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Abstract
Although cancer vaccines with defined antigens are commonly used, the use of whole tumor cell preparations in tumor immunotherapy is a very promising approach and can obviate some important limitations in vaccine development. Whole tumor cells are a good source of TAAs and can induce simultaneous CTLs and CD4(+) T helper cell activation. We review current approaches to prepare whole tumor cell vaccines, including traditional methods of freeze-thaw lysates, tumor cells treated with ultraviolet irradiation, and RNA electroporation, along with more recent methods to increase tumor cell immunogenicity with HOCl oxidation or infection with replication-incompetent herpes simplex virus.
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Chu CS, Kim SH, June CH, Coukos G. Immunotherapy opportunities in ovarian cancer. Expert Rev Anticancer Ther 2008; 8:243-57. [PMID: 18279065 DOI: 10.1586/14737140.8.2.243] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ovarian cancer is responsible for the majority of gynecologic cancer deaths and despite the highest standard of multimodality therapy with surgery and cytotoxic chemotherapy, long-term survival remains low. With compelling evidence that epithelial ovarian cancer is an immunogenic tumor capable of stimulating an antitumor immune response, renewed efforts to develop immune therapies to augment the efficacy of traditional therapies are underway. Current immunotherapies focus on varied modes of antitumor vaccine development, particularly with the use of dendritic cell vaccines, effective methods for adoptive T-cell transfer and combinatorial approaches with immune modulatory therapy subverting natural tolerance mechanisms or boosting effector mechanisms. Additional combinatorial approaches include the use of cytokines and/or chemotherapy with immune therapy.
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Affiliation(s)
- Christina S Chu
- University of Pennsylvania, Division of Gynecologic Oncology, Center for Research on Ovarian Cancer, PA, USA.
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Oflazoglu E, Elliott M, Takita H, Ferrone S, Henderson RA, Repasky EA. Adoptively transferred human lung tumor specific cytotoxic T cells can control autologous tumor growth and shape tumor phenotype in a SCID mouse xenograft model. J Transl Med 2007; 5:29. [PMID: 17592641 PMCID: PMC1933531 DOI: 10.1186/1479-5876-5-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Accepted: 06/25/2007] [Indexed: 12/11/2022] Open
Abstract
Background The anti-tumor efficacy of human immune effector cells, such as cytolytic T lymphocytes (CTLs), has been difficult to study in lung cancer patients in the clinical setting. Improved experimental models for the study of lung tumor-immune cell interaction as well as for evaluating the efficacy of adoptive transfer of immune effector cells are needed. Methods To address questions related to the in vivo interaction of human lung tumor cells and immune effector cells, we obtained an HLA class I + lung tumor cell line from a fresh surgical specimen, and using the infiltrating immune cells, isolated and characterized tumor antigen-specific, CD8+ CTLs. We then established a SCID mouse-human tumor xenograft model with the tumor cell line and used it to study the function of the autologous CTLs provided via adoptive transfer. Results The tumor antigen specific CTLs isolated from the tumor were found to have an activated memory phenotype and able to kill tumor cells in an antigen specific manner in vitro. Additionally, the tumor antigen-specific CTLs were fully capable of homing to and killing autologous tumors in vivo, and expressing IFN-γ, each in an antigen-dependent manner. A single injection of these CTLs was able to provide significant but temporary control of the growth of autologous tumors in vivo without the need for IL-2. The timing of injection of CTLs played an essential role in the outcome of tumor growth control. Moreover, immunohistochemical analysis of surviving tumor cells following CTL treatment indicated that the surviving tumor cells expressed reduced MHC class I antigens on their surface. Conclusion These studies confirm and extend previous studies and provide additional information regarding the characteristics of CTLs which can be found within a patient's tumor. Moreover, the in vivo model described here provides a unique window for observing events that may also occur in patients undergoing adoptive cellular immunotherapy as effector cells seek and destroy areas of tumor growth and for testing strategies to improve clinical effectiveness.
