Cancer treatment using NK cells and EGFR-targeting antibodies

Abstract

The present invention particularly provides methods of treating patients suffering from EGFR+ cancer.

Description

[Technical Field]

[0001] Priority claim This application claims priority to U.S. Provisional Application No. 63 / 172,423, filed December 16, 2021, and U.S. Provisional Application No. 63 / 290,361, filed April 8, 2021, the entire contents of which are incorporated herein by reference. [Background technology]

[0002] Targeted therapies, including antibody therapy, have revolutionized cancer treatment. One mechanism by which antibody therapy induces cytotoxicity is antibody-dependent cell-mediated cytotoxicity (ADCC). Many cancer patients fail to generate a strong ADCC response. A reduced ADCC response significantly reduces the efficacy of any designated monoclonal antibody therapeutic agent in the patient, leading to non-response or relapse. Therefore, a reduced ADCC response can negatively impact clinical outcomes.

[0003] The use of anti-EGFR antibodies can result in patients not receiving the antibody at an optimal dose or can induce unacceptable toxicity. In some cases, patients may need to reduce the dose, omit or delay administration, or discontinue treatment altogether. Thus, the side effects of anti-EGFR antibodies can reduce the efficacy of the drug.

[0004] Despite the recent discovery and development of several anti-cancer drugs, the poor prognosis of many types of cancer, including EGFR+ cancers, still requires improved methods and therapeutic agents.

[0005] The present invention solves these and other problems in the art. Summary of the Invention [Problem to be solved by the invention]

[0006] NK cells are immune cells that can engage tumor cells not only through a complex array of cell surface receptors but also through antibody-dependent cell-mediated cytotoxicity (ADCC). NK cells can engage antibodies via their surface CD16 receptor to initiate ADCC. NK cells have advantages over other immune cells, such as T cells, used in CAR-T cell therapy and other cell therapies. One exemplary advantage is that NK cells can be used as allogeneic therapies, where NK cells derived from a single donor can be safely administered to one or more patients without HLA matching, gene editing, or other genetic manipulation. Allogeneic NK cells with anti-tumor activity can be safely administered to patients without many of the risks associated with T cell therapy, such as severe cytokine release syndrome (CRS) and neurotoxicity or graft-versus-host disease (GvHD).

[0007] Allogeneic NK cells can provide a significant treatment option for cancer patients. One exemplary advantage is that NK cells exhibit excellent drug tolerability without the onset of graft-versus-host disease, neurotoxicity, or cytokine release syndrome associated with other cell-based therapies. Another exemplary advantage is that NK cells do not require prior antigen exposure or specific antigen expression to identify and lyse tumor cells. Another exemplary advantage is that NK cells possess the unique ability to link innate immunity, mount a multi-clonal adaptive immune response, and build long-term anti-cancer immune memory. All of these characteristics contribute to the potential effectiveness of NK cells as a cancer treatment option.

[0008] For example, NK cells can recruit and activate other components of the immune system. Activated NK cells secrete cytokines and chemokines, such as interferon-γ (IFNγ); tumor necrosis factor-α (TNFα); and macrophage inflammatory protein 1 (MIP1), which signal and recruit T cells to tumors. NK cells also directly kill tumor cells, exposing tumor antigens for recognition by the adaptive immune system.

[0009] In conjunction with this, by using a diverse cord blood bank as a source of NK cells, cord blood with favorable characteristics (e.g., high-affinity CD16 and killer cell immunoglobulin-like receptor (KIR) B-haplotype) can be selected to enhance clinical activity. [Means for solving the problem]

[0010] As described herein, administration of allogeneic NK cells can enhance a patient's ADCC response, for example, during monoclonal antibody therapy. Cetuximab typically has little or no effect on tumors with KRAS mutations. This is because cetuximab typically binds to domain III of EGFR, preventing EGFR from binding to its ligand, epidermal growth factor (EGF). This inhibits EGFR dimerization and activation, which initiates a series of downstream signaling events. The signaling pathway can include K-ras. Unfortunately, K-ras can acquire activating mutations in exon 2, leading to constitutively active KRAS signaling. Such mutations render cancers resistant to cetuximab. Therefore, cetuximab is approved for treating KRAS wild-type cancers. However, cetuximab can mediate ADCC. As one exemplary advantage, the NK cells described herein have a mechanism of action that relies on ADCC, which is independent of EGFR and KRAS signaling. Thus, tumors that may be resistant to cetuximab alone can still respond to the combination of NK cells and cetuximab described herein.

[0011] The present invention provides, among other things, methods of treating patients suffering from EGFR+ cancer.

[0012] The present invention provides a method of treating a patient suffering from an EGFR+ cancer, comprising administering a population of natural killer cells (NK cells) and an antibody that targets human EGFR, wherein the NK cells are allogeneic to the patient, have a KIR-B haplotype, and are homozygous for a CD16 158V polymorphism.

[0013] In some embodiments, the cancer is selected from the group consisting of glioblastoma, lung adenocarcinoma, non-small cell lung cancer, low-grade glioma, colorectal adenocarcinoma, high-grade glioma, multiple myeloma, breast adenocarcinoma, pilocytic astrocytoma, and combinations thereof. In some embodiments, the patient has relapsed after treatment with an anti-EGFR antibody. In some embodiments, the patient has experienced disease progression after treatment with autologous stem cell transplantation or chimeric antigen receptor T-cell therapy (CAR-T).

[0014] In some embodiments, the patient is administered 1×10 NK cells 8 ~1×10 10 In some embodiments, the patient is administered 1×10 NK cells. 9 ~8×10 9 In some embodiments, the patient is administered 4×10 NK cells. 8 , 1×10 9 , 4×10 9 or 8×10 9 Administer one dose.

[0015] In some embodiments, the patient is administered an antibody at a dose of 100-500 mg / m 2 In some embodiments, the antibody is cetuximab.

[0016] In some embodiments, the patient undergoes lymphodepleting chemotherapy prior to treatment. In some embodiments, the lymphodepleting chemotherapy is non-myeloablative chemotherapy. In some embodiments, the lymphodepleting chemotherapy comprises treatment with one or more of cyclophosphamide and fludarabine. In some embodiments, the lymphodepleting chemotherapy comprises treatment with cyclophosphamide and fludarabine. In some embodiments, cyclophosphamide is administered at a dose of 100-500 mg / m 2 / day. In some embodiments, cyclophosphamide is administered at 250 mg / m 2 / day. In some embodiments, cyclophosphamide is administered at 500 mg / m 2 / day. In some embodiments, fludarabine is administered at 10-50 mg / m 2 / day. In some embodiments, fludarabine is administered at 30 mg / m 2 / day. In some embodiments, the method further comprises administering IL-2. In some embodiments, IL-2 is administered to the patient at a dose of 1 x 10 6 IU / m 2 In some embodiments, IL-2 is administered to the patient at 6,000,000 IU. In some embodiments, administration of IL-2 occurs within 1-4 hours of administration of the NK cells.

[0017] In some embodiments, the NK cells and the human EGFR-targeting antibody are administered weekly. In some embodiments, the NK cells and the human EGFR-targeting antibody are administered weekly for 4-8 weeks. In some embodiments, the NK cells are administered weekly and the human EGFR-targeting antibody is administered every other week.

[0018] In some embodiments, the NK cells are not genetically modified.

[0019] In some embodiments, at least 70% of the NK cells are CD56+ and CD16+. In some embodiments, at least 85% of the NK cells are CD56+ and CD3-. In some embodiments, 1% or less of the NK cells are CD3+, 1% or less of the NK cells are CD19+, and 1% or less of the NK cells are CD14+. In some embodiments, each administration of NK cells comprises 1 x 10 NK cells. 9 ~5×10 9 In some embodiments, a dose of an EGFR-targeting antibody is administered to the patient prior to the first administration of NK cells. In some embodiments, the expanded natural killer cells are expanded cord blood natural killer cells.

[0020] In some embodiments, the expanded population of natural killer cells comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% CD16+ cells. In some embodiments, the expanded population of natural killer cells comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% NKG2D+ cells. In some embodiments, the expanded population of natural killer cells comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% NKp46+ cells. In some embodiments, the expanded population of natural killer cells comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% NKp30+ cells. In some embodiments, the expanded natural killer cell population comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% DNAM-1+ cells. In some embodiments, the expanded natural killer cell population comprises at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% NKp44+ cells. In some embodiments, the expanded natural killer cell population comprises less than 20%, e.g., 10% or less, 5% or less, 1% or less, 0.5% or less, or 0% CD3+ cells. In some embodiments, the expanded natural killer cell population comprises less than 20%, e.g., 10% or less, 5% or less, 1% or less, 0.5% or less, or 0% CD14+ cells. In some embodiments, the expanded natural killer cell population comprises less than 20%, e.g., 10% or less, 5% or less, 1% or less, 0.5% or less, or 0% CD19+ cells. In some embodiments, the expanded natural killer cell population comprises less than 20%, e.g., 10% or less, 5% or less, 1% or less, 0.5% or less, or 0% CD38+ cells.

[0021] In some embodiments, the natural killer cells do not comprise a CD16 transgene. In some embodiments, the natural killer cells do not express exogenous CD16 protein. In some embodiments, the expanded natural killer cells are not genetically engineered.

[0022] In some embodiments, the expanded natural killer cells are derived from the same cord blood donor.

[0023] In some embodiments, the population of NK cells comprises at least 100 million expanded natural killer cells, e.g., 200 million, 250 million, 300 million, 400 million, 500 million, 600 million, 700 million, 750 million, 800 million, 900 million, 1 billion, 2 billion, 3 billion, 4 billion, 5 billion, 6 billion, 7 billion, 8 billion, 9 billion, 10 billion, 15 billion, 20 billion, 25 billion, 50 billion, 75 billion, 80 billion, 90 billion, 100 billion, 200 billion, 250 billion, 300 billion, 400 billion, 500 billion, 600 billion, 700 billion, 800 billion, 900 billion, 1 trillion, 2 trillion, 3 trillion, 4 trillion, 5 trillion, 6 trillion, 7 trillion, 8 trillion, 9 trillion, or 10 trillion.

[0024] In some embodiments, the population of NK cells is produced by a method comprising the steps of: (a) obtaining seed cells comprising natural killer cells from umbilical cord blood; (b) depleting the seed cells of CD3+ cells; and (c) expanding the natural killer cells by culturing the depleted seed cells with a first plurality of Hut78 cells engineered to express membrane-bound IL-21, a TNFα mutant, and a 4-1BBL gene to produce expanded natural killer cells, thereby producing a population of expanded natural killer cells.

[0025] In some embodiments, the population of NK cells is produced by a method comprising the steps of: (a) obtaining seed cells comprising natural killer cells from umbilical cord blood; (b) depleting the seed cells of CD3+ cells; (c) expanding the natural killer cells by culturing the depleted seed cells with a first plurality of Hut78 cells engineered to express membrane-bound IL-21, a TNFα mutation, and a 4-1BBL gene, to produce a master cell bank population of expanded natural killer cells; and (d) expanding the master cell bank population of expanded natural killer cells by culturing a second plurality of Hut78 cells engineered to express membrane-bound IL-21, a TNFα mutation, and a 4-1BBL gene, to produce expanded natural killer cells; thereby producing a population of expanded natural killer cells.

[0026] In some embodiments, the population of NK cells is produced by a method that, after step (c), additionally comprises the steps of: (i) freezing the master cell bank population of expanded natural killer cells in multiple containers; and (ii) thawing the containers containing aliquots of the master cell bank population of expanded natural killer cells, wherein in step (d), expanding the master cell bank population of expanded natural killer cells comprises amplifying the aliquots of the master cell bank population of expanded natural killer cells.

[0027] In some embodiments, the cord blood is from a donor who is KIR-B haplotype and homozygous for the CD16 158V polymorphism.

[0028] In some embodiments, the population of NK cells is produced by a method comprising expanding natural killer cells from umbilical cord blood by at least 10,000-fold, e.g., 15,000-fold, 20,000-fold, 25,000-fold, 30,000-fold, 35,000-fold, 40,000-fold, 45,000-fold, 50,000-fold, 55,000-fold, 60,000-fold, 65,000-fold, or 70,000-fold.

[0029] In some embodiments, the expanded population of natural killer cells is not enriched or sorted after expansion.

[0030] In some embodiments, the percentage of NK cells expressing CD16 in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0031] In some embodiments, the percentage of NKG2D-expressing NK cells in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0032] In some embodiments, the percentage of NKp30-expressing NK cells in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0033] In some embodiments, the percentage of NKp44-expressing NK cells in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0034] In some embodiments, the percentage of NKp46-expressing NK cells in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0035] In some embodiments, the percentage of NK cells expressing DNAM-1 in the expanded population of natural killer cells is the same as or higher than the percentage of natural killer cells in seed cells derived from umbilical cord blood.

[0036] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Methods and materials for use in the present invention are described herein; other suitable methods and materials known in the art may also be used. The materials, methods, and examples are illustrative only and are not limiting. All publications, patent applications, patents, sequences, database entries, and other references mentioned in this application are incorporated herein by reference in their entirety. In the event of a conflict, the present specification, including definitions, will control.

[0037] Other features and advantages of the invention will become apparent from the following detailed description and drawings, and from the claims.

[0038] Incorporation by reference All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.

[0039] The novel features of the invention are set forth with particularity in the appended claims. The patent or application file contains one or more drawings executed in color. Copies of this patent or patent application publication containing color drawing(s) will be provided by the Patent and Trademark Office upon request and payment of the appropriate fee. The features and advantages of the present invention will be better understood by reference to the following detailed description and accompanying drawings that set forth illustrative embodiments, in which the principles of the invention are applied. [Brief explanation of the drawings]

[0040] [Figure 1] FIG. 1 shows an exemplary embodiment for a method for expanding and stimulating NK cells. [Figure 2] FIG. 1 shows that in preclinical experiments, umbilical cord blood-derived NK cells (CB-NK) have approximately 10 times the culture expansion capacity of peripheral blood-derived NK cells (PB-NK). [Figure 3]FIG. 1 shows that expression of tumor-engaging NK-activating immunoreceptors is higher and more consistent in cord blood-derived products compared to peripheral blood sources. [Figure 4] FIG. 1 shows the phenotype of expanded and stimulated NK cell populations. [Figure 5] FIG. 1 shows the key steps of manufacturing AB-101 drug product as an example of a cord blood-derived NK cell expanded population. [Figure 6] FIG. 1 shows the purity of AB-101 (n=9). [Figure 7] FIG. 1 shows the purity of CD3-depleted cells, MCB and DP produced under GMP conditions. [Figure 8] FIG. 1 shows the expression of NK cell receptors in CD3-depleted cells, MCB and DP produced under GMP conditions. [Figure 9] FIG. 1 shows NK purity (CD56+ / CD3−) measured by flow cytometry. [Figure 10] FIG. 1 shows CD38+ expression on expanded NK cells derived from three types of cord blood donors. [Figure 11] FIG. 1 shows the mean fluorescence intensity of CD38+ of CD38+ NK cells derived from three types of cord blood donors. [Figure 12] FIG. 1 shows differential surface protein expression on NK cell sources compared to AB-101 cells as starting material. [Figure 13] Figure 1 shows short-term cytotoxicity against various head and neck squamous cell carcinoma cell lines (E:T ratio = 3:1). [Figure 14] Figure 1 shows short-term cytotoxicity against various head and neck squamous cell carcinoma cell lines (cetuximab 1 μg / ml, n=2). [Figure 15] FIG. 1 shows short-term cytotoxicity against various colorectal cancer cell lines. [Figure 16] FIG. 1 shows long-term cytotoxicity against various colorectal cancer cell lines. [Figure 17] FIG. 1 shows short-term cytotoxicity against breast cancer cell lines. [Figure 18]FIG. 1 shows intracellular staining of treated breast cancer cell lines. [Figure 19] FIG. 1 shows long-term cytotoxicity against breast cancer cell lines. DETAILED DESCRIPTION OF THE INVENTION

[0041] The present invention provides, inter alia, natural killer (NK) cells, e.g., expanded and stimulated NK cells, methods for producing NK cells, pharmaceutical compositions comprising NK cells, and methods for treating patients, e.g., suffering from cancer, with NK cells.

[0042] I. Expansion and stimulation of natural killer cells In some embodiments, natural killer cells are expanded and stimulated, for example, by culturing and stimulating with feeder cells.

[0043] NK cells can be expanded and stimulated, for example, as described in US2020 / 0108096 or WO2020 / 101361, both of which are incorporated herein by reference in their entirety. Briefly, the source cells are recombinant HuT-78 (ATCC 94224), engineered to express 4-1BBL, membrane-bound IL-21, and mutant TNFα, as described in US2020 / 0108096. (R) TIB-161 TM ) cells.

[0044] Suitable NK cells can also be expanded and stimulated as described herein.

[0045] In some embodiments, NK cells are expanded and stimulated by a method comprising: (a) providing NK cells, e.g., a composition comprising NK cells, e.g., CD3(-) depleted cells; and (b) culturing in a medium comprising feeder cells and / or stimulatory factors to produce a population of expanded and stimulated NK cells.

[0046] A. Natural Killer Cell Sources In some embodiments, the NK cell source is selected from the group consisting of peripheral blood, peripheral blood lymphocytes (PBLs), peripheral blood mononuclear cells (PBMCs), bone marrow, umbilical cord blood (umbilical cord blood or cord blood), isolated NK cells, NK cells derived from induced pluripotent stem cells, NK cells derived from embryonic stem cells, and combinations thereof.

[0047] In some embodiments, the NK cell source is a single unit of umbilical cord blood.

[0048] In some embodiments, a natural killer cell source, e.g., a single unit of umbilical cord blood, contains 1×10 total nucleated cells. 7 or about 1 x 10 7 ~1×10 9 or about 1 x 10 9 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, comprises 1 x 10 total nucleated cells. 8 or about 1 x 10 8 ~1.5×10 8 or about 1.5 x 10 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, comprises 1 x 10 total nucleated cells. 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, comprises about 1 x 10 total nucleated cells. 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, comprises 1 x 10 total nucleated cells. 9 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, comprises about 1 x 10 total nucleated cells. 9 Includes pieces.

[0049] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, comprises about 20% to about 80% CD16+ cells. In some embodiments, the NK cell source, e.g., umbilical cord blood unit, comprises about 20% or about 20% to about 80% or about 80%, about 20% to 70% or about 70%, about 20% to 60% or about 60%, about 20% to 50% or about 50%, about 20% to 40% or about 40%, about 20% to 30% or about 30%, about 30% to 80% or about 80%, about 30% to 70% or about 70%, about 30% to 60% or about 60%, about 30% to 60% or about 60%. In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains 80% or less CD16+ cells. Alternatively, some NK cell sources may contain greater than 80% CD16+ cells.

[0050] In some embodiments, the NK cell source, eg, umbilical cord blood unit, comprises no more than 40% MLG2A+ cells, eg, no more than 30%, eg, no more than 20%, eg, no more than 10%, eg, no more than 5%.

[0051] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% NKG2C+ cells.

[0052] In some embodiments, the NK cell source, eg, umbilical cord blood unit, contains no more than 40%, eg, no more than 30%, eg, no more than 20%, eg, no more than 10%, eg, no more than 5% NKG2D+ cells.

[0053] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% NKp46+ cells.

[0054] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% NKp30+ cells.

[0055] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% DNAM-1+ cells.

[0056] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% NKp44+ cells.

[0057] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, comprises no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% CD25+ cells.

[0058] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% CD62L+ cells.

[0059] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% CD69+ cells.

[0060] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, contains no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% CXCR3+ cells.

[0061] In some embodiments, the NK cell source, e.g., umbilical cord blood unit, comprises no more than 40%, e.g., no more than 30%, e.g., no more than 20%, e.g., no more than 10%, e.g., no more than 5% CD57+ cells.

[0062] In some embodiments, the NK cells in the NK cell source comprise the KIR B allele of the KIR receptor system. See, e.g., Hsu et al., "The Killer Cell Immunoglobulin-Like Receptor (KIR) Genomic Region: Gene-Order, Haplotypes and Allelic Polymorphism," Immunological Review 190:40-52 (2002); and Pyo et al., "Different Patterns of Evolution in the Centromeric and Telomeric Regions of Group A and B Haplotypes of the Human Killer Cell Ig-like Receptor Locus," PLoS One 5:e15115 (2010).

[0063] In some embodiments, the NK cells in the NK source contain the 158V / V variant of CD16 (i.e., homozygous CD16 15V polymorphism). See, e.g., Koene et al., "FcγRIIIa-158V / F Polymorphism Influences the Binding of IgG by Natural Killer Cell FcgammaRIIIa, Independently of the FcgammaRIIIa-48L / R / H Phenotype," Blood 90:1109-14 (1997).

[0064] In some embodiments, the NK cells in the cell source contain both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16.

[0065] In some embodiments, the NK cells in the cell source are not genetically engineered.

[0066] In some embodiments, the NK cells in the cell source do not contain a CD16 transgene.

[0067] In some embodiments, the NK cells in the cell source do not express exogenous CD16 protein.

[0068] In some embodiments, the NK cell source is CD3(+) depleted. In some embodiments, the method comprises depleting the NK cell source of CD3(+) cells. In some embodiments, depleting the NK cell source of CD3(+) cells comprises contacting the NK cell source with a CD3-binding antibody or antigen-binding fragment thereof. In some embodiments, the CD3-binding antibody or antigen-binding fragment thereof is selected from the group consisting of OKT3, UCHT1, and HIT3a, and fragments thereof. In some embodiments, the CD3-binding antibody or antigen-binding fragment thereof is OKT3 or its antigen-binding fragment. In some embodiments, the antibody or antigen-binding fragment thereof is attached to beads, e.g., magnetic beads. In some embodiments, depleting the CD3(+) cells in the composition comprises contacting the composition with a CD3-targeting antibody or antigen-binding fragment thereof attached to beads to remove bead-bound CD3(+) cells from the composition. Compositions can be CD3 depleted by immunomagnetic selection, for example using the CliniMACS T cell depletion set (LS Depletion set (162-01) Miltenyi Biotec).

[0069] In some embodiments, the NK cell source is CD56+ enriched, for example, by gating on CD56 expression.

[0070] In some embodiments, the NK cell source is CD56+ enriched and CD3(+) depleted, for example, by sorting for CD56+CD3- expressing cells.

[0071] In some embodiments, the NK cell source contains both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and CD56+ enrichment and CD3(+) depletion is achieved, for example, by sorting for CD56+CD3- expressing cells.

