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1 Chantale Bernatchez: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA; Department of Translational Molecular Pathology, The University of Texas MDACC, Houston, TX, USA.
2 Rodabe N. Amaria: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA.
1 Chantale Bernatchez: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA; Department of Translational Molecular Pathology, The University of Texas MDACC, Houston, TX, USA.
2 Rodabe N. Amaria: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA.
Figure 1. Proposed model for a potential impact of anti-CTLA4 exposure on IL-2 expanded TIL…
Figure 1. Proposed model for a potential impact of anti-CTLA4 exposure on IL-2 expanded TIL during initial activation in the REP
Panel A. depicts the expected proliferative outcome after checkpoint naïve IL-2 propagated TIL are activated at the initial step of the REP. TIL are activated through their TCR following interaction with anti-CD3 (OKT3) loaded on the surface of the feeder cells (pool of 3 to 6 normal donors irradiated PBMC). The feeder cells represent an important expansion platform in the initial activation of the TIL, providing TCR stimulation as well as costimulation through expression of CD80/CD86, ligands of the CD28 molecule expressed at the surface of the TIL. Panel B. shows the theoretical outcome of a anti-CTLA4 exposed TIL in the initial step of activation of the REP. Unlike the checkpoint naïve TIL, the anti-CTLA4 exposed TIL contain a high level of intracellular CTLA molecules which quickly accumulate at the surface of the TIL at the time of TCR activation through anti-CD3 interaction. Following surface accumulation, the CTLA4 molecules compete against the outnumbered CD28 molecules for binding of the CD80/CD86 molecules. This binding results in suppression of the TIL activation and proliferation, leading to a suboptimal TIL expansion through the REP. Panel C. illustrates the protection from suppression provided by the addition of anti-CTLA4 to the REP. Blocking CTLA4 access to CD80/CD86 gives the opportunity for CD28 to interact with the ligands for positive feedback.