背景:T细胞的过继转移是一种新兴的癌症治疗方法。然而,细胞的命运,一旦转移,通常是未知的。我们描述了首次使用非侵入性生物标志物在细胞疗法输注后测定凋亡细胞分数(ACF)的临床经验,在头颈部鳞状细胞癌(HNSCC)的背景下进行测试。患有HNSCC的患者接受用全氟化碳(PFC)纳米乳液细胞示踪剂标记的自体肿瘤浸润淋巴细胞(TIL)。纳米乳液,从凋亡细胞释放,通过网状内皮系统清除,特别是肝脏的Kupffer细胞,和肝脏的氟-19(19F)磁共振波谱(MRS)用于非侵入性推断ACF。
方法:从50多岁复发的患者中分离出自体TIL,难治性人乳头瘤病毒介导的右扁桃体鳞状细胞癌,转移到肺。使用快速扩增方案切除肺转移用于T细胞收获和扩增。通过在培养的最后24小时共孵育,用PFC纳米乳液示踪剂在细胞内标记扩增的TIL。然后是洗涤步骤。静脉输注TIL后22天,使用3TMRI系统在体内进行定量单体素肝脏19FMRS。从这些数据来看,我们对初始细胞接种剂的表观ACF进行建模。
结果:我们表明,在临床细胞处理设施中,单批PFC标记〜70×1010TIL(F-TIL)是可行的,同时保持>90%的细胞活力和基于标准流式细胞术的表型和功能释放标准。基于肝脏中的定量体内19FMRS测量,我们估计过继转移的F-TIL的约30%细胞当量在转移后22天已经凋亡。
结论:每个患者的原代细胞治疗产品的存活率可能不同。随着时间的推移,ACF的非侵入性测定可能会提供对反应和非反应机制的深入了解。为未来的临床研究提供信息。该信息可能对细胞疗法的开发者和临床医生有用,因为它开辟了量化细胞产品存活和植入的途径。
Adoptive transfer of T cells is a burgeoning cancer therapeutic approach. However, the fate of the cells, once transferred, is most often unknown. We describe the first clinical experience with a non-invasive biomarker to assay the apoptotic cell fraction (ACF) after cell therapy infusion, tested in the setting of head and neck squamous cell carcinoma (HNSCC). A patient with HNSCC received autologous tumor-infiltrating lymphocytes (TILs) labeled with a perfluorocarbon (PFC) nanoemulsion cell tracer. Nanoemulsion, released from apoptotic cells, clears through the reticuloendothelial system, particularly the Kupffer cells of the liver, and fluorine-19 (19F) magnetic resonance spectroscopy (MRS) of the liver was used to non-invasively infer the ACF.
Autologous TILs were isolated from a patient in their late 50s with relapsed, refractory human papillomavirus-mediated squamous cell carcinoma of the right tonsil, metastatic to the lung. A lung metastasis was resected for T cell harvest and expansion using a rapid expansion protocol. The expanded TILs were intracellularly labeled with PFC nanoemulsion tracer by coincubation in the final 24 hours of culture, followed by a wash step. At 22 days after intravenous infusion of TILs, quantitative single-voxel liver 19F MRS was performed in vivo using a 3T MRI system. From these data, we model the apparent ACF of the initial cell inoculant.
We show that it is feasible to PFC-label ~70×1010 TILs (F-TILs) in a single batch in a clinical cell processing facility, while maintaining >90% cell viability and standard flow cytometry-based release criteria for phenotype and function. Based on quantitative in vivo 19F MRS measurements in the liver, we estimate that ~30% cell equivalents of adoptively transferred F-TILs have become apoptotic by 22 days post-transfer.
Survival of the primary cell therapy product is likely to vary per patient. A non-invasive assay of ACF over time could potentially provide insight into the mechanisms of response and non-response, informing future clinical studies. This information may be useful to developers of cytotherapies and clinicians as it opens an avenue to quantify cellular product survival and engraftment.