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Affiliation(s)
- Ezogelin Oflazoglu
- Department of Immunology Roswell Park Cancer Institute, Buffalo, NY, 14263 USA
| | | | - Hiroshi Takita
- Department of Surgery, Roswell Park Cancer Institute, Buffalo, NY, 14263 USA
| | - Soldano Ferrone
- Department of Immunology Roswell Park Cancer Institute, Buffalo, NY, 14263 USA
| | | | - Elizabeth A Repasky
- Department of Immunology Roswell Park Cancer Institute, Buffalo, NY, 14263 USA
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Coukos G, Conejo-Garcia JR, Roden RBS, Wu TC. Immunotherapy for gynaecological malignancies. Expert Opin Biol Ther 2005; 5:1193-210. [PMID: 16120050 DOI: 10.1517/14712598.5.9.1193] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Gynaecological malignancies, excluding breast cancer, cause approximately 25,000 deaths yearly among women in the US. Therefore, novel approaches for the prevention or treatment of these diseases are urgently required. In the case of cervical cancer, human papillomavirus (HPV) xenoantigens are readily recognised by the immune system, and their targeting has shown great promise in preclinical models of therapeutic vaccination and in clinical studies of preventative vaccination. A growing body of evidence indicates that ovarian cancer is also immunogenic and can thus be targeted through immunotherapy. This review outlines the principles and problems of immunotherapy for cervical and ovarian cancer, including the authors' personal assessment.
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MESH Headings
- Adoptive Transfer
- Animals
- Antigens, Heterophile/immunology
- Antigens, Neoplasm/immunology
- Cancer Vaccines/therapeutic use
- Clinical Trials as Topic
- Cytokines
- Drug Evaluation, Preclinical
- Female
- Genital Neoplasms, Female/immunology
- Genital Neoplasms, Female/prevention & control
- Genital Neoplasms, Female/therapy
- Humans
- Immunotherapy/methods
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/transplantation
- Ovarian Neoplasms/immunology
- Ovarian Neoplasms/prevention & control
- Ovarian Neoplasms/therapy
- Papillomaviridae/immunology
- T-Lymphocytes, Regulatory
- Uterine Cervical Neoplasms/immunology
- Uterine Cervical Neoplasms/prevention & control
- Uterine Cervical Neoplasms/therapy
- Vaccines, Attenuated/therapeutic use
- Viral Vaccines/therapeutic use
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Affiliation(s)
- George Coukos
- Abramson Cancer Research Institute, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Philadelphia, PA 19104, USA
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6
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Abstract
Ovarian cancer is a leading cause of cancer mortality. Chemotherapy is effective in reducing tumor burden in a majority of patients, however, only approximately 20% of advanced disease patients will ultimately survive tumor free, and further treatment options are needed. Continuing advances in immunology make immunotherapy a promising area for future research. The design of immunotherapy strategies for ovarian cancer requires an understanding of the immune microenvironment of the peritoneal cavity, which is frequently involved with ovarian cancer metastases and is the site of its most devastating effects. Immunotherapy approaches for ovarian cancer include locoregional and systemic cytokine therapies, prophylactic and therapeutic vaccines, and adoptive immunotherapy strategies. This review will summarize previous clinical trials as well as future directions for research. Further progress in T-cell specific immune responses will require the identification of specific ovarian cancer antigens that are processed and presented on the surface of tumor cells in the context of specific HLA molecules. In addition, a more detailed understanding of functional relations between the peritoneal microenvironment and the metastatic process is required.
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Affiliation(s)
- Patrick Hwu
- National Cancer Institute, Building 10, Room 2B42, 9000 Rockville Pike, Bethesda, MD 20892, USA.
