Cancer: A Pilot Study. J Urol 1997. [DOI: 10.1016/s0022-5347(01)64807-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Mark S. Litwin
- From the Departments of Urology, and Medicine/Hematology and Oncology, School of Medicine, and Departments of Health Services and Biostatistics, School of Public Health, University of California, Los Angeles, California
| | - Jennifer T. Fine
- From the Departments of Urology, and Medicine/Hematology and Oncology, School of Medicine, and Departments of Health Services and Biostatistics, School of Public Health, University of California, Los Angeles, California
| | - Frederick Dorey
- From the Departments of Urology, and Medicine/Hematology and Oncology, School of Medicine, and Departments of Health Services and Biostatistics, School of Public Health, University of California, Los Angeles, California
| | - Robert A. Figlin
- From the Departments of Urology, and Medicine/Hematology and Oncology, School of Medicine, and Departments of Health Services and Biostatistics, School of Public Health, University of California, Los Angeles, California
| | - Arie S. Belldegrun
- From the Departments of Urology, and Medicine/Hematology and Oncology, School of Medicine, and Departments of Health Services and Biostatistics, School of Public Health, University of California, Los Angeles, California
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35
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Health Related Quality of Life Outcomes in Patients Treated for Metastatic Kidney Cancer. J Urol 1997. [DOI: 10.1097/00005392-199705000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Dillman RO, Hurwitz SR, Schiltz PM, Barth NM, Beutel LD, Nayak SK, O'Connor AA. Tumor localization by tumor infiltrating lymphocytes labeled with indium-111 in patients with metastatic renal cell carcinoma, melanoma, and colorectal cancer. Cancer Biother Radiopharm 1997; 12:65-71. [PMID: 10851449 DOI: 10.1089/cbr.1997.12.65] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adoptive immunotherapy with autologous tumor infiltrating lymphocytes (TIL) is a promising approach for cancer bio-therapy. One issue, however, is whether such cells actually migrate to sites of tumor after intravenous infusion. There have been several reports of tumor uptake of radiolabeled TIL in patients with metastatic melanoma, but efforts to visualize tumor with radiolabeled TIL in other tumor types reportedly have been unsuccessful. METHODS Eight patients with metastatic cancer (5 renal, 2 melanoma, 1 colon) received an intravenous infusion of 2 to 100 billion autologous TIL, including 50 million TIL which had been conjugated to 500 microCi Indium-111, co-administered with interleukin-2 (IL-2). One patient received 1 gm/m2 of cyclophosphamide one day prior to TIL; seven patients received interferon alpha 2b for 4 days prior to receiving TIL. Total body gamma camera imaging, including single photon emission computerized tomography (SPECT), was performed at 24 and 48 hours. RESULTS All eight patients had demonstrable uptake of 111-Indium-labeled TIL into one or more known sites of tumor. There were no known sites of tumor which were not imaged. Metastatic sites imaged included bone, brain, mediastinal and perihilar lymph nodes, lung and liver parenchyma, abdominal periaortic nodes, and a pelvic mass. One patient served as a negative control in that the TIL scan was negative at a time when she had no evident disease, but a few weeks later had a positive TIL scan which lead to a diagnosis of axillary recurrence. CONCLUSION Uptake of radiolabeled TIL, whether CD8+ or CD4+, by metastatic renal cell carcinoma and other carcinomas was similar to that previously reported in melanoma. Pretreatment with cyclophosphamide was not a prerequisite for imaging, and TIL uptake did not predict tumor response.