[0072] B. Feeder cells The present invention discloses feeder cells for expanding NK cells. These feeder cells advantageously allow NK cells to be expanded to numbers suitable for producing the pharmaceutical compositions described herein. In some cases, the feeder cells allow NK cells to be expanded without a significant decrease in CD16 expression, often accompanied by cell expansion on other types of feeder cells or using other methods. In some cases, the feeder cells allow expanded NK cells to better tolerate freezing, such that a higher proportion of NK cells remain viable after a freeze / thaw cycle or the cells remain viable for a longer period during freezing. In some cases, the feeder cells allow NK cells to maintain high levels of cytotoxicity, such as ADCC, prolong survival, increase persistence, and enhance or maintain high levels of CD16. In some cases, the feeder cells allow NK cells to be expanded without inducing significant levels of exhaustion or senescence.

[0073] Feeder cells can be used to stimulate NK cells and help them expand more rapidly, for example, by providing substrate, growth factors and / or cytokines.

[0074] NK cells can be stimulated using various types of feeder cells, including, but not limited to, peripheral blood mononuclear cells (PBMCs), Epstein-Barr virus-transformed B-lymphoblastic cells (e.g., EBV-LCL), myeloid leukemia cells (e.g., K562), and CD4(+) T cells (e.g., HuT), and their derivatives.

[0075] In some embodiments, the feeder cells are inactivated, for example, by gamma-irradiation or mitomycin-c treatment.

[0076] Feeder cells suitable for use in the methods described herein are described, for example, in US2020 / 0108096, the entire contents of which are incorporated herein by reference.

[0077] In some embodiments, the feeder cells are inactivated CD4(+) T cells. In some embodiments, the inactivated CD4(+) T cells are HuT-78 cells (ATCC (R) TIB-161 TM ), or a variant or derivative thereof. In some embodiments, the HuT-78 derivative is H9 (ATCC (R) HTB-176 TM )

[0078] In some embodiments, the inactivated CD4(+) T cells express OX40L. In some embodiments, the inactivated CD4(+) T cells are HuT-78 cells that express OX40L (SEQ ID NO: 4), or a variant thereof, or a variant or derivative thereof.

[0079] In some embodiments, the feeder cells are HuT-78 cells engineered to express one or more genes selected from the group consisting of 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and mutant TNFα (SEQ ID NO: 3) (“eHut-78 cells”), or variants thereof.

[0080] In some embodiments, the inactivated CD4(+) T cells are selected from the group consisting of HuT-78 (ATCC (R) TIB-161 TM ) cells or mutants or derivatives expressing an OX40L ortholog, or variants thereof. In some embodiments, the feeder cells are HuT-78 cells engineered to express one or more genes selected from the group consisting of a 4-1BBL ortholog, or variants thereof, a membrane-bound IL-21 ortholog, or variants thereof, and a mutant TNFα ortholog, or variants thereof.

[0081] In some embodiments, the feeder cells are HuT-78 cells that express OX40L (SEQ ID NO: 4); 4-1BBL (SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2) and mutant TNFα (SEQ ID NO: 3) ("eHut-78 cells"), or variants or derivatives thereof.

[0082] In some embodiments, the feeder cells are expanded, eg, from frozen stocks, prior to culturing with the NK cells, eg, as described in Example 2.

[0083] C. Stimulating factor NK cells can also be stimulated with one or more other stimulatory factors other than feeder cells, eg, signaling factors, in addition to or instead of feeder cells.

[0084] In some embodiments, the stimulatory factors, e.g., signal transduction factors, are components of the culture medium, as described herein. In some embodiments, the stimulatory factors, e.g., signal transduction factors, are supplements to the culture medium, as described herein.

[0085] In some embodiments, the stimulatory factor is a cytokine. In some embodiments, the cytokine is selected from the group consisting of IL-2, IL-12, IL-15, IL-18, IL-21, IL-23, IL-27, IFN-α, IFN-β, and combinations thereof. In some embodiments, the cytokine is IL-2. In some embodiments, the cytokine is a combination of IL-2 and IL-15. In some embodiments, the cytokine is a combination of IL-2, IL-15, and IL-18. In some embodiments, the cytokine is a combination of IL-2, IL-18, and IL-21.

[0086] D. Culture NK cells can be expanded and stimulated by co-culturing the NK cell source with feeder cells and / or other stimulatory factors. Suitable NK cell sources, feeder cells, and stimulatory factors are described herein.

[0087] In some cases, the resulting expanded population of natural killer cells is enriched and / or sorted after expansion. In some cases, the resulting expanded population of natural killer cells is not enriched and / or sorted after expansion.

[0088] The present invention also describes compositions comprising various culture compositions described herein, e.g., NK cells, e.g., a composition comprising an expanded population of cord blood-derived natural killer cells comprising a KIR-B haplotype and homozygotes for the CD16 158V polymorphism, and a plurality of engineered HuT78 cells.

[0089] The invention also describes vessels, e.g., vials, cryobags, etc., containing the resulting expanded population of natural killer cells. In some cases, multiple containers contain portions of the resulting expanded population of natural killer cells, including at least 10, e.g., 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, or 1200 containers.

[0090] The present invention also describes bioreactors containing various culture compositions described herein, e.g., containing NK cells, e.g., cultures comprising natural killer cells derived from a natural killer cell source as described herein and feeder cells as described herein, e.g., as described herein. The present invention also describes bioreactors containing the resulting expanded population of natural killer cells.

[0091] 1. Culture Medium The present invention discloses culture media for expanding NK cells. These culture media advantageously allow NK cells to be expanded to a cell number suitable for producing the pharmaceutical compositions described herein. In some cases, the culture media can expand NK cells without a decrease in CD16 expression, often with cell expansion on other helper cells or in other media.

[0092] In some embodiments, the culture medium is a basal culture medium, optionally supplemented with additional components, for example, as described herein.

[0093] In some embodiments, the culture medium, e.g., the basal culture medium, is a serum-free culture medium. In some embodiments, the culture medium, e.g., the basal culture medium, is a serum-free culture medium supplemented with human plasma and / or serum.

[0094] Suitable basal culture media include DMEM, RPMI1640, MEM, DMEM / F12, and SCGM (CellGenix (R) , 20802-0500 or 20806-0500), LGM-3 TM (Lonza, CC-3211), TexMACS TM (Miltenyi Biotec, 130-097-196), ALyS TM 505NK-AC (Cell Science and Technology Institute, Inc., 01600P02), ALyS TM 505NK-EX (Cell Science and Technology Institute, Inc., 01400P10), CTS TM AIM-V TM SFM (ThermoFisher Scientific, A3830801), CTS TM OpTmizer TM (ThermoFisher Scientific, A1048501, ABS-001, StemXxVivo), and combinations thereof.

[0095] The culture medium may contain additional components or may be supplemented with additional components such as growth factors, signaling factors, nutrients, antigen-binding agents, etc. The culture medium may be supplemented by adding the respective additional component or components to the culture vessel before, simultaneously with, or after the medium is added to the culture vessel. The additional component or components may be added together or separately. If added separately, the additional components do not need to be added simultaneously.

[0096] In some embodiments, the culture medium comprises plasma, e.g., human plasma. In some embodiments, the culture medium is supplemented with plasma, e.g., human plasma. In some embodiments, the plasma, e.g., human plasma, comprises an anticoagulant, e.g., trisodium citrate.

[0097] In some embodiments, the medium comprises and / or is supplemented with plasma, e.g., human plasma, at 0.5% or about 0.5% to 10% or about 10% v / v. In some embodiments, the medium comprises 0.5% or about 0.5% to 9% or about 9%, 0.5% or about 0.5% to 8% or about 8%, 0.5% or about 0.5% to 7% or about 7%, 0.5% or about 0.5% to 6% or about 6%, 0.5% or about 0.5% to 5% or about 5%, 0.5% or about 0.5% to 4% or about 4%, 0.5% or about 0.5% to 3% or about 3%, 0.5% or about 0.5% to 2% or about 2%, 0.5% or about 0.5% to 1% or about 1%, 1% or about 1% to 10% or about 10%, 1% or about 1% to 9% or about 9%, 1% or about 1% to 8% or about 8%, 1% or about 1% to 7% or about 7%, 1% or about 1% to 6% or about 6%, 1% or about 1% to 5% or about 5%, 1% or about 1% to 4% or about 4%, 1% or about 1% to 3% or about 3%, 1% or about 1% to 2% or about 2%, 2% or about 2% to 10% or about 10%, 2% or about 2% to 9% or about 9%, 2% or about 2% to 8% or about 8%, 2% or about 2% to 7% or about 7%, 2% or about 2% to 6% or about 6%, 2% or about 2% to 5% or about 5%, 2% or about 2% to 4% or about 4%, 2% or about 2% to 3% or about 3%, 3% or about 3% to 10% or about 10%, 3% or about 3% to 9% or about 9%, 3% or about 3% to 8% or about 8%, 3% or about 3% to 7% or about 7%, 3% or about 3% to 6% or about 6%, 3% or about 3% to 5% or about 5%, 3% or about 3% to 4% or about 4%, 4% or about 4% to 10% or about 10%, 4% or about 4% to 9% or about 9%, 4% or about 4% to 8% or about 8%, 4% or about 4% to 7% or about 7%, 4% or about 4% to 6% or about 6%, 4% or about 4% to 5% or about 5%, 5% or about 5% to 10% or about 10%, 5% or about 5% to 9% or about 9%, 4% or about 4% to 8% or about 8%, 5% or about 5% to 7% or about 7%, 5% or about 5% to 6% or The culture medium is supplemented with plasma, e.g., human plasma, at about 6%, 6%, or about 6%-10%, or about 10%, 6%, or about 6%-9%, or about 9%, 6%, or about 6%-8%, or about 8%, 6%, or about 6%-7%, or about 7%, 7%, or about 7%-10%, or about 10%, 7%, or about 7%-9%, or about 9%, 7%, or about 7%-8%, or about 8%, 8%, or about 8%-10%, or about 10%, 8%, or about 8%-9%, or about 9%, or 9%, or about 9%-10%, or about 10% v / v. In some embodiments, the culture medium comprises and / or is supplemented with 0.8%-1.2% v / v human plasma. In some embodiments, the culture medium comprises and / or is supplemented with 1.0% v / v human plasma. In some embodiments, the culture medium comprises about 1.Contains and / or supplemented with 0% v / v.

[0098] In some embodiments, the culture medium comprises serum, e.g., human serum. In some embodiments, the culture medium is supplemented with serum, e.g., human serum. In some embodiments, the serum is inactivated, e.g., heat inactivated. In some embodiments, the serum is filtered, e.g., sterile-filtered.

[0099] In some embodiments, the culture medium comprises glutamine. In some embodiments, the culture medium is supplemented with glutamine. In some embodiments, the culture medium comprises and / or is supplemented with 2.0 or about 2.0 to 6.0 or about 6.0 mM glutamine. In some embodiments, the culture medium comprises and / or is supplemented with 2.0 or about 2.0 to 5.5 or about 5.5, 2.0 or about 2.0 to 5.0 or about 5.0, 2.0 or about 2.0 to 4.5 or about 4.5, 2.0 or about 2.0 to 4.0 or about 4.0, 2.0 or about 2.0 to 3.5 or about 3.5, 2.0 or about 2.0 to 3.0 or about 3.0, 2.0 or about 2.0 to 2.5 or about 2.5, 2.5 or about 2.5 to 6.0 or about 6.0, 2.5 or or about 2.5 to 5.5 or about 5.5, 2.5 or about 2.5 to 5.0 or about 5.0, 2.5 or about 2.5 to 4.5 or about 4.5, 2.5 or about 2.5 to 4.0 or about 4.0, 2.5 or about 2.5 to 3.5 or about 3.5, 2.5 or about 2.5 to 3.0 or about 3.0, 3.0 or about 3.0 to 6.0 or about 6.0, 3.0 or about 3.0 to 5.5 or about 5.5, 3.0 or about 3.0 to 5.0 or about 5.0, 3.0 or about 3.0 to 4.5 or about 4.5, 3.0 or about 3.0 to 4.0 or about 4.0, 3.0 or about 3.0 to 3.5 or about 3.5, 3.5 or about 3.5 to 6.0 or about 6.0, 3.5 or about 3.5 to 5.5 or about 5.5, 3.5 or about 3.5 to 5.0 or about 5.0, 3.5 or about 3.5 to 4.5 or about 4.5, 3.5 or about 3.5 to 4.0 or about 4.0, 4.0 or about 4.0 to 6.0 or about 6.0, 4.0 or about 4.0 to 5.5 or In some embodiments, the culture medium comprises and / or is supplemented with about 5.5, 4.0, or about 4.0-5.0, or about 5.0, 4.0, or about 4.0-4.5, or about 4.5, 4.5, or about 4.5-6.0, or about 6.0, 4.5, or about 4.5-5.5, or about 5.5, 4.5, or about 4.5-5.0, or about 5.0, 5.0, or about 5.0-6.0, or about 6.0, 5.0, or about 5.0-5.5, or about 5.5, or 5.5, or about 5.5-6.0, or about 6.0 mM glutamine. In some embodiments, the culture medium comprises and / or is supplemented with 3.2 mM to 4.8 mM glutamine.In some embodiments, the culture medium comprises and / or is supplemented with 4.0 mM glutamine. In some embodiments, the culture medium comprises and / or is supplemented with about 4.0 mM glutamine.

[0100] In some embodiments, the culture medium comprises one or more cytokines. In some embodiments, the culture medium is supplemented with one or more cytokines.

[0101] In some embodiments, the cytokine is selected from IL-2, IL-12, IL-15, IL-18, and combinations thereof.

[0102] In some embodiments, the culture medium comprises and / or is supplemented with IL-2. In some embodiments, the culture medium comprises and / or is supplemented with IL-2 at 150 or about 150-2,500 or about 2,500 IU / ml. In some embodiments, the culture medium comprises and / or is supplemented with IL-2 at 200 or about 200-2,250 or about 2,250, 200 or about 200-2,000 or about 2,000, 200 or about 200-1,750 or about 1,750, 200 or about 200-1,500 or about 1,500, 200 or about 200-1,250 or about 1,250, 200 or about 200-1,000 or about 1,000, 200 or about 200-750 or about 750, 200 or about 200-500 or about 500, 200 or about 200-250 or about 250, 250 or about 250-2,500 or about 2,500, 250 or about 250-2,250 or about 2,250, 250 or about 250-2,000 or about 2,000, 250 or about 250-1,750 or about 1,750, 250 or about 250-1,500 or about 1,500, 250 or about 250-1,250 or about 1,250, 250 or about 250-1,000 or about 1,000, 250 or about 250-7 50 or about 750, 250 or about 250 to 500 or about 500, 500 or about 500 to 2,500 or about 2,500, 500 or about 500 to 2,250 or about 2,250, 500 or about 500 to 2,000 or about 2,000, 500 or about 500 to 1,750 or about 1,750, 500 or about 500 to 1,500 or about 1,500, 500 or about 500 to 1,250 or about 1,250, 500 or about 500 to 1,000 or about 1,000, 500 or is about 500 to 750 or about 750, 750 or about 750 to 2,250 or about 2,250, 750 or about 750 to 2,000 or about 2,000, 750 or about 750 to 1,750 or about 1,750, 750 or about 750 to 1,500 or about 1,500, 750 or about 750 to 1,250 or about 1,250, 750 or about 750 to 1,000 or about 1,000, 1,000 or about 1,000 to 2,500 or about 2,500, 1,000 or about 1,000 to 2,250 or about 2,250, 1,000 or about 1,000 to 2,000 or about 2,000, 1,000 or about 1,000 to 1,750 or about 1,750, 1,000 or about 1,000 to 1,500 or about 1,500, 1,000 or about 1,000 to 1,250 or about 1,250, 1,250 or about 1,250 to 2,50 0 or about 2,500, 1,250 or about 1,250 to 2,250 or about 2,250, 1,250 or about 1,250 to 2,000 or about 2,000, 1,250 or about 1,250 to 1,750 or about 1,750, 1,250 or about 1,250 to 1,500 or about 1,500, 1,500 or about 1,500 to 2,500 is about 2,500, 1,500 or about 1,500 to 2,250 or about 2,250, 1,500 or about 1,500 to 2,000 or about 2,000, 1,500 or about 1,500 to 1,750 or about 1,750, 1,750 or about 1,750 to 2,500 or about 2,500, 1,750 or about 1,750 to 2,250 or about Containing and / or supplemented with 2,250, 1,750 or about 1,750 to 2,000 or about 2,000, 2,000 or about 2,000 to 2,500 or about 2,500, 2,000 or about 2,000 to 2,250 or about 2,250, or 2,250 or about 2,250 to 2,500 or about 2,500 IU / ml.

[0103] In some embodiments, the culture medium contains and / or is supplemented with 64 μg / L to 96 μg / L of IL-2. In some embodiments, the culture medium contains and / or is supplemented with 80 μg / L (approximately 1,333 IU / ml) of IL-2. In some embodiments, the culture medium contains and / or is supplemented with about 80 μg / L of IL-2.

[0104] In some embodiments, the culture medium comprises and / or is supplemented with a combination of IL-2 and IL-15. In some embodiments, the culture medium comprises and / or is supplemented with a combination of IL-2, IL-15 and IL-18. In some embodiments, the culture medium comprises and / or is supplemented with a combination of IL-2, IL-18 and IL-21.

[0105] In some embodiments, the culture medium comprises and / or is supplemented with glucose. In some embodiments, the culture medium comprises and / or is supplemented with 0.5 or about 0.5-3.5 g / L or about 3.5 g / L of glucose. In some embodiments, the culture medium comprises and / or is supplemented with 0.5 or about 0.5-3.0 or about 3.0, 0.5 or about 0.5-2.5 or about 2.5, 0.5 or about 0.5-2.0 or about 2.0, 0.5 or about 0.5-1.5 or about 1.5, 0.5 or about 0.5-1.0 or about 1.0, 1.0 or about 1.0-3.0 or about 3.0, 1.0 or about 1.0-2.5 or about 2.5, 1.0 or about 1.0-2.0 or about In some embodiments, the culture medium contains and / or is supplemented with glucose at 2.0, 1.0, or about 1.0-1.5, or about 1.5, 1.5, or about 1.5-3.0, or about 3.0, 1.5, or about 1.5-2.5, or about 2.5, 1.5, or about 1.5-2.0, or about 2.0, 2.0, or about 2.0-3.0, or about 3.0, 2.0, or about 2.0-2.5, or about 2.5, or 2.5, or about 2.5-3.0, or about 3.0 g / L. In some embodiments, the culture medium contains and / or is supplemented with glucose at 1.6-2.4 g / L. In some embodiments, the culture medium contains and / or is supplemented with 2.0 g / L of glucose. In some embodiments, the culture medium contains about 2.0 g / L of glucose.

[0106] In some embodiments, the culture medium comprises and / or is supplemented with sodium pyruvate. In some embodiments, the culture medium comprises and / or is supplemented with 0.1 or about 0.1-2.0 or about 2.0 mM sodium pyruvate. In some embodiments, the culture medium comprises and / or is supplemented with 0.1 or about 0.1-1.8 or about 1.8, 0.1 or about 0.1-1.6 or about 1.6, 0.1 or about 0.1-1.4 or about 1.4, 0.1 or about 0.1-1.2 or about 1.2, 0.1 or about 0.1-1.0 or about 1.0, 0.1 or about 0.1-0.8 or about 0.8, 0.1 or about 0.1-0.6 or about 0.6, 0.1 or about 0.1-0.4 or about 0.4, 0.1 or about 0.1-0.2 or about 0.2, 0. 2 or about 0.2 to 2.0 or about 2.0, 0.2 or about 0.2 to 1.8 or about 1.8, 0.2 or about 0.2 to 1.6 or about 1.6, 0.2 or about 0.2 to 1.4 or about 1.4, 0.2 or about 0.2 to 1.2 or about 1.2, 0.2 or about 0.2 to 1.0 or about 1.0, 0.2 or about 0.2 to 0.8 or about 0.8, 0.2 or about 0.2 to 0.6 or about 0.6, 0.2 or about 0.2 to 0.4 or about 0.4, 0.4 or about 0.4 to 2.0 or about 2.0, 0 0.4 or about 0.4 to 1.8 or about 1.8, 0.4 or about 0.4 to 1.6 or about 1.6, 0.4 or about 0.4 to 1.4 or about 1.4, 0.4 or about 0.4 to 1.2 or about 1.2, 0.4 or about 0.4 to 1.0 or about 1.0, 0.4 or about 0.4 to 0.8 or about 0.8, 0.4 or about 0.4 to 0.6 or about 0.6, 0.6 or about 0.6 to 2.0 or about 2.0, 0.6 or about 0.6 to 1.8 or about 1.8, 0.6 or about 0.6 to 1.6 or about 1.6 , 0.6 or about 0.6 to 1.4 or about 1.4, 0.6 or about 0.6 to 1.2 or about 1.2, 0.6 or about 0.6 to 1.0 or about 1.0, 0.6 or about 0.6 to 0.8 or about 0.8, 0.8 or about 0.8 to 2.0 or about 2.0, 0.8 or about 0.8 to 1.8 or about 1.8, 0.8 or about 0.8 to 1.6 or about 1.6, 0.8 or about 0.8 to 1.4 or about 1.4, 0.8 or about 0.8 to 1.4 or about 1.4, 0.8 or about 0.8 to 1.2 or about 1.2, 0.8 or about 0.8 to 1.0 or about 1.0, 1.0 or about 1.0 to 2.0 or about 2.0, 1.0 or about 1.0 to 1.8 or about 1.8, 1.0 or about 1.0 to 1.6 or about 1.6, 1.0 or about 1.0 to 1.4 or about 1.4, 1.0 or about 1.0 to 1.2 or about 1.2, 1.2 or about 1.2 to 2.0 or about 2.0, 1.2 or about 1.2 to 1.8 or about 1.8, 1.2 or about 1.2 to 1.6 or or about 1.6, 1.2, or about 1.2-1.4, or about 1.4, 1.4, or about 1.4-2.0, or about 2.0, 1.4, or about 1.4-1.8, or about 1.8, 1.4, or about 1.4-1.6, or about 1.6, 1.6, or about 1.6-2.0, or about 2.0, 1.6, or about 1.6-1.8, or about 1.8, or 1.8, or about 1.8-2.0, or about 2.0 mM sodium pyruvate. In some embodiments, the culture medium contains 0.8-1.2 mM sodium pyruvate. In some embodiments, the culture medium contains 1.0 mM sodium pyruvate. In some embodiments, the culture medium contains about 1.0 mM sodium pyruvate.

