Engineered TILs/CAR-TILs to Treat Advanced Solid Tumors

Study Overview
=================
Brief Summary
-----------------
Tumor infiltration lymphocytes (TILs) have been harvested from advanced cancer patients and constructed to knockout PD1 gene and express scFvs against both PD1 and CTALA4 and CARs against various antigens, followed by transfusion into the patients. The safety, tolerance, and preliminary clinical efficacy of the TILs will be evaluated.

Detailed Description
-----------------
Choose appropriate patients with advanced lung or other cancers, with written consent for this study; Perform biopsy or collect cancerous effusion in thorax or abdomen to obtain TILs by standard protocol; Grow TILs and engineered the tumor-effective TILs with CRISPRA-CAS9 technique to knockdown PD1 and electronic-transfection strategy to express scFvs that target PD1 and CTLA4; amplify the engineered T cells as needed, test the quality and killing activity of the TILs and then transfuse them back the patients via systemic or local injections via standard protocol, and follow up closely to collect related parameters as needed; To enhance the killing capability, tumor-noneffective TILs have also been genetically engineered to express various CARs targeting HER2/Mesothelin/Lewis-Y/PSCA/MUC1/ GPC3/AXL/EGFR/Claudin18.2/B7-H3/ROR1/GD2/AXL/Claudin6-DAP10 with knockdown of PD1/HPK1 as appropriate; Evaluate the clinical results as needed.

Official Title
-----------------
Engineered TILs/CAR-TILs With PD1 Knockout and Anti-PD1/CTLA4-scFv Secreting or CARs Against Various Antigens to Treat Advanced Solid Tumors

Conditions
-----------------
Breast Cancer, Colo-rectal Cancer, Brain Tumor, Solid Tumor, Adult, CTLA4, Liver Cancer, Lung Cancer, PD1

Intervention / Treatment
-----------------
* Biological: TILs and CAR-TILs targeting HER2, Mesothelin, PSCA, MUC1, Lewis-Y, GPC3, AXL, EGFR, Claudin18.2/6, ROR1, GD1, or B7-H3


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients with advanced cancers that failed to current available therapies; Life expectancy >12 weeks; Adequate heart, lung, liver, kidney functions; Available for tumor biopsy or cancerous effusions; Informed consent explained to, understood by and signed by patient/guardian. Patient/guardian given copy of informed consent. Exclusion Criteria: Had accepted gene therapy before; Severe virus infection such as HBV, HCV, HIV, et al; Known HIV positivity; Active infectious disease related to bacteria, virus, fungi, et al; Other severe diseases that the investigators consider not appropriate; Pregnant or lactating women; Systemic steroid treatment (greater than or equal to 0.5 mg prednisone equivalent/kg/day); Other conditions that the investigators consider not appropriate.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: TILs treatment of solid cancers
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TILs/CAR-TILs treatment<br>Obtain TILs/CAR-TILs from advanced solid tumor patients and infuse them back to evaluate safety and clinical efficacy of the treatment. | Biological: TILs and CAR-TILs targeting HER2, Mesothelin, PSCA, MUC1, Lewis-Y, GPC3, AXL, EGFR, Claudin18.2/6, ROR1, GD1, or B7-H3<br>* TILs and CAR-TILs injection: 1-10×10e7/kg cells for each treatment; 3 or more cycles.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety of TILs/CAR-TILs treatment in advanced solid cancers | Assessing Number of participants with treatment-related adverse events as assessed by CTCAE v4.0. | up to 36 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary clinical efficacy of the TILs/CAR-TILs treatment in advanced solid cancers | Assessing various clinical response rates including complete response, partial response, stable disease, and progress disease during and after TILs/CAR-TILs treatment in advanced solid cancers. | 15 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Mesothelin, B7-H3, CRISPRA-CAS9, liver Cancer, Lung Cancer, Solid Tumor, TIL, CAR-TIL, PD1, CTLA4, GPC3