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KULLANDER S, RAUSING A. On mononuclear cells in human endometrial carcinoma. Int J Gynecol Cancer 1997. [DOI: 10.1046/j.1525-1438.1997.00460.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
It appears that ovarian surface epithelial cells activated by contact with gonadotropin-stimulated preovulatory follicles can release bioactive substances that weaken the tunica albuginea and apical follicular wall (e.g. collagenolytic enzymes) and induce cell death (e.g. apoptotic agents). However, a definitive obligatory role of the ovarian surface epithelium in ovulation remains equivocal. Epithelium exfoliated from the dome of ovulatory follicles is replenished by generative stem cell replication and migration from the wound edges. Mutagenesis has been related to successive bouts of ovulation and mitosis. Common epithelial ovarian cancer is a deadly insidious disease, mainly because it is asymptomatic until the malignancy has reached beyond the ovaries. The most important susceptibility factors are nulliparity and association to an affected first-degree relative. It will be critical to resolve whether parity and oral contraceptive use confer significant protection to women with a family history of ovarian carcinoma. Clearly, innovative approaches to non-invasive screening and treatment are needed. Early detection is the key to saving lives (90% cure by salpingo-ovariectomy alone if diagnosis is at Stage I). Active immunization with defined tumor epitopes or (passive) intraperitoneal administration of effector-functional humanized antibodies may be of special value in the regional management of common epithelial ovarian cancer.
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Affiliation(s)
- W J Murdoch
- Reproductive Biology Program, University of Wyoming, Laramie 82071, USA
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Oltrogge JB, Donnerstag B, Baum RP, Noujaim AA, Träger L. Generation of Human Monoclonal Anti-idiotypic Antibodies with Specificity to the Murine Monoclonal Anti-CA 125 Antibody B43.13. Int J Biol Markers 1996; 11:211-5. [PMID: 9017445 DOI: 10.1177/172460089601100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two human monoclonal antibodies, HID-7E7 and ROB-6F2, were produced by EBV transformation of peripheral blood lymphocytes (PBL). PBL were obtained from a patient with ovarian cancer who had been exposed several times to a Tc-99m labeled murine monoclonal anti-CA 125 antibody (B43.13, Biomira, Edmonton) for immunoscintigraphy. The HID-7E7 and ROB-6F2 producing B-cells were cloned with a limiting dilution technique and have shown stable immunoglobulin secretion within a period of three years. The human monoclonal antibodies HID-7E7 and ROB-6F2 are of the IgG isotype, and bind with significant affinity to the murine monoclonal antibody B43.13, which was used for immunoscintigraphy. Binding affinity of ROB-6F2 to other murine antibodies could not be detected. Cross reactivity of HID-7E7 to a murine anti-CEA monoclonal antibody was observed. In order to verify the anti-idiotypic character of the generated human antibodies, the ability of HID-7E7 and ROB-6F2, respectively, to inhibit the formation of the CA125/B43.13 complex is demonstrated via an enzyme-linked immunosorbent assay. These human anti-idiotypic antibodies are possible candidates for immunotherapy of ovarian cancer in patients with a small tumor burden following surgery and/or chemotherapy.
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Affiliation(s)
- J B Oltrogge
- Department of Biological Chemistry, University Medical Center, Frankfurt/Main, Germany
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Freedman RS, Platsoucas CD. Immunotherapy for peritoneal ovarian carcinoma metastasis using ex vivo expanded tumor infiltrating lymphocytes. Cancer Treat Res 1996; 82:115-146. [PMID: 8849947 DOI: 10.1007/978-1-4613-1247-5_8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Surgery and chemotherapy have contributed to a modest overall survival in patients with epithelial ovarian carcinoma. It is therefore important to pursue novel therapy strategies for this disease that are different from conventional chemotherapy. Tumor infiltrating lymphocytes (TILs) from patients with ovarian carcinoma may represent an active immune response of the host directed against the tumor cells. These TILs can be expanded in vitro in low concentrations of recombinant interleukin-2 (rIL-2) by a few thousandfold. The resulting T-cell lines comprise CD3+CD4+TCR alpha beta + or CD3+CD8+TCR alpha beta + cells, or mixtures of both. These T-cell lines may exhibit either tumor-specific cytotoxicity against autologous tumor cells, or produce cytokines (interferon-gamma, tumor necrosis factor, and granulocyte stimulating factor) either in antigen-dependent (tumor-specific) or an antigen-independent manner. T-cell lines exhibiting primarily autologous tumor-specific cytotoxicity were developed from approximately 50% of the patients. Blocking experiments using appropriate monoclonal antibodies revealed that the CD3/TCR complex on the effector cells and the MHC class I antigens on the tumor cells were involved in the cytolytic process. We have developed a four-step method for the expansion of TILs to large numbers (1 x 10(10) to 1 x 10(11)) sufficient for clinical trials in patients with ovarian cancer. We have conducted a pilot clinical trial to examine the feasibility and clinical effects of intraperitoneal TILs and low-dose rIL-2 in patients with advanced ovarian carcinoma who were refractory to platinum-based chemotherapy. More recently, procedures have been developed for obtaining large numbers of purified CD8+ rIL-2-expanded TILs for the treatment of patients with ovarian carcinoma. The evolution of clinical trials and correlative studies necessary to develop an effective adoptive immunotherapy approach were discussed.