[0107] In some embodiments, the culture medium comprises and / or is supplemented with sodium bicarbonate. In some embodiments, the culture medium comprises and / or is supplemented with 0.5 or about 0.5 to 3.5 or about 3.5 g / L of sodium bicarbonate. In some embodiments, the culture medium comprises and / or is supplemented with 0.5 or about 0.5 to 3.0 or about 3.0, 0.5 or about 0.5 to 2.5 or about 2.5, 0.5 or about 0.5 to 2.0 or about 2.0, 0.5 or about 0.5 to 1.5 or about 1.5, 0.5 or about 0.5 to 1.0 or about 1.0, 1.0 or about 1.0 to 3.0 or about 3.0, 1.0 or about 1.0 to 2.5 or about 2.5, 1.0 or about 1.0 to 2.0 or about 2. In some embodiments, the culture medium contains and / or is supplemented with sodium bicarbonate at 0, 1.0, or about 1.0-1.5, or about 1.5, 1.5, or about 1.5-3.0, or about 3.0, 1.5, or about 1.5-2.5, or about 2.5, 1.5, or about 1.5-2.0, or about 2.0, 2.0, or about 2.0-3.0, or about 3.0, 2.0, or about 2.0-2.5, or about 2.5, or 2.5, or about 2.5-3.0, or about 3.0 g / L. In some embodiments, the culture medium contains and / or is supplemented with sodium bicarbonate at 1.6-2.4 g / L. In some embodiments, the culture medium contains and / or is supplemented with sodium bicarbonate at 2.0 g / L. In some embodiments, the culture medium contains sodium bicarbonate at about 2.0 g / L.

[0108] In some embodiments, the culture medium comprises and / or is supplemented with albumin, e.g., human albumin, e.g., a human albumin solution described herein, hi some embodiments, the culture medium comprises and / or is supplemented with a 20% albumin solution, e.g., 0.5% or about 0.5% to 3.5% or about 3.5% v / v of a 20% human albumin solution. In some embodiments, the culture medium contains a 20% albumin solution, e.g., a 20% human albumin solution, at 0.5 or about 0.5% to 3.0 or about 3.0%, 0.5% or about 0.5% to 2.5 or about 2.5%, 0.5% or about 0.5% to 2.0 or about 2.0%, 0.5% or about 0.5% to 1.5 or about 1.5%, 0.5% or about 0.5% to 1.0 or about 1.0%, 1.0 or about 1.0% to 3.0 or about 3.0%, 1.0 or about 1.0% to 2.5 or about 2.5 ...%, 1.0% to 2.5%, 1.0% to 2.5%, 1.0% to 2.5%, 1.0% to 2.5%, 1.0% to 2.5%, 1.0% to 2.5%, 1. In some embodiments, the culture medium comprises and / or is supplemented with 1.0% to 2.0% or about 2.0%, 1.0% to 1.5% or about 1.5%, 1.5% to 3.0% or about 3.0%, 1.5% to 2.5% or about 2.5%, 1.5% to 2.0% or about 2.0%, 2.0% to 3.0% or about 3.0%, 2.0% to 2.0% or about 2.5% or about 2.5%, or 2.5% to 3.0% or about 3.0% v / v. In some embodiments, the culture medium comprises and / or is supplemented with 1.6% to 2.4% v / v of a 20% albumin solution, e.g., a 20% human albumin solution. In some embodiments, the culture medium comprises and / or is supplemented with a 20% albumin solution, e.g., 2.0% v / v of a 20% human albumin solution. In some embodiments, the culture medium comprises a 20% albumin solution, e.g., about 2.0% v / v of a 20% human albumin solution.

[0109] In some embodiments, the culture medium comprises and / or is supplemented with 2 or about 2-6 or about 6 g / L of albumin, e.g., human albumin. In some embodiments, the culture medium comprises and / or is supplemented with 2 or about 2-5.5 or about 5.5, 2 or about 2-5.0 or about 5.0, 2 or about 2-4.5 or about 4.5, 2 or about 2-4 or about 4, 2 or about 2-3.5 or about 3.5, 2 or about 2-3 or about 3, 2 or about 2-2.5 or about 2.5, 2.5 or about 2.5-6 or about 6, 2.5 or about 2.5 to 5.5 or about 5.5, 2.5 or about 2.5 to 5.5 or about 5.5, 2.5 or about 2.5 to 5.0 or about 5.0, 2.5 or about 2.5 to 4.5 or about 4.5, 2.5 or about 2.5 to 4.0 or about 4.0, 2.5 or about 2.5 to 3.5 or about 3.5, 2.5 or about 2.5 to 3.0 or about 3.0, 3 or about 3 to 6 or about 6, 3 or about 3 to 5.5 or about 5.5, 3 or about 3 to 5 or about 5, 3 or about 3 to 4.5 or about 4.5, 3 or about 3 to 4 or about 4, 3 or about 3 to 3.5 or about 3.5, 3.5 or about 3.5 to 6 or about 6, 3.5 or about 3.5 to 5.5 or about 5.5, 3.5 or about 3.5 to 5 or about 5, 3.5 or about 3.5 to 4.5 or about 4.5, 3.5 or about 3.5 to 4 or about 4, 4 or about 4 to 6 or about 6, 4 or In some embodiments, the culture medium comprises and / or is supplemented with about 4 to 5.5 g / L, 4 or about 4 to 5 or about 5, 4 or about 4 to 4.5 or about 4.5, 4.5 or about 4.5 to 6 or about 6, 4.5 or about 4.5 to 5.5 or about 5.5, 4.5 or about 4.5 to 5 or about 5, 5 or about 5 to 6 or about 6, 5 or about 5 to 5.5 or about 5.5, or 5.5 or about 5.5 to 6 or about 6 g / L. In some embodiments, the culture medium comprises and / or is supplemented with 3.2 to 4.8 g / L of albumin, e.g., human albumin. In some embodiments, the culture medium comprises 4 g / L of albumin, e.g., human albumin. In some embodiments, the culture medium comprises about 4 g / L of albumin, e.g., human albumin.

[0110] In some embodiments, the culture medium is supplemented with Poloxamer 188. In some embodiments, the culture medium comprises and / or is supplemented with 0.1 or about 0.1-2.0 or about 2.0 g / L of Poloxamer 188. In some embodiments, the culture medium comprises and / or is supplemented with 0.1 or about 0.1-1.8 or about 1.8, 0.1 or about 0.1-1.6 or about 1.6, 0.1 or about 0.1-1.4 or about 1.4, 0.1 or about 0.1-1.2 or about 1.2, 0.1 or about 0.1-1.0 or about 1.0, 0.1 or about 0.1-0.8 or about 0.8, 0.1 or about 0.1-0.6 or about 0.6, 0.1 or about 0.1-0.4 or about 0.4, 0.1 or about 0.1-0.2 or about 0.2, 0.2 or about 0.2 to 2.0 or about 2.0, 0.2 or about 0.2 to 1.8 or about 1.8, 0.2 or about 0.2 to 1.6 or about 1.6, 0.2 or about 0.2 to 1.4 or about 1.4, 0.2 or about 0.2 to 1.2 or about 1.2, 0.2 or about 0.2 to 1.0 or about 1.0, 0.2 or about 0.2 to 0.8 or about 0.8, 0.2 or about 0.2 to 0.6 or about 0.6, 0.2 or about 0.2 to 0.4 or about 0.4, 0.4 or about 0.4 to 2.0 is about 2.0, 0.4 or about 0.4 to 1.8 or about 1.8, 0.4 or about 0.4 to 1.6 or about 1.6, 0.4 or about 0.4 to 1.4 or about 1.4, 0.4 or about 0.4 to 1.2 or about 1.2, 0.4 or about 0.4 to 1.0 or about 1.0, 0.4 or about 0.4 to 0.8 or about 0.8, 0.4 or about 0.4 to 0.6 or about 0.6, 0.6 or about 0.6 to 2.0 or about 2.0, 0.6 or about 0.6 to 1.8 or about 1.8, 0.6 or about 0.6 to 1.6 or about 1.6, 0.6 or about 0.6 to 1.4 or about 1.4, 0.6 or about 0.6 to 1.2 or about 1.2, 0.6 or about 0.6 to 1.0 or about 1.0, 0.6 or about 0.6 to 0.8 or about 0.8, 0.8 or about 0.8 to 2.0 or about 2.0, 0.8 or about 0.8 to 1.8 or about 1.8, 0.8 or about 0.8 to 1.6 or about 1.6, 0.8 or about 0.8 to 1.4 or about 1.4, 0.8 or about 0.8 to 1.4 or about 1.4, 0.8 or about 0.8 to 1.2 or about 1.2, 0.8 or about 0.8 to 1.0 or about 1.0, 1.0 or about 1.0 to 2.0 or about 2.0, 1.0 or about 1.0 to 1.8 or about 1.8, 1.0 or about 1.0 to 1.6 or about 1.6, 1.0 or about 1.0 to 1.4 or about 1.4, 1.0 or about 1.0 to 1.2 or about 1.2, 1.2 or about 1.2 to 2.0 or about 2.0, 1.2 or about 1.2 to 1.8 or about 1.8, 1.2 or about 1.2 to In some embodiments, the culture medium comprises and / or is supplemented with 1.6 or about 1.6, 1.2 or about 1.2 to 1.4 or about 1.4, 1.4 or about 1.4 to 2.0 or about 2.0, 1.4 or about 1.4 to 1.8 or about 1.8, 1.4 or about 1.4 to 1.6 or about 1.6, 1.6 or about 1.6 to 2.0 or about 2.0, 1.6 or about 1.6 to 1.8 or about 1.8, or 1.8 or about 1.8 to 2.0 or about 2.0 g / L of Poloxamer 188. In some embodiments, the culture medium comprises 0.8 to 1.2 g / L of Poloxamer 188. In some embodiments, the culture medium comprises 1.0 g / L of Poloxamer 188. In some embodiments, the culture medium comprises about 1.0 g / L of Poloxamer 188.

[0111] In some embodiments, the culture medium contains and / or is supplemented with one or more antibiotics.

[0112] An exemplary first culture medium is shown in Table 1.

[0113] [Table 1]

[0114] Exemplary second culture media are referenced in Table 2.

[0115] [Table 2]

[0116] 2.CD3 binding antibody In some embodiments, the culture medium comprises and / or is supplemented with a CD3-binding antibody or antigen-binding fragment thereof. In some embodiments, the CD3-binding antibody or antigen-binding fragment thereof is selected from the group consisting of OKT3, UCHT1, and HIT3a, or variants thereof. In some embodiments, the CD3-binding antibody or antigen-binding fragment thereof is OKT3 or an antigen-binding fragment thereof.

[0117] In some embodiments, the CD3 binding antibody or antigen-binding fragment thereof and the feeder cells are added to the culture vessel prior to the addition of the NK cells and / or culture medium.

[0118] In some embodiments, the culture medium comprises and / or is supplemented with OKT3 at 5 or about 5 ng / ml to 15 or about 15 ng / ml. In some embodiments, the culture medium comprises and / or is supplemented with OKT3 at 5 or about 5 to 12.5 or about 12.5, 5 or about 5 to 10 or about 10, 5 or about 5 to 7.5 or about 7.5, 7.5 or about 7.5 to 15 or about 15, 7.5 or about 7.5 to 12.5 or about 12.5, 7.5 or about 7.5 to 10 or about 10, 10 or about 10 to 15 or about 15, 10 or about 10 to 12.5 or about 12.5, or 12.5 or about 12.5 to 15 or about 15 ng / ml. In some embodiments, the culture medium comprises and / or is supplemented with OKT3 at 10 ng / ml. In some embodiments, the culture medium contains and / or is supplemented with OKT3 at about 10 ng / ml.

[0119] 3.Culture container A variety of vessels are contemplated within the teachings of the present invention. In some embodiments, the culture vessel is selected from the group consisting of a flask, a bottle, a dish, a multi-well plate, a roller bottle, a bag, and a bioreactor.

[0120] In some embodiments, the culture vessel is treated to be hydrophilic. In some embodiments, the culture vessel is treated to promote attachment and / or proliferation. In some embodiments, the surface of the culture vessel is coated with serum, collagen, laminin, gelatin, poly-L-lysine, fibronectin, extracellular matrix proteins, and combinations thereof.

[0121] In some embodiments, different types of culture vessels are used for different culture stages.

[0122] In some embodiments, the culture vessel has a volume of at or about 100 ml to at or about 1,000 L. In some embodiments, the culture vessel has a volume of at or about 125 ml, 250 ml, or about 250 ml, 500 ml, or about 500 ml, 1 L, or about 1 L, 5 L, or about 5 L, 10 L, or about 10 L, or 20 L, or about 20 L.

[0123] In some embodiments, the culture vessel is a bioreactor. In some embodiments, the bioreactor is a rocking bed (wave motion) bioreactor. In some embodiments, the bioreactor is a stirred tank bioreactor. In some embodiments, the bioreactor is a rotating wall vessel. In some embodiments, the bioreactor is a perfusion bioreactor. In some embodiments, the bioreactor is an isolation / expansion automated system. In some embodiments, the bioreactor is an automated or semi-automated bioreactor. In some embodiments, the bioreactor is a disposable bag bioreactor.

[0124] In some embodiments, the bioreactor has a volume of about 100 ml to about 1,000 L. In some embodiments, the bioreactor has a volume of about 10 L to about 1,000 L. In some embodiments, the bioreactor has a volume of about 100 L to about 900 L. In some embodiments, the bioreactor has a volume of about 10 L to about 800 L. In some embodiments, the bioreactor may be about 10 L to about 700 L, about 10 L to about 600 L, about 10 L to about 500 L, about 10 L to about 400 L, about 10 L to about 300 L, about 10 L to about 200 L, about 10 L to about 100 L, about 10 L to about 90 L, about 10 L to about 80 L, about 10 L to about 70 L, about 10 L to about 60 L, about 10 L to about 50 L, about 10 L to about 40 L, about 10 L to about 30 L, about 10 L to about 2 0l, about 20l to about 1,000l, about 20l to about 900l, about 20l to about 800l, about 20l to about 700l, about 20l to about 600l, about 20l to about 500l, about 20l to about 400l, about 20l to about 300l, about 20l to about 200l, about 20l to about 100l, about 20l to about 90l, about 20l to about 80l, about 20l to about 70l, about 20l to about 60l, about 20l to about 50l, about 20l to about 40l, about 20l to about 30l, about 30l to about 1,000l, about 30l to about 900l, about 30l to about 800l, about 30l to about 700l, about 30l to about 600l, about 30l to about 500l, about 30l to about 400l , about 30l to about 300l, about 30l to about 200l, about 30l to about 100l, about 30l to about 90l, about 30l to about 80l, about 30l to about 70l, about 30l to about 60l, about 30l to about 50l, about 30l ~40l, 40l~1,000l, 40l~900l, 40l~800l, 40l~700l, 40l~600l, 40l~500l, 40l~400l, 40 l ~ about 300l, about 40l - about 200l, about 40l - about 100l, about 40l - about 90l, about 40l - about 80l, about 40l - about 70l, about 40l - about 60l, about 40l - about 50l, about 50l - about 1,000l, about 50l to about 900l, about 50l to about 800l, about 50l to about 700l, about 50l to about 600l, about 50l to about 500l, about 50l to about 400l, about 50l to about 300l, about 50l to about 200l, about 50l to about 100l, about 50l to about 90l, about 50l to about 80l, about 50l to about 70l, about 50l to about 60l, about 60l to about 1,000l, about 60l to about 900l, about 60l to about 800l, about 60l to about 700l, about 60l to about 600l, about 60l to about 500l, about 60l to about 400l, about 60l to about 300l, about 60l to about 200l, about 60l to about 100l, about 60l to about 90l, about 60l to about 80l, about 60l to about 70l, about 70l to about 1,000l, about 70l to about 900l, about 70l to about 800l, about 70l to about 700l, about 70l to about 600l, about 70l to about 500l, about 70l to about 400l, about 70l to about 300l, about 70l to about 200l, about 70l to about 100l, about 70l to about 90l, about 70l to about 80l, about 80l to about 1,000l, about 80l to about 900l, about 80l to about 800l, about 80l to about 700l, about 80l to about 600l, about 8 0l to about 500l, about 80l to about 400l, about 80l to about 300l, about 80l to about 200l, about 80l to about 100l, about 80l to about 90l, about 90l to about 1,000l, about 90l to about 900l, about 90l to about 800l, about 90l to about 700l, about 90l to about 600l, about 90l to about 500l, about 90l to about 400l, about 90l to about 300l, about 90l to about 200l, about 90l to about 100l, about 100l to about 1,000l, about 100l to about 900l, about 100l to about 800l, about 100l to about 700l, about 100l to about 600l, about 1 1,000 liters, about 1000 liters to about 500 liters, about 1000 liters to about 400 liters, about 1000 liters to about 300 liters, about 1000 liters to about 2000 liters, about 2000 liters to about 1,000 liters, about 2000 liters to about 9000 liters, about 2000 liters to about 8000 liters, about 2000 liters to about 7000 liters, about 2000 liters to about 6000 liters, about 2000 liters to about 5000 liters, about 2000 liters to about 4000 liters, about 2000 liters to about 3000 liters, about 3000 liters to about 1,000 liters, about 3000 liters to about 9000 liters, about 3000 liters to about 8000 liters, about 3000 liters to about 7000 liters, about 3000 liters to about 6000 liters, about 3000 liters to about 5000 liters, about 3000 liters to about 4000 liters, about 4000 liters to about 1,000l, about 400l to about 900l, about 400l to about 800l, about 400l to about 700l, about 400l to about 600l, about 400l to about 500l, about 500l~approx. 1,000l, approx. 500l~approx. 900l, approx. 500l~approx. 800l, approx. 500l~approx. 700l, approx. 500l~approx. 600l, approx. 600l The bioreactor has a volume of about 1,000 L, about 600 L to about 900 L, about 600 L to about 800 L, about 600 L to about 700 L, about 700 L to about 1,000 L, about 700 L to about 900 L, about 700 L to about 800 L, about 800 L to about 1,000 L, about 800 L to about 900 L, or about 900 L to about 1,000 L. In some embodiments, the bioreactor has a volume of about 50 L.

[0125] In some embodiments, the bioreactor has a volume of 100 ml to 1,000 L. In some embodiments, the bioreactor has a volume of 10 L to 1,000 L. In some embodiments, the bioreactor has a volume of 100 L to 900 L. In some embodiments, the bioreactor has a volume of 10 L to 800 L. In some embodiments, the bioreactor has a volume of 10 L to 700 L, 10 L to 600 L, 10 L to 500 L, 10 L to 400 L, 10 L to 300 L, 10 L to 200 L, 10 L to 100 L, 10 L to 90 L, 10 L to 80 L, 10 L to 70 L, 10 L to 60 L, 10 L to 50 L, 10 L to 40 L, 10 L to 30 L, 10 L to 20 L, 20 L to 1,000 L, 20 L to 900 L, 20 L to 800 L, 20 L to 700 L, 20 L to 600 L, 20 L to 500 L , 20l~400l, 20l~300l, 20l~200l, 20l~100l, 20l~90l, 20l~80l, 20l~70l, 20l~60l, 20l~50l, 20l~40l, 20l~30l, 30l~1,000 l, 30l~900l, 30l~800l, 30l~700l, 30l~600l, 30l~500l, 30l~400l, 30l~300l, 30l~200l, 30l~100l, 30l~90l, 30l~80l, 30l ~70l, 30l~60l, 30l~50l, 30l~40l, 40l~1,000l, 40l~900l, 40l~800l, 40l~700l, 40l~600l, 40l~500l, 40l~400l, 40l~300 l, 40l~200l, 40l~100l, 40l~90l, 40l~80l, 40l~70l, 40l~60l, 40l~50l, 50l~1,000l, 50l~900l, 50l~800l, 50l~700l, 50l~ 600l, 50l~500l, 50l~400l, 50l~300l, 50l~200l, 50l~100l, 50l~90l, 50l~80l, 50l~70l, 50l~60l, 60l~1,000l, 60l~900l, 60l~800l, 60l~700l, 60l~600l, 60l~500l, 60l~400l, 60l~300l, 60l~200l, 60l~100l, 60l~90l, 60l~80l, 60l~70l, 70l~1,000l, 70l~900l, 70l~800l, 70l~700l, 70l~600l, 70l~500l, 70l~400l, 70l~300l, 70l~200l, 70l~100l, 70l~90l, 70 l~80l, 80l~1,000l, 80l~900l, 80l~800l, 80l~700l, 80l~600l, 80l~500l, 80l~400l, 80l~300l, 80l~200l, 80l~100l , 80l~90l, 90l~1,000l, 90l~900l, 90l~800l, 90l~700l, 90l~600l, 90l~500l, 90l~400l, 90l~300l, 90l~200l, 90l~ 100l, 100l~1,000l, 100l~900l, 100l~800l, 100l~700l, 100l~600l, 100l~500l, 100l~400l, 100l~300l, 100l~200l, 200l~1,000l, 200l~900l, 200l~800l, 200l~700l, 200l~600l, 200l~500l, 200l~400l, 200l~300l, 300l~1,000l, 30 0l~900l, 300l~800l, 300l~700l, 300l~600l, 300l~500l, 300l~400l, 400l~1,000l, 400l~900l, 400l~800l, 400l~70 The bioreactor has a volume of 0 L, 400 L to 600 L, 400 L to 500 L, 500 L to 1,000 L, 500 L to 900 L, 500 L to 800 L, 500 L to 700 L, 500 L to 600 L, 600 L to 1,000 L, 600 L to 900 L, 600 L to 800 L, 600 L to 700 L, 700 L to 1,000 L, 700 L to 900 L, 700 L to 800 L, 800 L to 1,000 L, 800 L to 900 L, or 900 L to 1,000 L. In some embodiments, the bioreactor has a volume of 50 L.

[0126] 4. Cell Expansion and Stimulation In some embodiments, a natural killer cell source, for example, a single unit of umbilical cord blood, is co-cultured with feeder cells to produce expanded and stimulated NK cells.

[0127] In some embodiments, the co-culture is carried out in a culture medium described herein, for example, Culture Medium Example #1 (Table 1) or Culture Medium Example #2 (Table 2).

[0128] In some embodiments, a natural killer cell source, e.g., a single unit of umbilical cord blood, is prepared from 1×10 total nucleated cells prior to expansion. 7 or about 1 x 10 7 ~1×10 9 or about 1 x 10 9 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, contains 1 x 10 total nucleated cells prior to expansion. 8 or about 1 x 10 8 ~1.5×10 8 or about 1.5 x 10 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, contains 1 x 10 total nucleated cells prior to expansion. 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, contains about 1 x 10 total nucleated cells prior to expansion. 8 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, contains 1 x 10 total nucleated cells prior to expansion. 9 In some embodiments, the natural killer cell source, e.g., a single unit of umbilical cord blood, contains about 1 x 10 total nucleated cells prior to expansion. 9 Includes pieces.