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Affiliation(s)
- R O Dillman
- Patty and George Hoag Cancer Center, Hoag Memorial Hospital Presbyterian, Newport Beach, California 92658, USA
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37
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Steger GG, Gnant MF, Djavanmard MP, Mader RM, Jakesz R, Pierce W, deKernion JB, Figlin R, Belldegrun A. The in vitro effects of interleukin-12 upon tumor-infiltrating lymphocytes derived from renal cell carcinoma. J Cancer Res Clin Oncol 1997; 123:317-24. [PMID: 9222297 DOI: 10.1007/bf01438307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Clinical trials utilising interleukin (IL)-2 with tumor-infiltrating lymphocytes (TIL) have demonstrated efficacy in the treatment of metastatic renal cell carcinoma (RCC). Several cytokines, as well as growth factors have demonstrated modulatory effects upon the biological properties of TIL from RCC, suggesting a potentially important role for cytokines other than IL-2 in the development of active and tumor-specific TIL. IL-12 was recently characterized as a natural-killer-cell-stimulatory factor or cytotoxic-T-cell-maturation factor. These properties of IL-12 prompted us to investigate the impact of this cytokine upon the activation of TIL from human RCC. In an attempt to enhance the in vitro growth and activity of renal TIL, we have grown eight renal TIL cultures in varying concentrations of IL-2 (8, 40, 80, 400 U/ml) and IL-12 (200 U/ml). In addition, IL-12 (200 U/ml) was added to TIL cultures pre-activated with IL-2 (400 U/ml). Growth, cell expansion, and the ability of TIL to release certain cytokines upon tumor stimulation were determined. Proliferation assays, phenotypic analysis, and cytotoxicity assays were performed at an early and a late culture stage. IL-12, alone and when added to suboptimal concentrations of IL-2, failed to induce TIL growth. While the addition of IL-12 to optimal doses of IL-2 suppressed TIL culture expansion, sequential culture exposure first to IL-2 and then to IL-2+IL-12 increased the number of cells expressing CD3+/CD56+ and these cultures demonstrated enhanced in vitro lysis of autologous tumor. IL-12 clearly demonstrated a sequence-dependent impact of the biological behaviour of TIL from RCC. The optimal use of IL-12 in the in vitro expansion of renal TIL may result in cells with an enhanced specific anti-tumor effect.
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Affiliation(s)
- G G Steger
- University of Vienna, Department of Internal Medicine I, Austria.
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39
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Sokoloff MH, Belldegrun A. Immunotherapy and Gene Therapy for Genitourinary Malignancies. Int J Urol 1996. [DOI: 10.1111/j.1442-2042.1996.tb00336.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Affiliation(s)
- S H Goey
- Department of Medical Oncology, Rotterdam Cancer Institute (Daniel den Hoed Kliniek), The Netherlands
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41
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Haas GP, Hillman GG. Update on the Role of Immunotherapy in the Management of Kidney Cancer. Cancer Control 1996; 3:536-541. [PMID: 10764514 DOI: 10.1177/107327489600300617] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- GP Haas
- Department of Urology, State University of New York Health Sciences Center, Syracuse, USA
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Tanguay S, Swanson DA, Putnam JB. Renal cell carcinoma metastatic to the lung: potential benefit in the combination of biological therapy and surgery. J Urol 1996; 156:1586-9. [PMID: 8863544 DOI: 10.1016/s0022-5347(01)65454-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE We evaluated outcomes in cases of renal cell carcinoma metastatic to the lung treated with surgery or biological therapy followed by surgery. MATERIALS AND METHODS We retrospectively evaluated 22 patients treated with surgical resection and 29 treated with biological therapy followed by surgery. RESULTS At the time of this study 31 patients (61%) were alive, including 15 with no residual disease and 16 with disease. Of the 22 patients treated with surgery without initial biological therapy 12 (55%) were alive at a median followup of 57 months (range 17 to 148) and 19 of the 29 (66%) treated with combination therapy were alive at a median followup of 48 months (range 19 to 78). A total of 19 patients (37%) died of progressive disease. CONCLUSIONS Our results suggest a role for an aggressive surgical approach in select patients with metastatic renal cell carcinoma, and demonstrate that patients who do not achieve a complete response to biological therapy may benefit from surgical resection of residual disease.
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Affiliation(s)
- S Tanguay
- Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Gaugler B, Brouwenstijn N, Vantomme V, Szikora JP, Van der Spek CW, Patard JJ, Boon T, Schrier P, Van den Eynde BJ. A new gene coding for an antigen recognized by autologous cytolytic T lymphocytes on a human renal carcinoma. Immunogenetics 1996; 44:323-30. [PMID: 8781117 DOI: 10.1007/bf02602776] [Citation(s) in RCA: 122] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Previous reports have described antigens that are recognized on human melanoma cells by autologous cytolytic T lymphocytes (CTL). The genes coding for a number of these antigens have been identified. Here we report the cloning of a gene that codes for an antigen recognized by autologous CTL on a human renal carcinoma cell line. This antigen is presented by HLA-B7 and is encoded by a new gene that we have named RAGE1. No expression of RAGE1 was found in normal tissues other than retina. RAGE1 expression was found in only one of 57 renal cell carcinoma samples, and also in some sarcomas, infiltrating bladder carcinomas, and melanomas. This represents the first identification of an antigen recognized by autologous CTL on a renal tumor.