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Affiliation(s)
- R S Freedman
- Department of Gynecological Oncology, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA
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van Ravenswaay Claasen HH, Eggermont AM. Intraperitoneal immunotherapy of cancer: a review of options for treatment. Cancer Treat Res 1996; 82:13-40. [PMID: 8849941 DOI: 10.1007/978-1-4613-1247-5_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Nash MA, Platsoucas CD, Wong BY, Wong PM, Cottler-Fox M, Otto E, Freedman RS. Transduction of rIL-2 expanded CD4+ and CD8+ ovarian TIL-derived T cell lines with the G1Na (neor) replication-deficient retroviral vector. Hum Gene Ther 1995; 6:1379-89. [PMID: 8573611 DOI: 10.1089/hum.1995.6.11-1379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We have expanded ovarian tumor-infiltrating lymphocytes (TIL) in low concentrations of recombinant interleukin-2 (rIL-2) to conduct intraperitoneal adoptive immunotherapy trials in patients with ovarian cancer. We have previously demonstrated that certain T cell lines and clones derived from ovarian TIL exhibit in vitro autologous tumor-specific cytotoxicity and/or cytokine production (interferon-gamma, tumor necrosis factor-alpha) preferentially in response to autologous tumor cells. Studies that utilize a marker gene introduced into the DNA of TIL can provide useful information on specific uptake or localization of TIL at tumor sites and on the survival of TIL in vivo. We have conducted a series of preclinical experiments in which we have successfully transfected TIL with G1Na, which encodes the gene for neomycin phosphotransferase (neoR). NeoR was detected in at least 10% of CD8+ cells (mean = 10.4%) and between 2.5 and 20% of CD4+ TIL (mean = 8.5%). Transduction of ovarian TIL with G1Na caused no substantial changes to the T cell phenotypes or in vitro cytotoxicities against ovarian and hematogenous tumor cell targets, or on the rIL-2 requirements of TIL for growth and proliferation. In addition, the intact G1Na provirus in transduced TIL cells was rescuable by replication-competent retrovirus and was transferred into the genome of NIH-3T3 fibroblasts, which were rendered resistant to G418. An enhanced polymerase chain reaction (PCR) procedure utilizing detection by ethidium bromide staining was developed. The enhanced PCR detected 1 in 100,000 neoR-labeled cells. Furthermore, detection of the G1Na genome in transduced TIL by in situ hybridization with an RNA probe provided evidence for expression of the neoR gene in transduced TIL. Results obtained from these studies suggest that ovarian TIL-derived T cell lines transduced with the neoR gene post infection with the G1Na retroviral vector can be utilized to examine the in vivo trafficking pattern of ovarian TIL-derived T cell lines expanded in low concentrations of rIL-2 and their survival.