[0129] In some embodiments, a natural killer cell source, e.g., cells derived from a co-culture of a single unit of umbilical cord blood with feeder cells, is collected and frozen, e.g., in a cryopreservation composition described herein. In some embodiments, the frozen cells derived from the co-culture are an infusion-ready drug product. In some embodiments, the frozen cells derived from the co-culture are used as a master cell bank (MCB) for producing an infusion-ready drug product, e.g., by one or more additional co-culture steps as described herein. Thus, for example, the natural killer cell source can be expanded and stimulated as described herein to produce expanded and stimulated NK cells suitable for use in an infusion-ready drug product without producing any intermediate product. The natural killer cell source can also be expanded and stimulated as described herein to produce an intermediate product, e.g., a primary master cell bank (MCB). The primary MCB can be used to produce expanded and stimulated NK cells suitable for use in an infusion-ready drug product, or alternatively, to produce other intermediate products, e.g., a secondary MCB. The secondary MCB can be used to produce expanded and stimulated NK cells suitable for use in injectable, finished pharmaceutical products, or alternatively, to produce other intermediate products, such as tertiary MCB.

[0130] In some embodiments, the ratio of feeder cells to natural killer cell source or MCB cells inoculated into the co-culture is 1:1 or about 1:1 to 4:1 or about 4:1. In some embodiments, the ratio of feeder cells:natural killer cell source or MCB cells is 1:1 or about 1:1 to 3.5:1 or about 3.5:1, 1:1 or about 1:1 to 3:1 or about 3:1, 1:1 or about 1:1 to 2.5:1 or about 2.5:1, 1:1 or about 1:1 to 2:1 or about 2:1, 1:1 or about 1:1 to 1.5 or about 1.5:1, 1.5:1 or about 1.5:1 to 4:1 or about 4:1, 1.5:1 or about 1.5:1 to 3.5:1 or about 3.5:1, 1.5:1 or about 1.5:1 to 3:1 or about 3:1, 1.5:1 or about 1.5:1 to 2.5:1 or about 2.5:1, 1.5 :1 or about 1.5:1 to 2:1 or about 2:1, 2:1 or about 2:1 to 4:1 or about 4:1, 2:1 or about 2:1 to 3.5:1 or about 3.5:1, 2:1 or about 2:1 to 3:1 or about 3:1, 2:1 or about 2:1 to 2.5:1 or about 2.5:1, 2.5:1 or about 2.5:1 to 4:1 or about 4:1, 2.5:1 or about 2.5:1 to 3.5:1 or about 3.5:1, 2.5:1 or about 2.5:1 to 3:1 or about 3:1, 3:1 or about 3:1 to 4:1 or about 4:1, 3:1 or about 3:1 to 3.5:1 or about 3.5:1, or 3.5:1 or about 3.5:1 to 4:1 or about 4:1. In some embodiments, the ratio of feeder cells to natural killer cell source or MCB cells inoculated into the co-culture is 2.5: 1. In some embodiments, the ratio of feeder cells to natural killer cell source or MCB cells inoculated into the co-culture is about 2.5: 1.

[0131] In some embodiments, the co-cultivation is carried out in a disposable culture bag, e.g., a 1 L disposable culture bag. In some embodiments, the co-cultivation is carried out in a bioreactor, e.g., a 50 L bioreactor. In some embodiments, after the primary inoculation, culture medium is added to the co-culture.

[0132] In some embodiments, the co-culture is carried out for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 15 days, 16 days, 17 days, 18 days, 19 days, 20 days, 21 days, 22 days, 23 days, 24 days, or longer. In some embodiments, the co-culture is carried out for up to 16 days.

[0133] In some embodiments, the co-cultivation is carried out at or about 37°C.

[0134] In some embodiments, the co-cultivation is carried out at or about pH 7.9.

[0135] In some embodiments, the co-cultivation is carried out at a dissolved oxygen (DO) level of 50% or greater.

[0136] In some embodiments, exemplary Culture Medium #1 (Table 1) is used to produce MCBs, and Culture Medium #2 (Table 2) is used to produce cells suitable for infusion—a finished drug product.

[0137] In some embodiments, a source of natural killer cells, e.g., umbilical cord blood single units, are co-cultured with feeder cells, e.g., MCB cells or 50 x 10 infusion-ready pharmaceutical cells. 8 or about 50 x 10 8 ~50×10 12 or about 50 x 10 12 In some embodiments, such expansion produces 50 x 10 cells, e.g., MCB cells or injectable finished drug product cells. 8 or about 50 x 10 8 ~25×10 10 or about 25 x 10 10 , 10×10 8 or about 10 x 10 8 ~1×10 10 or about 1 x 10 10 , 50×10 8 or about 50 x 10 8 ~75×10 9 or about 75 x 10 9 , 50×108 or about 50 x 10 8 ~50×10 9 or about 50 x 10 9 , 50×10 8 or about 50 x 10 8 ~25×10 9 or about 25 x 10 9 , 50×10 8 or about 50 x 10 8 ~1×10 9 or about 1 x 10 9 , 50×10 8 or about 50 x 10 8 ~75×10 8 or about 75 x 10 8 , 75×10 8 or about 75 x 10 8 ~50×10 10 or about 50 x 10 10 , 75×10 8 or about 75 x 10 8 ~25×10 10 or about 25 x 10 10 , 75×10 8 or about 75 x 10 8 ~1×10 10 or about 1 x 10 10 , 75×10 8 or about 75 x 10 8 ~75×10 9 or about 75 x 10 9 , 75×10 8 or about 75 x 10 8 ~50×10 9 or about 50 x 10 9 , 75×10 8 or about 75 x 10 8 ~25×10 9 or about 25 x 10 9 , 75×10 8 or about 75 x 10 8 ~1×10 9 or about 1 x 10 9 , 1×10 9 or about 1 x 10 9 ~50×10 10 or about 50 x 10 10 , 1×10 9 or about 1 x 109 ~25×10 10 or about 25 x 10 10 , 1×10 9 or about 1 x 10 9 ~1×10 10 or about 1 x 10 10 , 1×10 9 or about 1 x 10 9 ~75×10 9 or about 75 x 10 9 , 1×10 9 or about 1 x 10 9 ~50×10 9 or about 50 x 10 9 , 1×10 9 or about 1 x 10 9 ~25×10 9 or about 25 x 10 9 , 25×10 9 or about 25 x 10 9 ~50×10 10 or about 50 x 10 10 , 25×10 9 or about 25 x 10 9 ~25×10 10 or about 25 x 10 10 , 25×10 9 or about 25 x 10 9 ~1×10 10 or about 1 x 10 10 , 25×10 9 or about 25 x 10 9 ~75×10 9 or about 75 x 10 9 , 25×10 9 or about 25 x 10 9 ~50×10 9 or about 50 x 10 9 , 50×10 9 or about 50 x 10 9 ~50×10 10 or about 50 x 10 10 , 50×10 9 or about 50 x 10 9 ~25×10 10 or about 25 x 10 10 , 50×10 9 or about 50 x 10 9 ~1×10 10or about 1 x 10 10 , 50×10 9 or about 50 x 10 9 ~75×10 9 or about 75 x 10 9 , 75×10 9 or about 75 x 10 9 ~50×10 10 or about 50 x 10 10 , 75×10 9 or about 75 x 10 9 ~25×10 10 or about 25 x 10 10 , 75×10 9 or about 75 x 10 9 ~1×10 10 or about 1 x 10 10 , 1×10 10 or about 1 x 10 10 ~50×10 10 or about 50 x 10 10 , 1×10 10 or about 1 x 10 10 ~25×10 10 or about 25 x 10 10 , or 25 × 10 10 or about 25 x 10 10 ~50×10 10 or about 50 x 10 10 Individuals are produced.

[0138] In some embodiments, the amplification produces 60 or about 60-100 or about 100 vials containing 600 million or about 600 million to 1 billion or about 1 billion cells, e.g., MCB cells or injectable-finished drug product cells, respectively. In some embodiments, the amplification produces 80 or about 80 vials containing or consisting of 800 million or about 800 million cells, e.g., MCB cells or injectable-finished drug product cells, respectively.

[0139] In some embodiments, the expansion increases the number of cells, e.g., MCB cells, by 100-fold or about 100-fold to 500-fold or about 500-fold relative to the number of cells, e.g., NK cells, in the natural killer cell source. In some embodiments, the expansion is achieved by increasing the number of cells, e.g., the number of MCB cells, relative to the number of cells in the natural killer cell source, e.g., NK cells, by 100-fold or about 100-fold to 500-fold or about 500-fold, 100-fold or about 100-fold to 400-fold or about 400-fold, 100-fold or about 100-fold to 300-fold or about 300-fold, 100-fold or about 100-fold to 200-fold or about 200-fold, 200-fold or about 200-fold to 450-fold or about 450-fold, 200-fold or about 200-fold to 400-fold or about 400-fold, 100-fold or about 100-fold to 350-fold or about 350-fold, 200-fold or about 200-fold to 300-fold or about 300-fold, 200-fold or about 200-fold to 250-fold or about 250-fold, 250-fold or about 2 50-fold to 500-fold or about 500-fold, 250-fold or about 250-fold to 450-fold or about 450-fold, 200-fold or about 200-fold to 400-fold or about 400-fold, 250-fold or about 250-fold to 350-fold or about 350-fold, 250-fold or about 250-fold to 300-fold or about 300-fold, 300-fold or about 300-fold to 500-fold or about 500-fold, 300-fold or about Increase by 300-fold to 450-fold or about 450-fold, 300-fold or about 300-fold to 400-fold or about 400-fold, 300-fold or about 300-fold to 350-fold or about 350-fold, 350-fold or about 350-fold to 500-fold or about 500-fold, 350-fold or about 350-fold to 450-fold or about 450-fold, or 350-fold or about 350-fold to 400-fold or about 400-fold.

[0140] In some embodiments, the expansion increases the number of cells, e.g., MCB cells, by 100-fold or about 100-fold to 70,000-fold or about 70,000-fold relative to the number of cells, e.g., NK cells, in the natural killer cell source. In some embodiments, the expansion increases the number of cells, e.g., MCB cells, by at least 10,000-fold, e.g., 15,000-fold, 20,000-fold, 25,000-fold, 30,000-fold, 35,000-fold, 40,000-fold, 45,000-fold, 50,000-fold, 55,000-fold, 60,000-fold, 65,000-fold, or 70,000-fold relative to the number of cells, e.g., NK cells, in the natural killer cell source.

[0141] In some embodiments, co-culture of MCB cells with feeder cells produces cells, e.g., 500 million or about 500 million to 1.5 billion or about 1.5 billion NK cells suitable for use in MCB and / or injectable finished pharmaceutical products. In some embodiments, co-culture of MCB cells with feeder cells produces cells, e.g., 500 million or about 500 million to 1.5 billion or about 1.5 billion, 500 million or about 500 million to 1.25 billion or about 1.25 billion, 500 million or about 500 million to 1 billion or about 1 billion, 500 million or about 500 million to 750 million or about 750 million, 750 million or about 750 million to 1.5 billion or about 1.5 billion, 500 million or about 500 million to 1.25 billion or about 1.25 billion, 750 million or about 750 million to 1 billion or about 1 billion, 1 billion or about 1 billion to 1.5 billion or about 1.5 billion, 1 billion or about 1 billion to 1.25 billion or about 1.25 billion, or 1.25 billion to 1.5 billion or about 1.5 billion NK cells suitable for use in an MCB and / or injectable finished pharmaceutical product.

[0142] In some embodiments, co-culture of MCB cells with feeder cells produces 50 or about 50 to 150 or about 150 vials of cells, e.g., injectable-finished pharmaceutical product cells, containing at or about 750 million to 1.25 billion or about 1.25 billion cells, e.g., MCB and / or NK cells suitable for use in an injectable-finished pharmaceutical product, respectively. In some embodiments, co-culture of MCB cells with feeder cells produces 100 or about 100 vials containing or consisting of at or about 1 billion cells, e.g., MCB and / or NK cells suitable for use in an injectable-finished pharmaceutical product, respectively.

[0143] In some embodiments, the expansion increases the number of cells suitable for use in the MCB and / or injectable finished pharmaceutical product, e.g., NK cell numbers, by at or about 100-fold to at or about 500-fold compared to the initial MCB cell numbers. In some embodiments, expansion involves increasing the cell number, e.g., increasing the cell number of the MCB and / or NK cells suitable for use in an injectable finished pharmaceutical product, by 100-fold or about 100-fold to 500-fold or about 500-fold, 100-fold or about 100-fold to 400-fold or about 400-fold, 100-fold or about 100-fold to 300-fold or about 300-fold, 100-fold or about 100-fold to 200-fold or about 200-fold, 200-fold or about 200-fold to 450-fold or about 450-fold, 200-fold or about 200-fold to 400-fold or about 400-fold, 100-fold or about 100-fold to 350-fold or about 350-fold, 200-fold or about 200-fold to 300-fold or about 300-fold, 200-fold or about 200-fold to 250-fold or about 250-fold, 250-fold or about 250-fold to 500-fold or about 500-fold, 250-fold or about 250-fold to 450-fold or about 450-fold, 200-fold or about 200-fold to 400-fold or about 400-fold, 250-fold or about 250-fold to 350-fold or about 350-fold, 250-fold or about 250-fold to 300-fold or about 300-fold, 300-fold or about 300-fold to 500-fold or about 500-fold, 300-fold Or increase by about 300-fold to 450-fold or about 450-fold, 300-fold or about 300-fold to 400-fold or about 400-fold, 300-fold or about 300-fold to 350-fold or about 350-fold, 350-fold or about 350-fold to 500-fold or about 500-fold, 350-fold or about 350-fold to 450-fold or about 450-fold, 350-fold or about 350-fold to 400-fold or about 400-fold.

[0144] In some embodiments, the expansion increases the cell number, e.g., the number of NK cells suitable for use in the MCB and / or injectable finished drug product, by 100 or about 100 to 70,000 to about 70,000 fold compared to the initial MCB cell number. In some embodiments, the expansion increases the cell number, e.g., the number of NK cells suitable for use in the MCB and / or injectable finished drug product, by at least 10,000 fold, e.g., 15,000 fold, 20,000 fold, 25,000 fold, 30,000 fold, 35,000 fold, 40,000 fold, 45,000 fold, 50,000 fold, 55,000 fold, 60,000 fold, 65,000 fold, or 70,000 fold compared to the initial MCB cell number.

[0145] In embodiments in which cells are engineered during expansion and stimulation as described herein, not all expanded and stimulated cells will necessarily be successfully engineered, e.g., successfully transduced, e.g., successfully transduced with a vector comprising a heterologous protein, e.g., a heterologous protein comprising a CAR and / or IL-15, as described herein. Thus, the methods described herein can additionally include sorting engineered cells, e.g., engineered cells described herein, from non-engineered cells.

[0146] In some embodiments, engineered cells, e.g., transduced cells, are separated from non-engineered cells, e.g., non-transduced cells, using a reagent specific for an antigen on the engineered cells, e.g., an antibody that targets an antigen on the engineered cells but not on the non-engineered cells. In some embodiments, the antigen on the engineered cells is a component of a CAR, e.g., a component of a CAR described herein.

[0147] Systems for antigen-based cell separation are commercially available, e.g., CliniMACS (R) There is a classification system (Miltenyi Biotec).

[0148] In some embodiments, engineered cells, eg, transduced cells, are sorted from non-engineered cells, eg, non-transduced cells, using flow cytometry measurements.

[0149] In some embodiments, the sorted engineered cells are used as an MCB. In some embodiments, the sorted engineered cells are used as components of an injectable finished pharmaceutical product.

[0150] In some embodiments, engineered cells, e.g., transduced cells, are separated from non-engineered cells, e.g., non-transduced cells, using microfluidic cell sorting methods, such as those mentioned in Dalili et al., "A Review of Sorting, Separation and Isolation of Cells and Microbeads for Biomedical Applications: Microfluidic Approaches," Analyst 144:87 (2019).

[0151] In some embodiments, 1% or about 1% to 99% or about 99% of the expanded and stimulated cells are successfully engineered, e.g., successfully transduced, e.g., successfully transduced with a vector comprising a heterologous protein, e.g., a heterologous protein comprising CAR and / or IL-15, as described herein. In some embodiments, 1% or about 1% to 90% or about 90%, 1% or about 1% to 80% or about 80%, 1% or about 1% to 70% or about 70%, 1% or about 1% to 60% or about 60%, 1% or about 1% to 50% or about 50%, 1% or about 1% to 40% or about 40%, 1% or about 1% to 30% or about 30%, 1% or about 1% to 20% or about 20%, 1% or about 1% to 10% or about 10%, 1% or about 1% to 5% or about 5%, 5% or about 5% to 99% or about 99%, 5% or about 5% to 90% or about 90%, 5% or about 5% to 80% or about 80%, 5% or about 5% to 70% or about 70%, 5% or about 5% to 60% or about 60%, 5% or about 5% to 50% or about 50%, 5% or about 5% to 40% or about 40%, 5% or about 5% to 30% or about 30%, 5% or about 5% to 20% or about 20%, 5% or about 5% to 10% or about 1 0%, 10% or about 10% to 99% or about 99%, 10% or about 10% to 90% or about 90%, 10% or about 10% to 80% or about 80%, 10% or about 10% to 70% or about 70%, 10% or about 10% to 60% or about 60%, 10% or about 10% to 50% or about 50%, 10% or about 10% to 40% or about 40%, 10% or about 10% to 30% or about 30%, 10% or about 10% to 20% or about 20%, 20% or about 20% % to 99% or about 99%, 20% or about 20% to 90% or about 90%, 20% or about 20% to 80% or about 80%, 20% or about 20% to 70% or about 70%, 20% or about 20% to 60% or about 60%, 20% or about 20% to 50% or about 50%, 20% or about 20% to 40% or about 40%, 20% or about 20% to 30% or about 30%, 30% or about 30% to 99% or about 99%, 30% or about 30% to 90% or about 90%,30% or about 30% to 80% or about 80%, 30% or about 30% to 70% or about 70%, 30% or about 30% to 60% or about 60%, 30% or about 30% to 50% or about 50%, 30% or about 30% to 40% or about 40%, 40% or about 40% to 99% or about 99%, 40% or about 40% to 90% or about 90%, 40% or about 40% to 80% or about 8 0%, 40% or about 40% to 70% or about 70%, 40% or about 40% to 70% or about 70%, 40% or about 40% to 60% or about 60%, 40% or about 40% to 50% or about 50%, 50% or about 50% to 99% or about 99%, 50% or about 50% to 90% or about 90%, 50% or about 50% to 80% or about 80%, 50% or about 50% to 70% or About 70%, 50% or about 50% to 60% or about 60%, 60% or about 60% to 99% or about 99%, 60% or about 60% to 90% or about 90%, 60% or about 60% to 80% or about 80%, 60% or about 60% to 70% or about 70%, 70% or about 70% to 99% or about 99%, 70% or about 70% to 90% or about 90%, 70% or about 70% to 80% or about 80%, 80%, or about 80%-99%, or about 99%, 80%, or about 80%-90%, or about 90%, or 90%, or about 90%-99%, or about 99% are successfully engineered, e.g., successfully transduced, e.g., successfully transduced with a vector comprising a heterologous protein, e.g., a heterologous protein comprising CAR and / or IL-15, as described herein.

[0152] In some embodiments, frozen cells of the primary or secondary MCB are thawed and cultured. In some embodiments, a single vial of frozen cells of the primary or secondary MCB, e.g., a single vial containing 800 million or about 800 million cells, e.g., a single vial containing 800 million or about 800 million primary or secondary MCB cells, is thawed and cultured. In some embodiments, the frozen primary or secondary MCB cells are cultured with additional feeder cells to produce cells suitable for use as a secondary or tertiary MCB or in an injectable finished pharmaceutical product. In some embodiments, cells are harvested and frozen from a co-culture of the primary or secondary MCB.

[0153] In some embodiments, cells are harvested from a co-culture of a natural killer cell source, primary MCB, or secondary MCB, and frozen in a cryopreservation composition, e.g., a cryopreservation composition described herein. In some embodiments, the cells are washed after harvesting. That is, the present invention provides pharmaceutical compositions and cryopreservation compositions, e.g., cryopreservation compositions described herein, comprising activated and stimulated NK cells, e.g., activated and stimulated NK cells produced by the methods described herein, e.g., harvested and washed activated and stimulated NK cells produced by the methods described herein.

[0154] In some embodiments, the cells are mixed with a cryopreservation composition, e.g., as described herein, prior to freezing. In some embodiments, the cells are frozen in a cryobag. In some embodiments, the cells are frozen in a cryovial.

[0155] In some embodiments, the method additionally comprises isolating NK cells from the expanded and stimulated population of NK cells.

[0156] An example of a process for expanding and stimulating NK cells is shown in FIG.

[0157] 5.Operation In some embodiments, the method additionally includes engineering the NK cells to express a heterologous protein, e.g., a heterologous protein described herein, e.g., a heterologous protein including a CAR and / or IL-15.

[0158] In some embodiments, engineering NK cells to express a heterologous protein described herein comprises transforming, e.g., stably transforming, the NK cells with a vector comprising a polynucleic acid encoding a heterologous protein described herein. Suitable vectors are described herein.

[0159] In some embodiments, engineering NK cells to express a heterologous protein as described herein comprises introducing the heterologous protein by gene editing (e.g., zinc finger nuclease (ZFN) gene editing, ARCUS gene editing, CRISPR-Cas9 gene editing, or megaTAL gene editing) in combination with adeno-associated virus (AAV) technology.

[0160] In some embodiments, the NK cells are engineered to express a heterologous protein described herein, for example, during or after culturing the composition in medium containing feeder cells.

[0161] In some embodiments, the methods additionally include engineering the NK cells, for example, to express, overexpress, knock out, or knock down a gene or gene product.

[0162] In some embodiments, the natural killer cells are not genetically engineered.

[0163] E. Characterization of Expanded and Stimulated NK Cells For example, after ex vivo expansion and stimulation as described herein, the expanded and stimulated population of NK cells not only has a number / density (e.g., as described above) that would not occur naturally in the human body, but also has phenotypic characteristics (e.g., gene expression and / or surface protein expression) that differ from the starting source material or other naturally occurring populations of NK cells.

[0164] In some cases, the starting NK cell source is a sample derived from a single individual, e.g., a single umbilical cord blood unit without ex vivo expansion. Thus, in some cases, the expanded and stimulated NK cells share a common lineage, i.e., they are all generated from the expansion of the starting NK cell source, and thus share a genotype due to the clonal expansion of a cell population that itself originated from a single organism. However, these cells may not naturally occur at the densities achieved by ex vivo expansion, and they may exhibit differences in phenotypic characteristics from the starting NK cell source.