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Affiliation(s)
- B Gaugler
- Ludwig Institute for Cancer Research, Brussels Branch, 74 avenue Hippocrate, UCL 7459, B1200 Brussels, Belgium
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Freedman AL, Vates TS, Stewart T, Padiyar N, Perlmutter AD, Smith CA. Renal Cell Carcinoma in Children: The Detroit Experience. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66178-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Andrew L. Freedman
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
| | - Thomas S. Vates
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
| | - Thomas Stewart
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
| | - Niru Padiyar
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
| | - Alan D. Perlmutter
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
| | - Craig A. Smith
- Departments of Pediatric Urology and Pathology, Children's Hospital of Michigan and Department of Urology, Henry Ford Hospital, Detroit, Michigan
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Yannelli JR, Hyatt C, McConnell S, Hines K, Jacknin L, Parker L, Sanders M, Rosenberg SA. Growth of tumor-infiltrating lymphocytes from human solid cancers: summary of a 5-year experience. Int J Cancer 1996; 65:413-21. [PMID: 8621219 DOI: 10.1002/(sici)1097-0215(19960208)65:4<413::aid-ijc3>3.0.co;2-#] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Between 1989 and 1993, 255 tumor biopsies representing 4 tumor histologies (melanoma, breast cancer, colon cancer and renal cell cancer) were received by the Surgery Branch of the National Cancer Institute. Tumor-infiltrating lymphocytes (TIL) were grown from single-cell suspensions of tumor biopsies over the course of 30-45 days. The TIL were grown in medium containing IL-2. To obtain numbers suitable for therapy (>10(11)), TIL were expanded using a large-scale system of cell culture and harvesting. While the largest number of biopsies was obtained from melanoma patients, TIL were successfully grown from 160 of 255 tumor biopsies representing all 4 histologies. Under the culture conditions employed, several characteristics of TIL expansion were observed. The cell surface phenotype of TIL which grew out from the tumor biopsies was generally a mix of CD3+/CD4+ or CD3+/CD8+ lymphocytes. Only TIL from melanoma biopsies were found to be consistently cytolytic and, in many cases, lysed autologous tumor cells preferentially. Interestingly, TIL derived from extra-nodal sites of metastatic melanoma biopsies (subcutaneous, lung, bowel; 36 of 67, 54%) were more likely to have these cytolytic characteristics than TIL derived from tumor-involved lymph node biopsies (7 of 39, 18%). The present study summarizes 5 years of laboratory effort and validates the technologies developed for the large-scale growth and harvesting of TIL. In addition, it summarizes the laboratory effort supporting previously published clinical reports on TIL from our group.
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Affiliation(s)
- J R Yannelli
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
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Sokoloff MH, Belldegrun A. Immunotherapy and Gene Therapy for Genitourinary Malignancies. Int J Urol 1996; 3:S4-18. [DOI: 10.1111/j.1442-2042.1996.tb00081.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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49
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Mydlo JH. Growth factors and renal cancer: characterization and therapeutic implications. World J Urol 1995; 13:356-63. [PMID: 9116755 DOI: 10.1007/bf00191217] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The heterogeneiety renal-cell carcinoma can lead to unpredictable behavior: the ability to achieve a large volume yet not metastasize, the ability to demonstrate late recurrence or spontaneous regression, or the capability to metastasize at a relatively small volume. One-third of all patients who undergo radical nephrectomy for presumed localized disease will eventually have metastasis. Since renal-cell carcinoma is not significantly radio- or chemosensitive, it is important to investigate new avenues for treatment of this tumor once it has spread, specifically at the molecular level. This review discusses the most recent work on growth factors and renal cancer and proposes possible modalities for treatment.
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Affiliation(s)
- J H Mydlo
- Department of Urology, State University of New York Health Science Center at Brooklyn 11203, USA
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50
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Novick AC. Renal cell carcinoma. J Urol 1994; 152:857-8. [PMID: 8051735 DOI: 10.1016/s0022-5347(17)32590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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