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Affiliation(s)
- M A Nash
- Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Mitropoulos D, Kooi S, Rodriguez-Villanueva J, Platsoucas CD. Characterization of fresh (uncultured) tumour-infiltrating lymphocytes (TIL) and TIL-derived T cell lines from patients with renal cell carcinoma. Clin Exp Immunol 1994; 97:321-7. [PMID: 8050183 PMCID: PMC1534685 DOI: 10.1111/j.1365-2249.1994.tb06088.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Fresh (uncultured) TIL from 12 untreated patients with primary renal cell carcinoma were prepared from tumour specimens by enzymatic digestion, and were characterized by immunofluorescence using MoAbs recognizing leucocyte differentiation antigens or particular V alpha or V beta segments of the T cell receptor (TCR). These fresh TIL comprised CD3+ (20-84%); CD4+ (3-15%); CD8+ (13-35%); alpha beta TCR+ (20-50%); gamma delta TCR+ (3-17%); CD16+ (1-18%) and CD56+ (3-10%) cells. Significant proportions of V alpha 2+, V beta 5.1+ and V beta 6+ cells were found in TIL of certain patients with renal cell carcinoma, suggesting that they comprised oligoclonal T cells. T cell lines were developed in low concentrations of rIL-2 (200 U/ml) from TIL from 11 patients with renal cell carcinoma, and were characterized by immunofluorescence and cell-mediated cytotoxicity. These T cell lines consisted primarily of CD3+ (51-94%); CD4+ (1-80%); CD8+ (0-84%); alpha beta TCR+ (65-87%); gamma delta TCR+ (0-25%); CD16+ (0-16%) and CD56+ (2-57%) cells. These T cell lines exhibited non-specific cytotoxicity against autologous and allogeneic renal tumour cells, with the exception of one T cell line that exhibited preferential cytotoxicity against autologous renal tumour cells. These results suggest that fresh TIL from patients with renal cell carcinoma contain significant proportions of oligoclonal T cells that may have accumulated at the tumour site as a result of a clonal expansion.
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Affiliation(s)
- D Mitropoulos
- Department of Immunology, University of Texas, M.D. Anderson Cancer Centre, Houston
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Freedman RS, Tomasovic B, Templin S, Atkinson EN, Kudelka A, Edwards CL, Platsoucas CD. Large-scale expansion in interleukin-2 of tumor-infiltrating lymphocytes from patients with ovarian carcinoma for adoptive immunotherapy. J Immunol Methods 1994; 167:145-60. [PMID: 8308273 DOI: 10.1016/0022-1759(94)90084-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Tumor infiltrating lymphocytes (TIL) from malignant ascites or solid tumor specimens obtained from patients with ovarian carcinoma were expanded to large numbers in vitro (10(10)-10(11)) by a four-step method using AIM V medium and low concentrations of recombinant interleukin-2 (rIL-2). The expansion procedure employed 24-well culture plates, T-flasks, polyolefin gas-permeable bags (PGPB), and an artificial capillary culture system (ACCS). The mean number of mononuclear leukocytes introduced into the 24-well plates was 16.5 +/- 4.2 x 10(6) cells. TIL from a total of 16 patients were expanded only through the first three steps of the process (24-well-plates, T-flasks, and PGPB) with an overall expansion of 255 +/- 99 fold and mean duration of 27.4 +/- 2.2 days. TIL from 9 of 16 patients were expanded further through the fourth step (ACCS) of the expansion method. The cumulative fold-expansion in nine patients was 8044 +/- 4807 (mean +/- SEM), the median was 2876 and the mean expansion time was 47.1 +/- 4.7 days. TIL from seven additional patients did not grow in rIL-2. Six of these 7 patients received chemotherapy at least four weeks before the specimens were collected. Two ACCS were used in parallel to facilitate expansion of TIL. Viable rIL-2-expanded TIL in the range of 1 x 10(10)-1 x 10(11) were recovered from the two ACCS, a number sufficient for adoptive immunotherapy of patients with ovarian carcinoma. The rIL-2-expanded TIL were predominantly CD3+ CD4+ CD8- alpha beta TCR+, although CD3+ CD4- CD8+ alpha beta TCR+ T cell lines were obtained from certain patients. An increase (43 +/- 8 vs 75 +/- 13; P = 0.05) in the proportion of CD4+ cells was observed over the duration of the four expansion steps. However, CD8+ TIL-derived T cells lines were also expanded in the ACCS. The four-step expansion method described here has several significant advantages over existing techniques. It requires substantially less personnel, equipment and space and the risk of contamination during expansion of the cultures is decreased. These results demonstrate that the four-step method described here can be effectively used for the large-scale expansion of ovarian TIL for the treatment of patients with ovarian carcinoma by adoptive immunotherapy.
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Affiliation(s)
- R S Freedman
- Department of Gynecology, University of Texas M.D. Anderson Cancer Center, Houston 77030
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