[0165] In some cases, the population of expanded and stimulated NK cells comprises at least 100 million, e.g., 200 million, 250 million, 300 million, 400 million, 500 million, 600 million, 700 million, 750 million, 800 million, 900 million, 1 billion, 2 billion, 3 billion, 4 billion, 5 billion, 6 billion, 7 billion, 8 billion, 9 billion, 10 billion, 15 billion, 20 billion, 25 billion, 50 billion, 75 billion, 80 billion, 90 billion, 100 billion, 200 billion, 250 billion, 300 billion, 400 billion, 500 billion, 600 billion, 700 billion, 800 billion, 900 billion, 1 trillion, 2 trillion, 3 trillion, 4 trillion, 5 trillion, 6 trillion, 7 trillion, 8 trillion, 9 trillion, or 10 trillion expanded natural killer cells.

[0166] In some embodiments, the expanded and stimulated NK cells comprise at least 80%, eg, at least 90%, at least 95%, at least 99%, or 100% CD56+CD3- cells.

[0167] In some embodiments, the expanded and stimulated NK cells are not genetically engineered. In some embodiments, the expanded and stimulated NK cells do not contain a CD16 transgene. In some embodiments, the expanded and stimulated NK cells do not express exogenous CD16 protein.

[0168] Expanded and stimulated NK cells are characterized, for example, by surface expression of one or more of CD16, CD56, CD3, CD38, CD14, CD19, NKG2D, NKp46, NKp30, DNAM-1, and NKp44.

[0169] The surface protein expression levels referenced herein are, in some cases, achieved without positive selection for the particular proteins referenced. For example, in some cases, an NK cell source, e.g., a single umbilical cord blood unit, contains both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and is CD56+ enriched and CD3(+) depleted, e.g., by gating on CD56+CD3- expression, but does not select for expression of other surface proteins during expansion and stimulation.

[0170] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKG2D+ cells.

[0171] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKp46+ cells.

[0172] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKp30+ cells.

[0173] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% DNAM-1+ cells.

[0174] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKp44+ cells.

[0175] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, comprise at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% CD94+(KLRD1) cells.

[0176] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CD3+ cells.

[0177] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CD14+ cells.

[0178] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CD19+ cells.

[0179] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, contain 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CXCR+ cells.

[0180] In some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, e.g., as described above, comprise 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CD122+(IL2RB) cells.

[0181] As described herein, the inventors have surprisingly found that NK cells expanded and stimulated by the methods described herein express high levels of CD16 due to the expansion and stimulation process, resulting in a cell population with high CD16 expression. High CD16 expression obviates the need to engineer expanded cells to express CD16, which is important for initiating ADCC, and this is a surprising and unexpected advantage of the expansion and stimulation methods described herein. Thus, in some embodiments, expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, as described above, comprise 50% or more CD16+ NK cells, e.g., 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95% CD16+ NK cells.

[0182] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, derived from the expansion and stimulation of, e.g., a single cord blood unit, comprise both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and comprise 50% or more, e.g., 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90% or 95% CD16+ NK cells.

[0183] In some embodiments, the percentage of expanded and stimulated NK cells that express CD16, e.g., the percentage of expanded and stimulated NK cells derived from, e.g., the expansion and stimulation of a single cord blood unit as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0184] In some embodiments, the percentage of expanded and stimulated NK cells that express NKG2D, e.g., the percentage of expanded and stimulated NK cells derived from, e.g., the expansion and stimulation of a single cord blood unit as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0185] In some embodiments, the percentage of expanded and stimulated NK cells that express NKp30, e.g., the percentage of expanded and stimulated NK cells derived from, e.g., the expansion and stimulation of a single cord blood unit as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0186] In some embodiments, the percentage of expanded and stimulated NK cells that express DNAM-1, e.g., the percentage of expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0187] In some embodiments, the percentage of expanded and stimulated NK cells that express NKp44, e.g., the percentage of expanded and stimulated NK cells derived from, e.g., the expansion and stimulation of a single cord blood unit as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0188] In some embodiments, the percentage of expanded and stimulated NK cells that express NKp46, e.g., the percentage of expanded and stimulated NK cells derived from, e.g., the expansion and stimulation of a single cord blood unit as described above, is the same as or higher than the percentage of natural killer cells in the seed cells derived from the cord blood.

[0189] As described herein, the inventors have surprisingly found that NK cells expanded and stimulated by the methods described herein express low levels of CD38. CD38 is an effective target for certain cancer therapies (e.g., multiple myeloma and acute myeloid leukemia). See, for example, Jiao et al., "CD38: Targeted Therapy in Multiple Myeloma and Therapeutic Potential for Solid Cancers," Expert Opinion on Investigational Drugs 29(11):1295-1308 (2020). However, when an anti-CD38 antibody is administered together with NK cells, there is a risk of high fratricide because NK cells naturally express CD38. However, NK cells expanded and stimulated by the methods described herein express low levels of CD38, thereby eliminating the expected fratricide. While other groups have relied on engineering methods such as genome editing to reduce CD38 expression (see, e.g., Gurney et al., "CD38 Knockout Natural Killer Cells Expressing an Affinity Optimized CD38 Chimeric Antigen Receptor Successfully Target Acute Myeloid Leukemia with Reduced Effector Cell Fratricide," Haematologica doi:10.3324 / haematol.2020.271908 (2020)), NK cells expanded and stimulated by the methods described herein express low levels of CD38 without genetic engineering, which provides a surprising and unexpected advantage for using NK cells expanded and stimulated as described herein, e.g., in combination with CD38 antibodies, to treat, e.g., CD38+ cancers.

[0190] Thus, in some embodiments, the expanded and stimulated NK cells, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of, e.g., a single cord blood unit, as described above, comprise 80% or less CD38+ cells, e.g., 75% or less, 70% or less, 65% or less, 60% or less, 55% or less, 50% or less, 45% or less, 40% or less, 35% or less, 30% or less, 25% or less, or 20% or less CD38+ cells.

[0191] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., expanded and stimulated NK cells derived from the expansion and stimulation of a single cord blood unit, comprise both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and comprise 80% or less CD38+ cells, e.g., 75% or less, 70% or less, 65% or less, 60% or less, 55% or less, 50% or less, 45% or less, 40% or less, 35% or less, 30% or less, 25% or less, or 20% or less CD38+ cells.

[0192] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., derived from the expansion and stimulation of a single cord blood unit, comprise both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and comprise 80% or less, e.g., 75% or less, 70% or less, 65% or less, 60% or less, 55% or less, 50% or less, 45% or less, 40% or less, 35% or less, 30% or less, 25% or less, or 20% or less CD38+ cells, and 50% or more, e.g., 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90% or 95% CD16+ NK cells.

[0193] In some embodiments, the expanded and stimulated NK cells, e.g., as described above, e.g., derived from the expansion and stimulation of a single cord blood unit, comprise both the KIR B allele of the KIR receptor system and the 158V / V variant of CD16, and include: i) 50% or more, e.g., 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95% CD16+ NK cells; and / or ii) 80% or less CD38+ cells, e.g., 75% or less, 70% or less, 65% or less, 60% or less, 55% or less, 50% or less, 45% or less, 40% or less, 35% or less, 30% or less, 25% or less, or 20% or less CD38+ cells; and / or ii i) at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKG2D+ cells; and / or iv) at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKp46+ cells; and / or v) at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95% , at least 99% or 100% NKp30+ cells; and / or vi) at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% DNAM-1+ cells; and / or vii) at least 60%, e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% NKp44+ cells; and / or viii) at least 60% , e.g., at least 70%, at least 80%, at least 90%, at least 95%, at least 99% or 100% CD94+(KLRD1) cells; and / or ix) 20% or less, e.g., 10% or less, 5% or less, 1% or less or 0% CD3+ cells; and / or x) 20% or less, e.g., 10% or less, 5% or less, 1% or less or 0% CD14+ cells; and / or xi) 20% or less, e.g., 10% or less, 5% or less, 1% or less or 0% CD19+ cells;and / or xii) 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CXCR+ cells; and / or xiii) 20% or less, e.g., 10% or less, 5% or less, 1% or less, or 0% CD122+ (IL2RB) cells;

[0194] In some embodiments, a residual signature of the feeder cells may be detected, for example, by the presence of residual cells (e.g., by detecting cells that exhibit specific surface protein expression) or by residual nucleic acids and / or proteins expressed by the feeder cells, but which do not persist in the expanded and stimulated NK cells.

[0195] For example, in some cases, the methods described herein involve expanding and stimulating natural killer cells using engineered feeder cells, e.g., the aforementioned eHuT-78 feeder cells, engineered to express sequences not expressed by cells in a natural killer cell source, such as natural killer cells. For example, the engineered feeder cells can be engineered to express one or more genes selected from the group consisting of 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and mutant TNFα (SEQ ID NO: 3) ("eHut-78 cells"), or variants thereof.

[0196] Although these feeder cells may not persist in the expanded and stimulated NK cells, the expanded and stimulated NK cells may retain detectable residual amounts of cells, proteins, and / or nucleic acids derived from the feeder cells. Thus, the presence of such residues in the expanded and stimulated NK cells can be detected, for example, by detecting the cells themselves (e.g., by flow cytometry), proteins expressed by these cells, and / or nucleic acids expressed by these cells.

[0197] Thus, the present invention also describes a population of expanded and stimulated NK cells that contain residual feeder cells (living or dead) or cellular impurities of the residual feeder cells (e.g., proteins or portions thereof, and / or genetic material such as nucleic acids or portions thereof) of the residual feeder cells. In some cases, the expanded and stimulated NK cells contain residual feeder cells, e.g., eHuT-78 feeder cells, at a level greater than 0% and less than or equal to 0.3%.

[0198] In some cases, the expanded and stimulated NK cells contain residual feeder cells encoding, for example, residual 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and / or mutant TNFα (SEQ ID NO: 3), or portions thereof. In some cases, the membrane-bound IL-21 contains the CD8 transmembrane domain.

[0199] In some cases, the expanded and stimulated NK cells comprise a residual % of feeder cells of greater than 0% and less than or equal to 0.2%, e.g., as measured by the relative proportion of feeder cell-specific proteins or nucleic acid sequences (i.e., proteins or nucleic acid sequences not expressed by natural killer cells) in the sample, e.g., by qPCR, e.g., as described herein.

[0200] In some embodiments, the remaining feeder cells are CD4(+) T cells. In some embodiments, the remaining feeder cells are engineered CD4(+) T cells. In some embodiments, the remaining feeder cells are engineered to express one or more genes selected from the group consisting of 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and mutant TNFα (SEQ ID NO: 3) ("eHut-78 cells"), or variants thereof. Thus, in some cases, the feeder cell-specific protein is 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and / or mutant TNFα (SEQ ID NO: 3). Accordingly, the feeder cell-specific nucleic acid is a nucleic acid encoding 4-1BBL (UniProtKB P41273, SEQ ID NO: 1), membrane-bound IL-21 (SEQ ID NO: 2), and / or mutant TNFα (SEQ ID NO: 3), or portions thereof. In some cases, the membrane-bound IL-21 comprises the CD8 transmembrane domain.

[0201] A wide variety of different methods can be used to analyze and detect the presence of nucleic acid or protein gene products in biological samples. As used herein, "detection" can refer to a method used to discover, confirm, or verify the coexistence or presence of a compound and / or substance (e.g., a cell, a protein, and / or a nucleic acid). In some embodiments, a detection method can be used to detect proteins. In some embodiments, detection can include chemiluminescent or fluorescent techniques. In some embodiments, detection can include immunologically-based methods (e.g., quantitative enzyme-linked immunosorbent assay (ELISA), Western blotting, or dot blotting) that use antibodies to specifically react with the entire protein or a specific epitope of a protein. In some embodiments, detection can include protein immunoprecipitation (Jungblut et al., J Biotechnol. 31;41(2-3):111-20 (1995); Franco et al., Eur J Morphol. 39(1):3-25 (2001)). In some embodiments, a detection method can be used to detect nucleic acids (e.g., DNA and / or RNA). In some embodiments, detection can involve Northern blot analysis, nuclease protection assay (NPA), in situ hybridization, or reverse transcription-polymerase chain reaction (RT-PCR) (Raj et al., Nat. Methods 5, 877-879 (2008); Jin et al., J Clin Lab Anal. 11(1):2-9 (1997); Ahmed, J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 20(2):77-116 (2002)).

[0202] For this reason, the present invention also describes methods for detecting a population of expanded and stimulated NK cells co-cultured with engineered feeder cells, e.g., eHuT-78 feeder cells, as described herein, e.g., a population of expanded and stimulated NK cells using the methods described herein.

[0203] II. Manipulation of Natural Killer Cells In some embodiments, natural killer cells are engineered to produce CAR-NK and / or NK expressing IL-15.

[0204] In some embodiments, the natural killer cells are manipulated, e.g., transduced, during expansion and stimulation, e.g., during expansion and stimulation as described herein. In some embodiments, the natural killer cells are manipulated during expansion and stimulation, e.g., during production of an MCB as described herein. In some embodiments, the natural killer cells are manipulated during expansion and stimulation, e.g., during production of NK cells suitable for use in an injectable-finished pharmaceutical product and / or during production of an MCB as described above. Thus, in some embodiments, the NK cells are host cells, and the invention provides NK host cells that express a heterologous protein, e.g., a heterologous protein as described above.

[0205] In some embodiments, the natural killer cells are manipulated prior to expansion and stimulation. In some embodiments, the natural killer cells are manipulated after expansion and stimulation.

[0206] In some embodiments, the NK cells are engineered by transduction with a vector. Suitable vectors are described herein, for example, lentiviral vectors, e.g., lentiviral vectors comprising a heterologous protein, e.g., a heterologous protein described herein. In some embodiments, the NK cells are transduced during production of the first MCB, as described herein.

[0207] In some embodiments, NK cells are transduced at a multiplicity of infection of 1 or about 1 to 40 or about 40 viral particles / cell. In some embodiments, NK cells are transduced at a multiplicity of infection of 1 or about 1, 5 or about 5, 10 or about 10, 15 or about 15, 20 or about 20, 25 or about 25, 30 or about 30, 35 or about 35, or 40 or about 40 viral particles / cell.

[0208] A. Chimeric Antigen Receptor In some embodiments, the heterologous protein is a fusion protein, for example, a fusion protein comprising a chimeric antigen receptor (CAR), which is introduced into the NK cells, for example, during the expansion and stimulation process.

[0209] In some embodiments, the CAR comprises one or more of the following: a signal sequence, an extracellular domain, a hinge, a transmembrane domain, and one or more intracellular signaling domain sequences. In some embodiments, the CAR additionally comprises a spacer sequence.

[0210] In some embodiments, the CAR comprises (from N- to C-terminal) a signal sequence, an extracellular domain, a hinge, a spacer, a transmembrane domain, a first signaling domain sequence, a second signaling domain sequence, and a third signaling domain sequence.

[0211] In some embodiments, the CAR comprises (from N- to C-terminal) a signal sequence, an extracellular domain, a hinge, a transmembrane domain, a first signaling domain sequence, a second signaling domain sequence, and a third signaling domain sequence.

[0212] In some embodiments, the extracellular domain comprises an antibody or an antigen-binding portion thereof.

[0213] In some embodiments, the one or more intracellular signaling domain sequences are CD28 intracellular signaling sequences. In some embodiments, the CD28 intracellular signaling sequence comprises or consists of SEQ ID NO:5.

[0214] In some embodiments, the one or more intracellular signaling domain sequences are OX40L signaling sequences. In some embodiments, the OX40L signaling sequence comprises or consists of SEQ ID NO:8.

[0215] In some embodiments, the one or more intracellular signaling domain sequences are CD3ζ intracellular signaling domain sequences. In some embodiments, the CD3ζ intracellular signaling sequence comprises or consists of SEQ ID NO:11.

[0216] In some embodiments, the CAR comprises a CD28 intracellular signaling sequence (SEQ ID NO: 5), an OX40L intracellular signaling sequence (SEQ ID NO: 8), and a CD3ζ intracellular signaling sequence (SEQ ID NO: 11).

[0217] In some embodiments, the CAR comprises an intracellular signaling domain that comprises or consists of SEQ ID NO:19.

[0218] In some embodiments, the CAR does not comprise an OX40L intracellular signaling domain sequence.

[0219] In some embodiments, the CAR comprises the CD28 intracellular signaling sequence (SEQ ID NO: 5) and the CD3ζ intracellular signaling sequence (SEQ ID NO: 11), but does not comprise the OX40L intracellular signaling domain sequence.

[0220] B.IL-15 In some embodiments, NK cells are engineered to express IL-15, e.g., human IL-15 (UniProtKB#P40933; NCBI Gene ID#3600), e.g., soluble human IL-15 or an ortholog thereof, or a variant of any of the foregoing. In some embodiments, IL-15 is expressed as part of a fusion protein that additionally includes a cleavage site. In some embodiments, IL-15 is expressed as part of a polyprotein that includes a T2A ribosomal skip sequence site (sometimes referred to as a self-cleavage site).

[0221] In some embodiments, the IL-15 comprises or consists of SEQ ID NO:16.

[0222] In some embodiments, the T2A truncation comprises or consists of SEQ ID NO:14.

[0223] In some embodiments, the IL-15 is expressed as part of a fusion protein comprising a CAR, e.g., a CAR described herein.

[0224] In some embodiments, the fusion protein comprises (N- to C-terminally) a CAR, a cleavage site, and IL-15.

[0225] In some embodiments, the fusion protein comprises SEQ ID NO:20.

[0226] C. Inhibitory receptors In some embodiments, the NK cells are engineered to alter, eg, reduce, the expression of one or more inhibitory receptor genes.

[0227] In some embodiments, the inhibitory receptor gene is an HLA-specific inhibitory receptor. In some embodiments, the inhibitory receptor gene is an HLA-non-specific inhibitory receptor.

[0228] In some embodiments, the inhibitory receptor gene is selected from the group consisting of KIR, CD94 / NKG2A, LILRB1, PD-1, IRp60, Siglec-7, LAIR-1, and combinations thereof.

[0229] D. Polynucleic Acids, Vectors and Host Cells The present invention also provides polynucleic acids encoding fusion proteins or portions thereof, for example, polynucleotide sequences encoding the polypeptides described herein, as set forth in the sequence tables provided herein.

[0230] Additionally, the present invention provides vectors comprising the polynucleic acids, and cells, eg, NK cells, comprising such vectors.

[0231] In some embodiments, the vector is a lentiviral vector. See, e.g., Milone et al., "Clinical Use of Lentiviral Vectors," Leukemia 32:1529-41 (2018). In some embodiments, the vector is a retroviral vector. In some embodiments, the vector is a gamma retroviral vector. In some embodiments, the vector is a non-viral vector, e.g., a piggyback non-viral vector (PB transposon, e.g., Wu et al., "piggyback is a Flexible and Highly Active Transposon as Compared to Sleeping Beauty, Tol2, and Mos1 in Mammalian Cells," PNAS 103(41):15008-13 (2006)), a Sleeping Beauty non-viral vector (SB transposon, see e.g., Hudecek et al., "Going Non-Viral: the Sleeping Beauty Transposon System Breaks on Through to the Clinical Side," Critical Reviews in Biochemistry and Molecular Biology 52(4):355-380 (2017)), or an mRNA vector.

[0232] III. Freezing storage A. Freeze preservation composition The present invention provides cryopreserved compositions, e.g., cryopreserved compositions suitable for intravenous administration, e.g., for intravenous administration of NK cells, e.g., NK cells described herein. In some embodiments, a pharmaceutical composition comprises the cryopreserved composition and cells, e.g., NK cells described herein.

[0233] 1. Albumin In some embodiments, the cryopreservation composition comprises an albumin protein, e.g., human albumin protein (UniProtKB Accession P0278, SEQ ID NO: 21), or a variant thereof. In some embodiments, the cryopreservation composition comprises an albumin protein, e.g., an ortholog of human albumin protein, or a variant thereof. In some embodiments, the cryopreservation composition comprises a biologically active portion of an albumin protein, e.g., human albumin, or a variant thereof.

[0234] In some embodiments, the albumin, e.g., human albumin, is provided as a solution, which is also referred to herein as an albumin solution or a human albumin solution. Thus, in some embodiments, the cryopreservation composition is or comprises an albumin solution, e.g., a human albumin solution. In some embodiments, the albumin solution is a serum-free albumin solution.

[0235] In some embodiments, the albumin solution is suitable for intravenous use.

[0236] In some embodiments, the albumin solution comprises 40, or about 40-200, or about 200 g / L of albumin. In some embodiments, the albumin solution comprises 40, or about 40-50, or about 50 g / L of albumin, e.g., human albumin. In some embodiments, the albumin solution comprises about 200 g / L of albumin, e.g., human albumin. In some embodiments, the albumin solution comprises 200 g / L of albumin, e.g., human albumin.

[0237] In some embodiments, the albumin solution comprises a protein composition that is 95% or more albumin protein, e.g., human albumin protein, hi some embodiments, 96%, 97%, 98%, or 99% or more of the protein is albumin, e.g., human albumin.

[0238] In some embodiments, the albumin solution additionally comprises sodium. In some embodiments, the albumin solution comprises 100, or about 100-200, or about 200 mmol of sodium. In some embodiments, the albumin solution comprises 130, or about 130-160, or about 160 mmol of sodium.

[0239] In some embodiments, the albumin solution additionally comprises potassium. In some embodiments, the albumin solution additionally comprises up to 3 mmol of potassium. In some embodiments, the albumin solution additionally comprises up to 2 mmol of potassium.

[0240] In some embodiments, the albumin solution additionally comprises one or more stabilizers. In some embodiments, the stabilizers are selected from the group consisting of sodium caprylate, caprylic acid, (2S)-2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as acetyltryptophan, N-acetyl-L-tryptophan, and acetyl-L-tryptophan), and 2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as N-acetyltryptophan, DL-acetyltryptophan, and N-acetyl-DL-tryptophan). In some embodiments, the solution comprises less than 0.1 mmol of each of the one or more stabilizers per gram of protein in the solution. In some embodiments, the solution comprises 0.05, or about 0.05 to 0.1, or about 0.1, e.g., 0.064, or about 0.064 to 0.096, or about 0.096 mmol of each of the stabilizers per gram of protein in the solution. In some embodiments, the solution comprises less than 0.1 mmol of total stabilizer per gram of protein in the solution, hi some embodiments, the solution comprises 0.05 or about 0.05 to 0.1 or about 0.1, e.g., 0.064 or about 0.064 to 0.096 or about 0.096 mmol of total stabilizer per gram of protein in the solution.

