@article {Kvernelande003499, author = {Anders Handrup Kverneland and Christopher Aled Chamberlain and Troels Holz Borch and Morten Nielsen and Sofie Kirial M{\o}rk and Julie Westerlin Kjeldsen and Cathrine Lund Lorentzen and Lise Pyndt J{\o}rgensen and Lene Buhl Riis and Christina Westmose Yde and {\"O}zcan Met and Marco Donia and Inge Marie Svane}, title = {Adoptive cell therapy with tumor-infiltrating lymphocytes supported by checkpoint inhibition across multiple solid cancer types}, volume = {9}, number = {10}, elocation-id = {e003499}, year = {2021}, doi = {10.1136/jitc-2021-003499}, publisher = {BMJ Specialist Journals}, abstract = {Background Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) has shown remarkable results in malignant melanoma (MM), while studies on the potential in other cancer diagnoses are sparse. Further, the prospect of using checkpoint inhibitors (CPIs) to support TIL production and therapy remains to be explored.Study design TIL-based ACT with CPIs was evaluated in a clinical phase I/II trial. Ipilimumab (3 mg/kg) was administered prior to tumor resection and nivolumab (3 mg/kg, every 2 weeks {\texttimes}4) in relation to TIL infusion. Preconditioning chemotherapy was given before TIL infusion and followed by low-dose (2 10e6 international units (UI) {\texttimes}1 subcutaneous for 14 days) interleukin-2 stimulation.Results Twenty-five patients covering 10 different cancer diagnoses were treated with in vitro expanded TILs. Expansion of TILs was successful in 97\% of recruited patients. Five patients had sizeable tumor regressions of 30\%{\textendash}63\%, including two confirmed partial responses in patients with head-and-neck cancer and cholangiocarcinoma. Safety and feasibility were comparable to MM trials of ACT with the addition of expected CPI toxicity. In an exploratory analysis, tumor mutational burden and expression of the alpha-integrin CD103 (p=0.025) were associated with increased disease control. In vitro tumor reactivity was seen in both patients with an objective response and was associated with regressions in tumor size (p=0.028).Conclusion High success rates of TIL expansion were demonstrated across multiple solid cancers. TIL ACTs were found feasible, independent of previous therapy. Tumor regressions after ACT combined with CPIs were demonstrated in several cancer types supported by in vitro antitumor reactivity of the TILs.Trial registration numbers NCT03296137, and EudraCT No. 2017-002323-25.Data are available upon reasonable request. Flow cytometry data and genetic data from the tumor material is avaliable to share upon reasonable request within the national legal framework of data sharing and GDPR.}, URL = {https://jitc.bmj.com/content/9/10/e003499}, eprint = {https://jitc.bmj.com/content/9/10/e003499.full.pdf}, journal = {Journal for ImmunoTherapy of Cancer} }