[0241] In some embodiments, the albumin solution is comprised of a protein composition that is 95% or greater albumin protein, in water, and one or more stabilizers selected from the group consisting of sodium, potassium, and sodium caprylate, caprylic acid, (2S)-2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as acetyltryptophan, N-acetyl-L-tryptophan, and acetyl-L-tryptophan), 2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as N-acetyltryptophan, DL-acetyltryptophan, and N-acetyl-DL-tryptophan).

[0242] In some embodiments, the cryopreservation composition comprises 10% or about 10% v / v to 50% or about 50% v / v of an albumin solution, such as an albumin solution described herein. In some embodiments, the cryopreservation composition comprises 10% or about 10% to 50% or about 50%, 10% or about 10% to 45% or about 45%, 10% or about 10% to 40% or about 40%, 10% or about 10% to 35% or about 35%, 10% or about 10% to 30% or about 30%, 10% or about 10% to 25% or about 25%, 10% or about 10% to 20% or about 20%, 10% or about 10% to 15% or about 15%, 15% or about 15% to 5% 0% or about 50%, 15% or about 15% to 45% or about 45%, 15% or about 15% to 40% or about 40%, 15% or about 15% to 35% or about 35%, 15% or about 15% to 30% or about 30%, 15% or about 15% to 25% or about 25%, 15% or about 15% to 20% or about 20%, 20% or about 20% to 50% or about 50%, 20% or about 20% to 45% or about 45%, 20% or about 20% to 40% or about 40%, 2 0% or about 20% to 35% or about 35%, 20% or about 20% to 30% or about 30%, 20% or about 20% to 25% or about 25%, 25% or about 25% to 50% or about 50%, 25% or about 25% to 45% or about 45%, 25% or about 25% to 40% or about 40%, 25% or about 25% to 35% or about 35%, 25% or about 25% to 30% or about 30%, 30% or about 30% to 50% or about 50%, 30% or about 30% to 40% The albumin solution described herein may be 5% or about 45%, 30% or about 30% to 40% or about 40%, 30% or about 30% to 35% or about 35%, 35% or about 35% to 50% or about 50%, 35% or about 35% to 45% or about 45%, 35% or about 35% to 40% or about 40%, 40% or about 40% to 50% or about 50%, 40% or about 40% to 45% or about 45%, or 45% or about 45% to 50% or about 50% v / v.In some embodiments, the cryopreservation composition comprises about 10%, about 15%, about 20%, about 25%, about 30%, about 35%, about 40%, about 45%, or about 50% v / v of the albumin solution described herein. In some embodiments, the cryopreservation composition comprises 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, or 50% v / v of the albumin solution described herein.

[0243] In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 20 or about 20-100 or about 100 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 20 or about 20-100 or about 100, 20 or about 20-90 or about 90, 20 or about 20-80 or about 80, 20 or about 20-70 or about 70, 20 or about 20-60 or about 60, 20 or about 20-50 or about 50, 20 or about 20-40 or about 40, 20 or about 20-30 or about 30, 30 or about 30-10 0 or about 100, 30 or about 30-90 or about 90, 30 or about 30-80 or about 80, 30 or about 30-70 or about 70, 30 or about 30-60 or about 60, 30 or about 30-50 or about 50, 30 or about 30-40 or about 40, 40 or about 40-100 or about 100, 40 or about 40-90 or about 90, 40 or about 40-80 or about 80, 40 or about 40 to 70 or about 70, 40 or about 40 to 60 or about 60, 40 or about 40 to 50 or about 50, 50 or about 50 to 100 or about 100, 50 or about 50 to 90 or about 90, 50 or about 50 to 80 or about 80, 50 or about 50 to 70 or about 70, 50 or about 50 to 60 or about 60, 60 or about 60 to 100 or about 100, 60 or about 60 to 90 or about 90 , 60 or about 60-80 or about 80, 60 or about 60-70 or about 70, 70 or about 70-100 or about 100, 70 or about 70-90 or about 90, 70 or about 70-80 or about 80, 80 or about 80-100 or about 100, 80 or about 80-90 or about 90, or 90 or about 90-100 or about 100 g / l of albumin, e.g., human albumin.

[0244] In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 20 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 40 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 70 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at 100 g / L.

[0245] In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at about 20 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at about 40 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at about 70 g / L. In some embodiments, the cryopreservation composition comprises albumin, e.g., human albumin, at about 100 g / L.

[0246] In some embodiments, the cryopreservation composition additionally comprises a stabilizer, such as an albumin stabilizer. In some embodiments, the stabilizer is selected from the group consisting of sodium caprylate, caprylic acid, (2S)-2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as acetyltryptophan, N-acetyl-L-tryptophan, and acetyl-L-tryptophan), and 2-acetamido-3-(1H-indol-3-yl)propanoic acid (also referred to herein as N-acetyltryptophan, DL-acetyltryptophan, and N-acetyl-DL-tryptophan). In some embodiments, the cryopreservation composition comprises less than 0.1 mmol of each of one or more stabilizers per gram of protein, such as albumin protein, in the composition. In some embodiments, the cryopreserved composition comprises 0.05 or about 0.05 to 0.1 or about 0.1, e.g., 0.064 or about 0.064 to 0.096 or about 0.096 mmol of stabilizer per gram of protein, e.g., albumin protein, in the composition. In some embodiments, the cryopreserved composition comprises less than 0.1 mmol of total stabilizer per gram of protein, e.g., albumin protein, in the cryopreserved composition. In some embodiments, the cryopreserved composition comprises 0.05 or about 0.05 to 0.1 or about 0.1, e.g., 0.064 or about 0.064 to 0.096 or about 0.096 mmol of total stabilizer per gram of protein, e.g., albumin protein, in the cryopreserved composition.

[0247] 2. Dextran In some embodiments, the cryopreservation composition comprises dextran or a derivative thereof.

[0248] Dextran is an anhydroglucose polymer ((CH)) composed of approximately 95% α-D-(1-6) linkages. 10 O5) nDextran fractions are available in molecular weights ranging from about 1,000 daltons to about 2,000,000 daltons, designated by a number (Dextran X), e.g., Dextran 1, Dextran 10, Dextran 40, Dextran 70, etc., where X is the average molecular weight divided by 1,000 daltons. Thus, for example, Dextran 40 has an average molecular weight of at or about 40,000 daltons.

[0249] In some embodiments, the average molecular weight of the dextran is at or about 1,000 daltons to 2,000 or about 2,000,000 daltons. In some embodiments, the average molecular weight of the dextran is at or about 40,000 daltons. In some embodiments, the average molecular weight of the dextran is at or about 70,000 daltons.

[0250] In some embodiments, the dextran is selected from the group consisting of dextran 40, dextran 70, and combinations thereof. In some embodiments, the dextran is dextran 40.

[0251] In some embodiments, the dextran, e.g., Dextran 40, is provided in a solution, also referred to herein as a dextran solution or a Dextran 40 solution. Thus, in some embodiments, the composition comprises a dextran solution, e.g., a Dextran 40 solution.

[0252] In some embodiments, the dextran solution is suitable for intravenous use.

[0253] In some embodiments, the dextran solution comprises about 5% to about 50% w / w of dextran, for example, dextran 40. In some embodiments, the dextran solution comprises 5% or about 5% to 50% or about 50%, 5% or about 5% to 45% or about 45%, 5% or about 5% to 40% or about 40%, 5% or about 5% to 35% or about 35%, 5% or about 5% to 30% or about 30%, 5% or about 5% to 25% or about 25%, 5% or about 5% to 20% or about 20%, 5% or about 5% to 15% or about 15%, 5% or about 5% to 10% or about 10%, 10% or about 10% to 50% or about 50%, 10% or about 1 0% to 45% or about 45%, 10% or about 10% to 40% or about 40%, 10% or about 10% to 35% or about 35%, 10% or about 10% to 30% or about 30%, 10% or about 10% to 25% or about 25%, 10% or about 10% to 20% or about 20%, 10% or about 10% to 15 or about 15%, 15% or about 15% to 50% or about 50%, 15% or about 15% to 45% or about 45%, 15% or about 15% to 40% or about 40%, 15% or about 15% to 35% or about 35% , 15% or about 15% to 30% or about 30%, 15% or about 15% to 25% or about 25%, 15% or about 15% to 20% or about 20%, 20% or about 20% to 50% or about 50%, 20% or about 20% to 45% or about 45%, 20% or about 20% to 40% or about 40%, 20% or about 20% to 35% or about 35%, 20% or about 20% to 30% or about 30%, 20% or about 20% to 25% or about 25%, 25% or about 25% to 50% or about 50%, 25 or about 25% ~45% or about 45%, 25% or about 25% to 40% or about 40%, 25% or about 25% to 35% or about 35%, 25% or about 25% to 30% or about 30%, 30% or about 30% to 50% or about 50%, 30% or about 30% to 45% or about 45%, 30% or about 30% to 40% or about 40%, 30% or about 30% to 35% or about 35%, 35% or about 35% to 50% or about 50%, 35% or about 35% to 45% or about 45%, 35% or about 35% to 40% or about 40%,The dextran solution comprises 40%, or about 40%-50%, or about 50%, 40%, or about 40%-45%, or about 45%, or 45%, or about 45%-50%, or about 50% w / w dextran, e.g., dextran 40. In some embodiments, the dextran solution comprises 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, or 50% w / w dextran, e.g., dextran 40. In some embodiments, the dextran solution comprises about 5%, about 10%, about 15%, about 20%, about 25%, about 30%, about 35%, about 40%, about 45%, or about 50% w / w dextran, e.g., dextran 40.

[0254] In some embodiments, the dextran solution comprises dextran, eg, Dextran 40, at or about 25 g / L to 200 or about 200 g / L. In some embodiments, the dextran solution is a mixture of dextran, e.g., dextran 40, 35 or about 35-200 or about 200, 25 or about 25-175 or about 175, 25 or about 25-150 or about 150, 25 or about 25-125 or about 125, 25 or about 25-100 or about 100, 25 or about 25-75 or about 75, 25 or about 25-50 or about 50, 50 or about 50-200 or about 200, 50 or about 50-175 or about 175, 50 or about 50-150 or about 150, 50 or about 50-125 or about 125, 50 or about 50-100 or about 100, 50 or about 50-75 or about 75, 75 or about 75-200 or about 200, 75 or about 75 to 175 or about 175, 75 or about 75 to 150 or about 150, 75 or about 75 to 125 or about 125, 75 or about 75 to 100 or about 100, 100 or about 100 to 200 or about 200, 100 or about 100 to 175 or about 175, 100 or about 100 to 150 or about 150, 100 or In some embodiments, the dextran solution comprises about 100-125, 125, 125, or about 125-200, or about 200, 125, or about 125-175, or about 175, 125, or about 125-150, or about 150, 150, or about 150-200, or about 200, 150, or about 150-175, or about 175, or 175, or about 175-200, or about 200 g / L. In some embodiments, the dextran solution comprises 25, 50, 75, 100, 125, 150, 175, or 200 g / L of dextran, e.g., Dextran 40. In some embodiments, the dextran solution comprises 100 g / L of dextran, e.g., Dextran 40. In some embodiments, the dextran solution comprises about 25, about 50, about 75, about 100, about 125, about 150, about 175, or about 200 g / L of dextran, e.g., Dextran 40. In some embodiments, the dextran solution comprises about 100 g / L of dextran, e.g., Dextran 40.

[0255] In some embodiments, the dextran solution additionally comprises glucose (also referred to as dextrose). In some embodiments, the dextran solution comprises glucose at 10 or about 10 g / L to 100 or about 100 g / L. In some embodiments, the dextran solution comprises glucose at 10 or about 10 to 100 or about 100, 10 or about 10 to 90 or about 90, 10 or about 10 to 80 or about 80, 10 or about 10 to 70 or about 70, 10 or about 10 to 60 or about 60, 10 or about 10 to 50 or about 50, 10 or about 10 to 40 or about 40, 10 or about 10 to 30 or about 30, 10 or about 10 to 20 or about 20, 20 or about 20 to 100 or about 100, 20 or about 20 to 90 or about 90, 20 or about 20 to 80 or about 80, 20 or about 20 to 70 or about 70, 20 or about 20 to 60 or about 60, 20 or about 20 to 50 or about 50, 20 or about 20 to 40 or about 40, 20 or about 20 to 30 or about 30, 30 or about 30 to 100 or about 100, 30 or about 30 to 90 or about 90, 30 or about 30 to 80 or about 80, 30 or about 30 to 70 or about 70, 30 or about 30 to 60 or about 60, 30 or about 30 to 50 or about 50, 30 or about 30-40 or about 40, 40 or about 40-100 or about 100, 40 or about 40-90 or about 90, 40 or about 40-80 or about 80, 40 or about 40-70 or about 70, 40 or about 40-60 or about 60, 40 or about 40-50 or about 50, 50 or about 50-100 or about 100, 50 or about 50-90 or about 90, 50 or about 50-80 or about 80, 50 or about 50-70 or about 70, 50 or about 50-60 or about 60, 60 or about 60-100 or about 100, 60 or about 60-90 or about 90, 60 or about 60-80 or about 80, 60 or about 60-70 or about 70, 70 or about 70-100 or about 100, 70 or about 70-90 or about 90, 70 or about 70-80 or about 80, 80 or about 80-90 or about 90, 80 or about 80-100 or about 100, 80 or about 80-90 or about 90, or 90 or about 90-100 or about 100 g / l.In some embodiments, the dextran solution comprises 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 g / L of glucose. In some embodiments, the dextran solution comprises 50 g / L of glucose. In some embodiments, the dextran solution comprises about 10, about 20, about 30, about 40, about 50, about 60, about 70, about 80, about 90, or about 100 g / L of glucose. In some embodiments, the dextran solution comprises 50 g / L of glucose.

[0256] In some embodiments, the dextran solution is composed of dextran, eg, dextran 40, and glucose in water.

[0257] In some embodiments, the cryopreservation composition comprises 10% or about 10% v / v to 50% or about 50% v / v of a dextran solution described herein. In some embodiments, the cryopreservation composition comprises 10% or about 10% to 50%, 10% or about 10% to 45% or about 45%, 10% or about 10% to 40% or about 40%, 10% or about 10% to 35% or about 35%, 10% or about 10% to 30% or about 30%, 10% or about 10% to 25% or about 25%, 10% or about 10% to 20% or about 20%, 10% or about 10% to 15% or about 15% of a dextran solution, e.g., a dextran solution described herein. or about 15%, 15% or about 15% to 50% or about 50%, 15% or about 15% to 45% or about 45%, 15% or about 15% to 40% or about 40%, 15% or about 15% to 35% or about 35%, 15% or about 15% to 30% or about 30%, 15% or about 15% to 25% or about 25%, 15% or about 15% to 20% or about 20%, 20% or about 20% to 50% or about 50%, 20% or about 20% to 45% or about 45%, 20% or is about 20% to 40% or about 40%, 20% or about 20% to 35% or about 35%, 20% or about 20% to 30% or about 30%, 20% or about 20% to 25% or about 25%, 25% or about 25% to 50% or about 50%, 25% or about 25% to 45% or about 45%, 25% or about 25% to 40% or about 40%, 25% or about 25% to 35% or about 35%, 25% or about 25% to 30% or about 30%, 30% or about 30% to 50% or About 50%, 30%, or about 30% to 45%, or about 45%, 30%, or about 30% to 40%, or about 40%, 30%, or about 30% to 35%, or about 35%, 35%, or about 35% to 50%, or about 50%, 35%, or about 35% to 45%, or about 45%, 35%, or about 35% to 40%, or about 40%, 40%, or about 40% to 50%, or about 50%, 40%, or about 40% to 45%, or about 45%, or 45%, or about 45% to 50%, or about 50% v / v. In some embodiments, the cryopreservation composition comprises a dextran solution, e.g., a dextran solution described herein, at 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, or 50% v / v.In some embodiments, the cryopreservation composition comprises a dextran solution, such as a dextran solution described herein, at about 10%, about 15%, about 20%, about 25%, about 30%, about 35%, about 40%, about 45%, or about 50% v / v.

[0258] In some embodiments, the cryopreservation composition comprises 10 or about 10-50 or about 50 g / L of dextran, e.g., Dextran 40. In some embodiments, the cryopreservation composition comprises 10 or about 10-50 or about 50, 10 or about 10-45 or about 45, 10 or about 10-40 or about 40, 10 or about 10-35 or about 35, 10 or about 10-30 or about 30, 10 or about 10-25 or about 25, 10 or about 10-20 or about 20, 10 or about 10 to 15 or about 15, 15 or about 15 to 50 or about 50, 15 or about 15 to 45 or about 45, 15 or about 15 to 40 or about 40, 15 or about 15 to 35 or about 35, 15 or about 15 to 30 or about 30, 15 or about 15 to 25 or about 25, 15 or about 15 to 20 or about 20, 20 or about 20 to 50 or about 50, 20 or about 20 to 4 5 or about 45, 20 or about 20-40 or about 40, 20 or about 20-30 or about 30, 20 or about 20-25 or about 25, 25 or about 25-50 or about 50, 25 or about 25-45 or about 45, 25 or about 25-40 or about 40, 25 or about 25-35 or about 35, 25 or about 25-30 or about 30, 30 or about 30-50 or about 50, In some embodiments, the cryopreservation composition comprises 10, 15, 20, 25, 30, 30, 30-40, 40, 30, 30-40, 40, 30, 30-35, 35, 35-50, 35, 35-45, 35, 35-40, 40, 40-50, 40, 40-45, 45, 45, 45-50, 50 g / L. In some embodiments, the cryopreservation composition comprises 10, 15, 20, 25, 30, 30, 35, 40, 45, or 50 g / L of dextran, e.g., dextran 40. In some embodiments, the cryopreservation composition comprises about 10, about 15, about 20, about 25, about 30, about 30, about 35, about 40, about 45, or about 50 g / l of dextran, e.g., dextran 40.

[0259] 3. Glucose In some embodiments, the cryopreservation composition comprises glucose.

[0260] In some embodiments, the cryopreservation composition as described herein comprises a dextran solution containing glucose.

[0261] In some embodiments, the cryopreservation composition comprises a glucose-free dextran solution. In some embodiments, for example, when the dextran solution does not contain glucose, glucose is added separately to the cryopreservation composition.

[0262] In some embodiments, the cryopreservation composition comprises 5, or about 5-25, or about 25 g / L of glucose. In some embodiments, the cryopreservation composition comprises 5, or about 5-25, or about 25, 5, or about 5-20, or about 20, 5, or about 5-15, or about 15, 5, or about 5-10, or about 10, 10, or about 10-25, or about 25, 10, or about 10-20, or about 20, 10, or about 10-15, or about 15, 15, or about 15-25, or about 25, 15, or about 15-20, or about 20, or 20, or about 20-25, or about 25 g / L of glucose. In some embodiments, the cryopreservation composition comprises 5, 7.5, 10, 12.5, 15, 17.5, 20, 22.5, or 25 g / L of glucose. In some embodiments, the cryopreservation composition comprises 12.5 g / L of glucose. In some embodiments, the cryopreservation composition comprises about 5, about 7.5, about 10, about 12.5, about 15, about 17.5, about 20, about 22.5, or about 25 g / L of glucose, hi some embodiments, the cryopreservation composition comprises about 12.5 g / L of glucose.

[0263] In some embodiments, the cryopreservation composition comprises glucose at less than 2.75% w / v. In some embodiments, the cryopreservation composition comprises glucose at less than 27.5 g / l. In some embodiments, the cryopreservation composition comprises glucose at less than 2% w / v. In some embodiments, the cryopreservation composition comprises glucose at less than 1.5% w / v. In some embodiments, the cryopreservation composition comprises about 1.25% w / v or less.

[0264] 4. Dimethyl sulfoxide In some embodiments, the cryopreservation composition comprises dimethyl sulfoxide (DMSO, also known as methyl sulfoxide and methylsulfinylmethane).

[0265] In some embodiments, DMSO is provided as a solution, also referred to herein as a DMSO solution. Thus, in some embodiments, the cryopreservation composition comprises a DMSO solution.

[0266] In some embodiments, the DMSO solution is suitable for intravenous use.

[0267] In some embodiments, the DMSO solution comprises 1.1 g / ml DMSO. In some embodiments, the DMSO solution comprises about 1.1 g / ml DMSO.

[0268] In some embodiments, the cryopreservation composition comprises a DMSO solution at 1% or about 1% to 10% or about 10% v / v. In some embodiments, the cryopreservation composition comprises a DMSO solution at 1% or about 1% to 10% or about 10%, 1% or about 1% to 9% or about 9%, 1% or about 1% to 8% or about 8%, 1% or about 1% to 7% or about 7%, 1% or about 1% to 6% or about 6%, 1% or about 1% to 5% or about 5%, 1% or about 1% to 4% or about 4%, 1% or about 1% to 3% or about 3%, 1% or about 1% to 2% or about 2%, 2% or about 2% to 10% or about 10%, 2% or about 2% to 10% or about 10%, 3% or about 3 ... % or about 2% to 9% or about 9%, 8% or about 8%, 2% or about 2% to 7% or about 7%, 2% or about 2% to 6% or about 6%, 2% or about 2% to 5% or about 5%, 2% or about 2% to 4% or about 4%, 2% or about 2% to 3% or about 3%, 3% or about 3% to 10% or about 10%, 3% or about 3% to 9% or about 9%, 3% or about 3% to 8% or about 8%, 3% or about 3% to 7% or about 7%, 3% or about 3% to 6% or about 6%, 3% or about 3% to 5% or about 5%, 3% or about 3% to 4% or about 4%, 4% or about 4% to 10% or about 10%, 4% or about 4% to 9% or about 9%, 4% or about 4% to 8% or about 8%, 4% or about 4% to 7% or about 7%, 4% or about 4% to 6% or about 6%, 4% or about 4% to 5% or about 5%, 5% or about 5% to 10% or about 10%, 5% or about 5% to 9% or about 9%, 5% or about 5% to 8% or about 8%, 5 or about 5% to 7% or about 7%, In some embodiments, the cryopreservation composition comprises 5%, or about 5%, to 6%, or about 6%, 6%, or about 6% to 10%, or about 10%, 6%, or about 6% to 9%, or about 9%, 6%, or about 6% to 8%, or about 8%, 6%, or about 6% to 7%, or about 7%, 7%, or about 7% to 10%, or about 10%, 7%, or about 7% to 9%, or about 9%, 7%, or about 7% to 8%, or about 8%, 8%, or about 8% to 10%, or about 10%, 8%, or about 8% to 9%, or about 9%, or 9%, or about 9% to 10%, or about 10% v / v DMSO solution. In some embodiments, the cryopreservation composition comprises 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, or 10% v / v DMSO solution.In some embodiments, the cryopreservation composition comprises a 5% DMSO solution. In some embodiments, the cryopreservation composition comprises about 1%, about 2%, about 3%, about 4%, about 5%, about 6%, about 7%, about 8%, about 9%, or about 10% v / v DMSO solution. In some embodiments, the cryopreservation composition comprises about 5% DMSO solution.

[0269] In some embodiments, the cryopreservation composition comprises 11, or about 11-110, or about 110 g / L DMSO. In some embodiments, the cryopreservation composition comprises 11, or about 11-110, or about 110, 11, or about 11-99, or about 99, 11, or about 11-88, or about 88, 11, or about 11-77, or about 77, 11, or about 11-66, or about 66, 11, or about 11-55, or about 55, 11, or about 11-44, or about 44, 11, or about 11-33, or about 33, 11, or about 11-22, or about 22, 22, or about 22-110, or about 110, 22, or about 22 to 99 or about 99, 22 or about 22 to 88 or about 88, 22 or about 22 to 77 or about 77, 22 or about 22 to 77 or about 77, 22 or about 22 to 66 or about 66, 22 or about 22 to 55 or about 55, 22 or about 22 to 44 or about 44, 22 or about 22 to 33 or about 33, 33 or about 33 to 110 or about 110, 33 or about 33 to 99 or about 99, 33 or about 33 to 88 or about 88, 33 or about 33 to 77 or about 77, 33 or or about 33 to 66 or about 66, 33 or about 33 to 55 or about 55, 33 or about 33 to 44 or about 44, 44 or about 44 to 110 or about 110, 44 or about 44 to 99 or about 99, 44 or about 44 to 88 or about 88, 44 or about 44 to 77 or about 77, 44 or about 44 to 66 or about 66, 44 or about 44 to 55 or about 55, 55 or about 55 to 110 or about 110, 55 or about 55 to 99 or about 99, 55 or about 55 to 88 or about 8 In some embodiments, the cryopreservation composition comprises 8, 55, or about 55-77, or about 77, 55, or about 55-66, or about 66, 66, or about 66-110, or about 110, 66, or about 66-99, or about 99, 66, or about 66-88, or about 88, 66, or about 66-77, or about 77, 77, or about 77-119, or about 119, 77, or about 77-88, or about 88, 88, or about 88-110, or about 110, 88, or about 88-99, or about 99, or 99, or about 99-110, or about 110 g / L DMSO.In some embodiments, the cryopreservation composition comprises 55 g / L of DMSO. In some embodiments, the cryopreservation composition comprises about 11, about 22, about 33, about 44, about 55, about 66, about 77, about 88, about 99, or about 110 g / L of DMSO. In some embodiments, the cryopreservation composition comprises about 55 g / L of DMSO.

[0270] 5. Buffers In some embodiments, the cryopreserved composition comprises a buffer solution, for example, a buffer solution suitable for intravenous administration.

[0271] Buffer solutions include, but are not limited to, phosphate buffered saline (PBS), Ringer's solution, Tyrode's buffer, Hank's balanced salt solution, Earle's balanced salt solution, saline, and Tris.

[0272] In some embodiments, the buffer solution is phosphate buffered saline (PBS).

[0273] 6. Exemplary Cryopreservation Compositions In some embodiments, the cryopreservation composition comprises or consists of the following components: 1) albumin, e.g., human albumin, 2) dextran, e.g., dextran 40, 3) DMSO, and 4) a buffer solution. In some embodiments, the cryopreservation composition additionally comprises glucose. In some embodiments, the cryopreservation composition consists of 1) albumin, e.g., human albumin, 2) dextran, e.g., dextran 40, 3) glucose, 4) DMSO, and 5) a buffer solution.

[0274] In some embodiments, the cryopreservation composition comprises 1) an albumin solution described herein, 2) a dextran solution described herein, 3) a DMSO solution described herein, and 4) a buffer solution.

[0275] In some embodiments, the cryopreservation composition is comprised of 1) an albumin solution described herein, 2) a dextran solution described herein, 3) a DMSO solution described herein, and 4) a buffer solution.

[0276] In some embodiments, the cryopreservation composition does not include cell culture medium.

[0277] In one embodiment, the cryopreservation composition comprises about 40 mg / ml human albumin, 25 mg / ml dextran 40, 12.5 mg / ml glucose and 55 mg / ml DMSO.

[0278] In one embodiment, the cryopreservation composition comprises or consists of approximately 40 mg / ml human albumin, 25 mg / ml dextran 40, 12.5 mg / ml glucose, 55 mg / ml DMSO, and 0.5 mg / ml 100% phosphate buffered saline (PBS) in water.

[0279] In one embodiment, the cryopreservation composition comprises about 32 mg / ml human albumin, 25 mg / ml dextran 40, 12.5 mg / ml glucose and 55 mg / ml DMSO.

[0280] In one embodiment, the cryopreservation composition comprises or consists of approximately 32 mg / ml human albumin, 25 mg / ml dextran 40, 12.5 mg / ml glucose, 55 mg / ml DMSO, and 0.54 mg / ml 100% phosphate buffered saline (PBS) in water.

[0281] Examples of cryopreservation compositions are shown in Table 3.

[0282] [Table 3]

[0283] [Table 4]

[0284] [Table 5]

[0285] B. Freezing preservation method The cryopreservation compositions described herein can be used to cryopreserve cells, e.g., therapeutic cells, e.g., natural killer (NK) cells, e.g., NK cells described herein.

[0286] In some embodiments, the cells are animal cells. In some embodiments, the cells are human cells. In some embodiments, the cells are immune cells. In some embodiments, the immune cells are selected from basophils, eosinophils, neutrophils, mast cells, monocytes, macrophages, neutrophils, dendritic cells, natural killer cells, B cells, T cells, and combinations thereof. In some embodiments, the immune cells are natural killer (NK) cells. In some embodiments, natural killer cells are expanded and stimulated by the methods described herein.

[0287] In some embodiments, cryopreserving cells comprises mixing the cells with a cryopreservation composition described herein or a component thereof to produce a composition, e.g., a pharmaceutical composition; and freezing the mixture.

[0288] In some embodiments, cryopreserving cells includes mixing a composition comprising cells with a cryopreservation composition described herein or its components to produce a composition, e.g., a pharmaceutical composition; and freezing the mixture. In some embodiments, the composition comprising cells includes cells and a buffer. Suitable buffers are described herein.

[0289] In some embodiments, cryopreservation of cells comprises mixing a composition comprising cells and a buffer, e.g., PBS, with a composition comprising albumin, dextran, and DMSO, e.g., as described herein; and freezing the mixture.

[0290] In some embodiments, cryopreservation of cells includes mixing a composition comprising cells and a buffer, e.g., PBS, in a 1:1 ratio with a composition comprising 40 mg / ml albumin, e.g., human albumin, 25 mg / ml dextran, e.g., dextran 40, 12.5 mg / ml glucose, and 55 mg / ml DMSO.

[0291] In some embodiments, a composition comprising cells and a buffer, e.g., PBS, contains 2×10 cells. 7 or about 2 x 10 7 ~2×10 9 or about 2 x 10 9 In some embodiments, a composition comprising cells and a buffer, e.g., PBS, contains 2×10 cells / ml. 8 In some embodiments, a composition comprising cells and a buffer, e.g., PBS, comprises about 2 x 10 cells / ml. 8 Contains cells / ml.

[0292] In some embodiments, cell cryopreservation comprises mixing cells, a buffer, eg, PBS, albumin, eg, human albumin, dextran, eg, dextran 40, and DMSO; and freezing the mixture.

[0293] In some embodiments, the mixture comprises 1×10 7 or about 1 x 10 7 ~1×10 9 or about 1 x 10 9 In some embodiments, the mixture comprises 1 x 10 cells / ml. 8 In some embodiments, the mixture comprises about 1 x 10 cells / ml. 8 Contains cells / ml.

[0294] Suitable albumin, dextran and DMSO ranges are described above.

[0295] In some embodiments, the composition is frozen at -135°C or below.

[0296] In some embodiments, the composition freezes at a controlled rate.

[0297] IV. Antibodies In some embodiments, the EGFR-targeting antibody is an EGFR-targeting antibody selected from Table 6, or a combination thereof.

[0298] [Table 6-1]

[0299] [Table 6-2]

[0300] [Table 6-3]

[0301] In some embodiments, the EGFR-targeting antibody is selected from the group consisting of cetuximab (or a biosimilar thereof), panitumumab (or a biosimilar thereof), necitumumab (or a biosimilar thereof), and combinations thereof.

[0302] In some embodiments, the EGFR-targeting antibody is selected from cetuximab or a biosimilar thereof. In some embodiments, the EGFR-targeting antibody is cetuximab.

[0303] In some embodiments, the cetuximab biosimilar is CDP1 (Dragonboat Biopharmcaeutical Co., Ltd, Shanghai, China; clinicaltrials.gov: NCT04739111 (2021), NCT04151810 (2019), NCT03881787 (2019), and NCT03491709 (2018)), CMAB009 (Shanghai BioMab Pharmaceuticals Ltd; Shanghai Zhangjiang Biotechnology Co. Ltd; clinicaltrials.gov: NCT03206151 (2017), NCT01550055 (2009); WO2016110226; US20180030139; US10118966; Shi et al., "CMAB009 plus irinotecan versus irinotecan-only as "Second-line treatment after fluoropyrimidine and oxaliplatin failure in KRAS wild-type metastatic colorectal cancer patients: promising findings from a prospective, open-label, randomized, phase III trial," Cancer Comm (Lond) 39:29 (2019)), KL-140 (Sichuan Kelum Pharmaceutical Co., Ltd.; clinicaltrials.gov NCT03426371), ABP494 (Allergan, Inc.; Amgen), HLX05 (Shanghai Henlius Biotech Co. Ltd.; WO2015184403; US20170218073), and STI-001 (Mabtech; Sorrento Therapeutics; WO2017120613; US20170247458).

[0304] V. Pharmaceutical Compositions The present invention provides pharmaceutical compositions comprising the natural killer cells described herein and dosage units of the pharmaceutical compositions described herein.

[0305] In some cases, the dosage unit contains between 100 million and 1.5 billion cells, e.g., 100 million, 200 million, 300 million, 400 million, 500 million, 600 million, 700 million, 800 million, 900 million, 1 billion, 1.1 billion, 1.2 billion, 1.3 billion, 1.4 billion, or 1.5 billion cells.

[0306] Pharmaceutical compositions typically include a pharmaceutically acceptable carrier. As used herein, the term "pharmaceutically acceptable carrier" includes saline, solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like, suitable for pharmaceutical administration.

[0307] In some embodiments, the pharmaceutical composition comprises: a) natural killer cells described herein; and b) a cryopreserved composition.

[0308] Suitable cryopreservation compositions are described herein.

[0309] In some embodiments, the composition is frozen. In some embodiments, the composition is frozen for at least 3 months, e.g., at least 6 months, at least 9 months, at least 12 months, at least 15 months, at least 18 months, at least 24 months, or at least 36 months.

[0310] In some embodiments, at least 60%, eg, at least 70%, at least 80%, at least 90%, at least 95%, at least 99%, or 100% of the natural killer cells survive post-thawing.

[0311] In some embodiments, the pharmaceutical composition comprises: a) a cryopreserved composition described herein; and b) therapeutic cells.

[0312] In some embodiments, the therapeutic cell is an animal cell, hi some embodiments, the therapeutic cell is a human cell.

[0313] In some embodiments, the therapeutic cell is an immune cell, hi some embodiments, the immune cell is selected from a basophil, an eosinophil, a neutrophil, a mast cell, a monocyte, a macrophage, a neutrophil, a dendritic cell, a natural killer cell, a B cell, a T cell, and combinations thereof.

[0314] In some embodiments, the immune cells are natural killer (NK) cells. In some embodiments, the natural killer cells are expanded and stimulated by the methods described herein.

[0315] In some embodiments, the pharmaceutical composition additionally comprises c) a buffer solution. Suitable buffer solutions are, for example, as described herein for the cryopreserved compositions.

[0316] In some embodiments, the pharmaceutical composition comprises 1×10 cells 7 cells / ml or approximately 1 x 10 7 ~1×10 9 cells / ml or approximately 1 x 10 9 In some embodiments, the pharmaceutical composition contains 1 x 10 cells / ml. 8 In some embodiments, the pharmaceutical composition contains about 1 x 10 cells / ml. 8 Contains cells / ml.

[0317] In some embodiments, the pharmaceutical composition additionally comprises an antibody or antigen-binding fragment thereof, eg, an antibody described herein.

[0318] Pharmaceutical compositions are typically formulated for the intended route of administration, including parenteral, e.g., intravenous, intradermal, subcutaneous, oral (e.g., inhalation), transdermal (topical), transmucosal, and rectal administration.

[0319] Methods for formulating suitable pharmaceutical compositions are known in the art, see, for example, Remington: The Science and Practice of Pharmacy, 21st ed., 2005; and the books in the series Drugs and the Pharmaceutical Sciences: a Series of Textbooks and Monographs (Dekker, NY). For example, the solution or suspension used for parenteral, intradermal or subcutaneous administration can contain the following components: sterile diluent, such as water for injection, saline solution, fixed oil, polyethylene glycol, glycerin, propylene glycol or other synthetic solvent; antibacterial agent, such as benzyl alcohol or methylparaben; antioxidant, such as ascorbic acid or sodium bisulfite; chelating agent, such as ethylenediaminetetraacetic acid; buffer, such as acetate, citrate or phosphate, and tonicity adjuster, such as sodium chloride or dextrose. pH can be titrated using acid or base, such as hydrochloric acid or sodium hydroxide. The parenteral preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic.

[0320] Pharmaceutical compositions suitable for injectable use can include sterile acids and sterile aqueous solutions (where water soluble) or dispersions for the extemporaneous preparation of sterile injectable solutions or dispersions. For intravenous administration, suitable carriers include physiological saline, bacteriostatic water, Cremophor EL TM(BASF, Parsippany, NJ) or phosphate-buffered saline (PBS). In all cases, the composition must be sterile and fluid enough for easy syringability. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol), and suitable mixtures thereof. The proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants. The prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like. In many cases, it is preferable to add isotonic agents, for example, sugars, polyalcohols such as mannitol, sorbitol, or sodium chloride to the compositions. Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent which delays absorption, for example, aluminum monostearate and gelatin.

[0321] Sterile injectable solutions can be prepared by incorporating the active compound in the required amount into a suitable solvent with one or a combination of the ingredients listed above, and optionally sterilizing by filtration. Generally, dispersions are prepared by incorporating the active compound into a sterile vehicle containing a basic dispersion medium and other necessary ingredients from those listed above. For the preparation of sterile injectable solutions, the preferred method of preparation is vacuum drying and freeze-drying, which yields a powder of the active ingredient and any additional desired ingredients from the previously sterile-filtered solution.

[0322] VI. Treatment method The NK cells described herein have utility in treating cancer or other proliferative disorders.

[0323] Thus, the present invention also provides methods of treating a patient suffering from a disorder, e.g., a cancer-related disorder, e.g., an EGFR+ cancer, comprising administering an NK cell, e.g., an NK cell described herein, and an EGFR-targeting antibody, e.g., an antibody described herein.

[0324] The present invention also provides methods for preventing, reducing, and / or inhibiting the recurrence, growth, proliferation, migration, and / or metastasis of a cancer cell or population of cancer cells in an individual in need thereof, comprising administering NK cells, e.g., NK cells described herein, and an EGFR-targeting antibody, e.g., an antibody described herein.

[0325] Additionally, the present invention provides methods for enhancing, improving, and / or increasing response to anti-cancer therapy in an individual in need thereof, comprising administering NK cells, e.g., NK cells described herein, and an EGFR-targeting antibody, e.g., an antibody described herein.

[0326] The use of anti-EGFR antibodies can induce toxicities that prevent patients from receiving optimal or unacceptable doses of the antibody. In some cases, patients may need to reduce the dose, omit or delay administration, or discontinue treatment altogether. Thus, side effects of anti-EGFR antibodies can reduce the efficacy of the drug. The combination of NK cells and anti-EGFR antibodies described herein can enhance the efficacy of a given amount of antibody by enhancing the ADCC effect of the antibody. In this way, patients can receive the antibody at a lower dose while still achieving optimal or enhanced efficacy. This allows patients to avoid some of the side effects associated with anti-EGFR antibodies, including cetuximab. Patients may be able to complete a treatment cycle, or alternatively, may not be able to complete it without NK cells. Furthermore, because anti-EGFR antibodies are often administered until patients experience serious side effects, administering lower doses of the antibody and NK cells can provide patients with the benefit of a level of efficacy that is only possible when the antibody is used alone and severe side effects are present.

[0327] The present invention also provides a method of eliciting an immune system in an individual in need thereof, comprising administering NK cells, e.g., NK cells described herein, and an EGFR-targeting antibody, e.g., an antibody described herein.

[0328] The methods described herein include methods for treating disorders associated with abnormal apoptotic or differentiation processes, e.g., cell proliferative or cellular differentiation disorders, e.g., cancers such as solid tumors and hematopoietic cancers. Generally, the methods involve administering a therapeutically effective amount of a therapeutic agent as described herein to an individual in need thereof or determined to be in need of treatment. In some embodiments, the methods involve administering a therapeutically effective amount of a therapeutic agent comprising NK cells, e.g., NK cells described herein, and an EGFR-targeting antibody, e.g., an antibody described herein.

[0329] As used herein, the terms "treatment," "treating," and "treating" refer to the regression, alleviation, delay in onset, or inhibition of progression of a disorder associated with abnormal apoptotic or differentiation processes. For example, treatment can achieve a reduction in tumor size or growth rate. Administration of a therapeutically effective amount of a compound described herein to treat a condition associated with abnormal apoptotic or differentiation processes may achieve, among other things, a reduction in tumor size or growth rate, a reduction in the risk or frequency of recurrence, a delay in recurrence, a reduction in metastasis, an increase in survival, and / or a reduction in morbidity and mortality. In some embodiments, a therapeutic agent can be administered after one or more symptoms have manifested. In other embodiments, a therapeutic agent can be administered in the absence of symptoms. For example, a therapeutic agent can be administered to a susceptible individual before symptoms have begun (e.g., in light of a history of symptoms and / or in light of genetic or other susceptibility factors). A therapeutic agent can also continue to be administered after symptoms have resolved, e.g., to prevent or delay recurrence.

[0330] As used herein, the term "inhibition," in relation to cancer and / or cancer cell proliferation, means inhibiting the growth, division, maturation, or viability of cancer cells, either individually or collectively with other cancer cells, and / or inducing the death of cancer cells, by cytotoxicity, nutrient depletion, or induction of apoptosis.

[0331] As used herein, "delaying" the progression of a disease or disorder, or one or more symptoms thereof, means delaying, preventing, slowing, retarding, stabilizing, and / or postponing the onset of the disease, disorder, or its symptoms. The delay may be of varying lengths of time depending on the individual's history of the disease and / or treatment. As will be apparent to those skilled in the art, a sufficient or significant delay encompasses prevention, in that the disease, disorder, or its symptoms do not, in effect, occur in the individual. For example, a method for "delaying" the onset of cancer is one that reduces the probability of disease onset for a given time range and / or reduces the severity of the disease for a given time range compared to not using the method. Such comparisons can be based on clinical trials using a statistically significant number of individuals.

[0332] As used herein, "prevention" or "preventing" refers to preventing a disease or disorder from initiating, such that clinical symptoms of the disease do not occur. Thus, "prevention" refers to administering a therapy (e.g., administering a therapeutic agent) to an individual before symptoms of the disease become detectable in the individual and / or before the disease reaches a certain stage (e.g., administering a therapeutic agent to a patient whose cancer has not yet metastasized). An individual may be at risk for developing a disease or disorder or at risk for disease progression, e.g., at risk for cancer metastasis, or may have one or more risk factors known to be associated with the onset or initiation of a disease or disorder. For example, an individual may possess a mutation associated with the onset or progression of cancer. Furthermore, it is understood that prevention does not achieve complete prevention of the onset of a disease or disorder. In some cases, prevention includes a reduction in the risk of developing a disease or disorder. A reduction in risk may not achieve complete elimination of the risk of developing a disease or disorder.

[0333] The degree of "increased" or "enhanced" (e.g., with respect to anti-tumor response, metastasis of cancer cells) refers to an increase of 1.1-fold, 1.2-fold, 1.3-fold, 1.4-fold, 1.5-fold, 1.6-fold, 1.7-fold, 1.8-fold, 1.9-fold, 2-fold, 2.5-fold, 3-fold, 3.5-fold, 4-fold, 4.5-fold, 5-fold, 6-fold, 7-fold, 8-fold, 9-fold, 10-fold, 15-fold, 20-fold, 30-fold, 40-fold, 50-fold or higher (e.g., 100-fold, 500-fold, 1000-fold) relative to the amount or level recited herein (including all integers and decimal values ​​greater than 1 between the recited integers, e.g., 2.1, 2.2, 2.3, 2.4, etc.). This can also encompass an increase of at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, at least 150%, at least 200%, at least 500% or at least 1000% relative to the amounts or levels mentioned herein.

[0334] A "decreased" or "reduced" or "lesser" amount (e.g., with respect to tumor size, cancer cell proliferation or growth) refers to a 1.1-fold, 1.2-fold, 1.3-fold, 1.4-fold, 1.5-fold, 1.6-fold, 1.7-fold, 1.8-fold, 1.9-fold, 2-fold, 2.5-fold, 3-fold, 3.5-fold, 4-fold, 4.5-fold, 5-fold, 6-fold, 7-fold, 8-fold, 9-fold, 10-fold, 15-fold, 20-fold, 30-fold, 40-fold, 50-fold or higher (e.g., 100-fold, 500-fold, 1000-fold) reduction relative to the amount or level recited herein (including all integers and decimal values ​​greater than 1 between the recited integers, e.g., 1.5, 1.6, 1.7, 1.8, etc.). This can also encompass a reduction of at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, at least 150%, at least 200%, at least 500% or at least 1000% relative to the amounts or levels mentioned herein.

[0335] A. Disability The method and the composition prepared disclosed in the present application can be used to target a variety of disorders, such as cell proliferation disorders.In the present invention, the advantage of this approach is that allogeneic cells are used in combination with the administration of exogenous antibodies to target the specific proliferative cells targeted by the exogenous antibodies.By using this approach and pharmaceutical composition of the present invention, unlike existing therapies such as chemotherapy or radiotherapy, it is possible to specifically target cells that exhibit potentially harmful proliferative activity without administering systemic drugs or toxins that indiscriminately affect proliferative cells.

[0336] Examples of cell proliferative and / or differentiative disorders include cancer, e.g., carcinoma, sarcoma, metastatic disorders, or hematopoietic neoplastic disorders, e.g., leukemia, etc. Metastatic tumors can originate from a variety of primary tumor types, including, but not limited to, prostate, colon, lung, breast, and liver origin.

[0337] As used herein, the terms "cancer," "hyperproliferative," and "neoplastic" refer to cells having the capacity for autonomous growth, i.e., an abnormal or pathological state characterized by rapidly proliferating cell growth. Hyperproliferative and neoplastic disease states can be classified as pathological, i.e., characterized by or associated with a disease state, or non-pathological, i.e., not a normal state but not associated with a disease state. The terms are meant to encompass all types of cancerous growth or oncogenic processes, metastatic tissues, or malignantly transformed cells, tissues, or organs, regardless of histopathological type or stage of invasiveness. "Pathological hyperproliferative" cells occur in disease states characterized by malignant tumor growth. Examples of non-pathological hyperproliferative cells include cell proliferation associated with wound healing.

[0338] The term "cancer" or "neoplasm" encompasses malignancies of various organ systems, such as those arising in the lung, breast, thyroid, lymphatic system, gastrointestinal and genitourinary tract, as well as malignancies such as adenocarcinomas, e.g., most colon cancers, renal cell carcinoma, prostate cancer and / or testicular tumors, non-small cell lung carcinoma, small intestine cancer and esophageal cancer.

[0339] The term "carcinoma" is art-recognized and refers to malignant tumors of epithelial or endocrine tissues, such as respiratory system carcinoma, gastrointestinal system carcinoma, genitourinary system carcinoma, testicular carcinoma, breast carcinoma, prostate carcinoma, endocrine system carcinoma, and melanoma. In some embodiments, the disease is kidney cancer or melanoma. Examples of carcinomas include those arising from tissue of the cervix, lung, prostate, breast, head and neck, colon, and ovary. The term also encompasses carcinosarcomatosis, including, for example, malignant tumors composed of carcinomatous and sarcomatous tissues. "Adenocarcinoma" refers to a carcinoma derived from glandular tissue or in which the tumor cells originate from recognizable glandular structures.

[0340] The term "sarcoma" is art-recognized and refers to malignant tumors of mesenchymal derivation.

[0341] Additional examples of proliferative disorders include hematopoietic neoplastic disorders. As used herein, the term "hematopoietic neoplastic disorder" includes diseases involving hyperplastic / neoplastic cells of hematopoietic origin, e.g., originating from the myeloid, lymphoid, or erythroid lineages or their precursor cells. Preferably, the diseases arise from poorly differentiated acute leukemias, e.g., erythroblastic leukemia and acute megakaryoblastic leukemia. Examples of additional myeloid disorders include, but are not limited to, acute promyelocytic leukemia (APML), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML) (Vaickus, L. (1991) Crit Rev. in Oncol. / Hemotol. 11:267-97); lymphoid malignancies include, but are not limited to, ALL, including B-lineage acute lymphoblastic leukemia (ALL) and T-lineage ALL, chronic lymphocytic leukemia (CLL), prolymphoblastic leukemia (PLL), hairy cell leukemia (HLL), and Waldenstrom's macroglobulinemia (WM). Additional forms of malignant lymphoma include, but are not limited to, non-Hodgkin's lymphoma and its variants, peripheral T-cell lymphoma, adult T-cell leukemia / lymphoma (ATL), cutaneous T-cell lymphoma (CTCL), large granular lymphocytic leukemia (LGF), Hodgkin's disease, and Reed-Sternberg disease.

[0342] In some embodiments, the cancer is selected from the group consisting of acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), adrenocortical carcinoma, Kaposi's sarcoma, AIDS-related lymphoma, primary CNS lymphoma, anal cancer, appendix cancer, astrocytoma, typical teratoma / rhabdoid tumor, basal cell carcinoma, bile duct cancer, bladder cancer, bone cancer, brain cancer, breast cancer, bronchial tumor, Burkitt's lymphoma, carcinoid, cardiac tumor, medulloblastoma, germ cell tumor, primary CNS lymphoma, cervical cancer, bile duct cancer, chordoma, chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML), chronic myeloproliferative neoplasm, colorectal cancer, craniopharyngioma, cutaneous T-cell lymphoma, ductal carcinoma in situ, embryonal tumor, endometrial cancer, ependymoma, esophageal cancer, esthesioneuroblastoma, Ewing's sarcoma , extracranial germ cell tumors, extragonadal germ cell tumors, eye cancer (e.g., intraocular melanoma or retinoblastoma), fallopian tube cancer, fibrous histiocytoma of bone, osteosarcoma, gallbladder cancer, gastric cancer, gastrointestinal carcinoid tumor, gastrointestinal stromal tumor (GIST), germ cell tumors, gestational trophoblastic disease, hairy cell leukemia, head and neck cancer, cardiac tumors, hepatocellular carcinoma, histiocytosis, Hodgkin's lymphoma, hypopharyngeal cancer, intraocular melanoma, islet cell tumor, Pancreatic neuroendocrine tumors, renal (renal cell) carcinoma, Langerhans cell histiocytosis, laryngeal cancer, leukemia, lip and oral cavity cancer, liver cancer, lung cancer (e.g., non-small cell lung cancer, small cell lung carcinoma, pleuropulmonary blastoma, and tracheobronchial tumors), lymphoma, male breast cancer, malignant fibrous histiocytoma of bone, melanoma, Merkel cell carcinoma, mesothelioma, metastatic carcinoma, metastatic squamous cell carcinoma, midline carcinoma tract carcinoma, oral cavity cancer, multiple endocrine neoplasia syndrome, multiple myeloma / plasma cell neoplasm, mycosis fungoides, myelodysplastic syndrome, myelodysplastic / myeloproliferative neoplasm, myeloproliferative neoplasm, nasal cavity and paranasal sinus cancer, nasopharyngeal carcinoma, neuroblastoma, non-Hodgkin's lymphoma, oral cavity cancer, lip and oral cavity cancer, oropharyngeal cancer, osteosarcoma, malignant fibrous histiocytoma, ovarian cancer, pancreatic cancer, pancreatic neuroendocrine tumor, papillomatosis, paraganglioma, paranasal sinus and nasal cavity cancer, parathyroid cancer, penile cancer, pharyngeal cancer, pheochromocytoma, pituitary tumor, plasma cell neoplasm, multiple myeloma, pleuropulmonary blastoma, pregnancy and breast cancercancer), primary central nervous system malignant lymphoma, primary peritoneal cancer, prostate cancer, rectal cancer, recurrent cancer, renal cell carcinoma, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, sarcomas (e.g., childhood rhabdomyosarcoma, childhood vascular tumor, Ewing's sarcoma, Kaposi's sarcoma, osteosarcoma, soft tissue sarcoma, uterine sarcoma), Sézary syndrome, skin cancer, small intestine cancer, soft tissue sarcoma, squamous cell carcinoma, squamous cell carcinoma of the cervix, gastric cancer, T-cell lymphoma, testicular cancer, throat cancer, nasopharyngeal cancer, oropharyngeal cancer, hypopharyngeal cancer, thymoma and thymic carcinoma, thyroid cancer, tracheobronchial tumors, transitional cell carcinoma of the renal pelvis and ureter, urethral cancer, uterine cancer, uterine sarcoma, vaginal cancer, vascular tumors, vulvar cancer, and Wilms' tumor.

[0343] In some embodiments, the cancer is a solid tumor. In some embodiments, the cancer is metastatic.

[0344] In some embodiments, the cancer is an EGFR+ cancer, hi some embodiments, the EGFR+ cancer is selected from the group consisting of glioblastoma, lung adenocarcinoma, non-small cell lung cancer, low-grade glioma, colorectal adenocarcinoma, high-grade glioma, multiple myeloma, breast adenocarcinoma, pilocytic astrocytoma, and combinations thereof.

[0345] B.Patient In the present invention, patients suitable for the compositions and methods include those suffering from, diagnosed with, or suspected of suffering from a cell proliferative and / or differentiative disorder, such as cancer. Patients who undergo the treatments referred to in the present invention generally respond better to the methods and compositions of the present invention, in part because the pharmaceutical compositions are allogeneic and generally identify target cells with antibodies rather than targeting proliferating cells. As a result, there are fewer off-target effects, and patients are more likely to complete their therapeutic regimen without substantial adverse off-target effects.

[0346] In some embodiments, the therapeutic methods provided herein can be used to treat an individual (e.g., a human, monkey, dog, cat, mouse) diagnosed with or suspected of suffering from a cell proliferative and / or differentiative disorder, such as cancer. In some embodiments, the individual is a mammal. In some embodiments, the individual is a human.

[0347] As used herein, an individual refers to a mammal, including, for example, a human.

[0348] In some embodiments, the mammal is selected from the group consisting of armadillo, donkey, bat, bear, beaver, cat, chimpanzee, cow, coyote, deer, dog, dolphin, elephant, fox, panda, gibbon, giraffe, goat, gopher, hedgehog, hippopotamus, horse, humpback whale, jaguar, kangaroo, koala, leopard, deer, llama, lynx, mole, monkey, mouse, narwhal, orangutan, stag beetle, otter, bull, pig, polar bear, porcupine, puma, rabbit, raccoon, rat, rhinoceros, sheep, squirrel, tiger, walrus, weasel, wolf, zebra, goat, horse, and combinations thereof.

[0349] In some embodiments, the mammal is a human.

[0350] The individual, e.g., a human individual, may be a child, e.g., 0 or about 0 to 14 or about 14 years old. The individual may be a young person, e.g., 15 or about 15 to 24 or about 24 years old. The individual may be an adult, e.g., 25 or about 25 to 64 or about 64 years old. The individual may be an elderly person, e.g., 65 years or older.

[0351] In some embodiments, the individual may be a human suffering from one or more symptoms associated with a cell proliferative and / or differentiative disorder, e.g., cancer, e.g., a tumor. Various stages of cancer can be treated using any of the therapeutic methods provided herein. For example, cancer stages include, but are not limited to, early stage, advanced, locally advanced, in remission, refractory, recurrent after remission, and progressive. In some embodiments, the individual has early stage cancer. In other embodiments, the individual has advanced stage cancer. In various embodiments, the individual has stage 1, 2, 3, or 4 cancer. The therapeutic methods described herein can promote tumor reduction or shrinkage, reduce or inhibit tumor growth or cancer cell proliferation, and / or induce, increase, or promote tumor cell killing. In some embodiments, the individual is in cancer remission. The therapeutic methods described herein can prevent or delay cancer metastasis or recurrence.

[0352] In some embodiments, the individual is at risk for developing, or has genetic or other (e.g., risk factors for), a diagnosed or undiagnosed cell proliferative and / or differentiative disorder, e.g., cancer.

[0353] As used herein, an "at risk" individual is one who is at risk for developing a condition to be treated, e.g., a cell proliferative and / or differentiative disorder, e.g., cancer. Generally, an "at risk" individual may or may not have detectable disease, and may or may not have developed detectable disease prior to the treatment methods described herein. "At risk" means that the individual has one or more so-called risk factors, which are measurable parameters associated with the development of a disease or condition and are known in the art. For example, an at-risk individual may have one or more risk factors, which are measurable parameters associated with the development of cancer. Individuals with such one or more risk factors have a higher probability of developing cancer than individuals without such risk factors. Generally, risk factors can include, for example, age, sex, race, diet, history of previous disease, presence of precursor disease, genetic (e.g., hereditary) considerations, and environmental exposures. In some embodiments, individuals at risk of developing cancer encompass, for example, individuals who have had the disease among their relatives, and individuals who have a risk determined by genetic or biochemical marker analysis.

[0354] In addition, the individual may be undergoing one or more standard therapies, such as chemotherapy, radiation therapy, immunotherapy, surgery, or a combination thereof, and thus, the one or more kinase inhibitors may be administered before, during, or after the chemotherapy, radiation therapy, immunotherapy, surgery, or a combination thereof.

[0355] In certain embodiments, the individual may be a human who is (i) substantially refractory to one or more chemotherapeutic agents, or (ii) has relapsed after being treated with chemotherapy, or both. In some embodiments, the individual is refractory to two or more, three or more, or four or more chemotherapeutic agents (including standard or experimental chemotherapy).

[0356] In some embodiments, the patient is or has been diagnosed with EGFR+ cancer. In some embodiments, the patient is or has been diagnosed with EGFR+ cancer by immunohistochemical staining of a cancer biopsy or surgical sample. In some embodiments, the patient is or has been diagnosed with EGFR+ cancer by chromogenic in situ hybridization. In some embodiments, the patient is or has been diagnosed with EGFR+ cancer by fluorescent in situ hybridization of a cancer biopsy or surgical sample. In some embodiments, the patient is or has been diagnosed with EGFR+ cancer by genetic analysis, for example, by identifying an EGFR-mutated cancer, e.g., a somatic mutation in the EGFR gene.

[0357] In some embodiments, the patient has a cancer comprising one or more of the mutation sets set forth in Table 7, an insertion or deletion polymorphism in the EGFR gene, a copy number mutation in the EGFR gene, a methylation mutation in the EGFR gene, or a combination thereof.

[0358] In some embodiments, the patient has a chromosomal translocation associated with the cancer, e.g., an EGFR+ cancer. In some embodiments, the patient has a fusion gene associated with the cancer, e.g., an EGFR+ cancer.

[0359] In some embodiments, the patient has a chromosomal translocation associated with the cancer, e.g., an EGFR+ cancer. In some embodiments, the patient has a fusion gene associated with the cancer, e.g., an EGFR+ cancer.

[0360] [Table 7-1]

[0361] [Table 7-2]

[0362] [Table 7-3]

[0363] [Table 7-4]

[0364] [Table 7-5]

[0365] [Table 7-6]

[0366] [Table 7-7]

[0367] [Table 7-8]

[0368] [Table 7-9]

[0369] [Table 7-10]

[0370] In some embodiments, the patient has been refractory or has relapsed after treatment with an EGFR inhibitor, hi some embodiments, the patient has been refractory or has relapsed after treatment with a chemotherapeutic agent.

[0371] In some embodiments, the chemotherapy drug is selected from the group consisting of cisplatin, docetaxel, carboplatin, gemcitabine, cisplatin, pemetrexed, or a combination thereof.

[0372] In some embodiments, the patient is refractory or has relapsed after treatment with a tyrosine kinase inhibitor, in some embodiments, the tyrosine kinase inhibitor is selected from the group consisting of gefitinib, erlontinib, afatinib, osimertinib, and combinations thereof.

[0373] In some embodiments, the patient has a cancer that is resistant to an EGFR-specific antibody (e.g., as described herein). Optionally, the EGFR-specific antibody is an EGFR antagonist, such as cetuximab. Optionally, the EGFR-specific antibody is an EGFR antagonist that also has an ADCC mechanism, such as cetuximab.

[0374] Cetuximab resistance, for example, is associated with Ras pathway mutations (e.g., KRAS / NRAS / HRAS / BRAFI / PIK3CA. See, e.g., Song et al., "Qualitative Ras Pathway Signature for Cetixumab Therapy Reveals Resistance Mechanism in Colorectal Cancer," The FEBS Journal 287:5236-48 (2020); and Rampias et al., "RAS / PI3K Crosstalk and Cetuximab Resistance in Head and Neck Squamos Cell Carcinoma," Clin Cancer Res 20(11):2933-46 (2014); which are incorporated herein by reference in their entireties). Thus, in some embodiments, the patient has a Ras-activated cancer. For example, in some embodiments, the patient is not a Ras pathway wild-type patient (e.g., the patient has a mutation in or affects expression of one or more of KRAS, NRAS, BRAF, HRAS, or PIK3CA).

[0375] C. Lymphocyte depletion In some embodiments, the patient is lymphodepleted prior to treatment.

[0376] Exemplary lymphocyte-depleting chemotherapy regimens, along with associated useful biomarkers, are described in WO2016 / 191756 and WO2019 / 079564, which are incorporated herein by reference in their entireties. In certain embodiments, the lymphocyte-depleting chemotherapy regimen involves administering cyclophosphamide (200 mg / m 2 / day~2000mg / m 2 / day) and fludarabine (20 mg / m 2 / day~900mg / m 2 In some embodiments, lymphocyte depletion comprises cyclophosphamide at or about 250-500 or about 500 mg / m2 administration of, for example, cyclophosphamide 250 or about 250-500 or about 500, 250, 400, 500, about 250, about 400 or about 500 mg / m 2 In some embodiments, lymphocyte depletion involves administration of fludarabine at or about 20 mg / m 2 / day ~ 40 or approximately 40 mg / m 2 / day, e.g., 30 or about 30 mg / m 2 / day administration.

[0377] In some embodiments, lymphocyte depletion comprises administration of both cyclophosphamide and fludarabine. In some embodiments, patients receive cyclophosphamide (250 mg / m 2 / day) and fludarabine (30 mg / m 2 In some embodiments, patients are lymphodepleted by intravenous administration of cyclophosphamide (500 mg / m 2 / day) and fludarabine (30 mg / m 2 The mice are lymphodepleted by intravenous administration of 100mg / day.

[0378] In some embodiments, lymphocyte depletion is performed up to 5 days prior to the first administration of NK cells. In some embodiments, lymphocyte depletion is performed up to 7 days prior to the first administration of NK cells. In some embodiments, lymphocyte depletion is performed daily for 3 consecutive days (i.e., days -5 to -3) beginning 5 days prior to the first administration of NK cells. In some embodiments, lymphocyte depletion is performed on days -5, -4, and -3.

[0379] D. Administration 1.NK cells In some embodiments, the NK cells are administered as part of a pharmaceutical composition, e.g., a pharmaceutical composition described herein. The cells are thawed and then administered, optionally without any additional manipulation if the cryoprotectant is suitable for immediate administration. For a given individual, a therapeutic regimen often involves administering multiple aliquots or doses of NK cells derived from a common batch or donor over time.

[0380] In some embodiments, the NK cells, e.g., the NK cells described herein, are administered at a concentration of 1 x 10 NK cells per dose. 8 or about 1 x 10 8 ~8×10 9 or about 8 x 10 9 In some embodiments, the NK cells are administered at a dose of 1 x 10 cells per dose. 8 or about 1 x 10 8 , 1×10 9 or about 1 x 10 9 , 4×10 9 or about 4 x 10 9 , or 8 × 10 9 or about 8 x 10 9 Each dose is administered.

[0381] In some embodiments, the NK cells are administered weekly. In some embodiments, the NK cells are administered at or about 1 week. In some embodiments, the NK cells are administered at or about 8 weeks.

[0382] In some embodiments, the NK cells are cryopreserved in an infusion-ready media, for example, a cryopreservation composition suitable for intravenous administration, as described herein.

[0383] In some embodiments, the NK cells are at 1 x 10 cells per vial. 8 or about 1 x 10 8 ~8×10 9 or about 8 x 10 9 In some embodiments, the NK cells are frozen in single-dose vials.

[0384] In some embodiments, the cells are thawed, for example, in a 37° C. water bath, prior to administration.

[0385] In some embodiments, a thawed vial of NK cells is aseptically transferred to a single-dose container, e.g., a dosing bag, e.g., using a vial adapter and a sterile syringe. The NK cells can be administered to a patient by gravity from the container as an IV infusion through a Y-type blood / solution set filter.

[0386] In some embodiments, the NK cells are administered as soon as possible after thawing, preferably within 90 minutes, e.g., within 80 minutes, 70 minutes, 60 minutes, 50 minutes, 40 minutes, 30 minutes, 20 minutes, or 10 minutes. In some embodiments, the NK cells are administered within 30 minutes after thawing.

[0387] In some embodiments, the pharmaceutical composition is administered intravenously via a syringe.

[0388] In some embodiments, the patient is administered 1 ml, 4 ml, or 10 ml of the medication intravenously via a syringe.

[0389] 2. Antibodies In some embodiments, the NK cells described herein, e.g., a pharmaceutical composition comprising the NK cells referred to herein, are administered in combination with an antibody, e.g., an antibody described herein, e.g., an EGFR antibody. In some embodiments, the antibody is administered together with the NK cells as part of a pharmaceutical composition. In some embodiments, the antibody is administered separately from the NK cells, e.g., as part of a separate pharmaceutical composition. The antibody may be administered before, after, or simultaneously with the NK cells.

[0390] In some embodiments, the antibody is administered prior to administering the NK cells. In some embodiments, the antibody is administered after administering the NK cells.

[0391] In some embodiments, the NK cells are administered at least 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes, 210 minutes, or 240 minutes after completing antibody administration.

[0392] In some embodiments, NK cells are administered the next day after the antibody is administered. In some embodiments, NK cells are administered at each administration, and the antibody is administered only for a portion of the administration. For example, in some embodiments, NK cells are administered once a week, and the antibody is administered once a month.

[0393] In some embodiments, the antibody is administered weekly for 8 weeks. In some embodiments, the antibody is administered every two weeks for 8 weeks.

[0394] In some embodiments, a dose of antibody is provided prior to the primary administration of cells. In some embodiments, a reduced dose of antibody is provided prior to the primary administration of cells.

[0395] 3. Cytokines In some embodiments, a cytokine is administered to the patient.

[0396] In some embodiments, the cytokines are administered together with the NK cells as part of a pharmaceutical composition. In some embodiments, the cytokines are administered separately from the NK cells, e.g., as part of a separate pharmaceutical composition.

[0397] In some embodiments, the cytokine is IL-2. In some embodiments, IL-2 is administered subcutaneously. In some embodiments, IL-2 is administered 1-4 hours or about 1 to about 4 hours after completion of administration of NK cells. In some embodiments, IL-2 is administered at least 1 hour after completion of administration of NK cells. In some embodiments, IL-2 is administered within a maximum of 4 hours after completion of administration of NK cells. In some embodiments, IL-2 is administered within a minimum of 1 hour and a maximum of 4 hours after completion of administration of NK cells.

[0398] In some embodiments, IL-2 is administered at a dose of up to 10,000,000 IU / m 2 , for example, up to 1,000,000, 2,000,000, 3,000,000, 4,000,000, 5,000,000, 6,000,000, 7,000,000, 8,000,000, 9,000,000 or 10,000,000 IU / m 2 It is administered at .

[0399] In some embodiments, IL-2 is at or about 1,000,000, 2,000,000 or about 2,000,000, or 3,000,000 or about 3,000,000, or 4,000,000 or about 4,000,000, or 5,000,000 or about 5,000,000, or 6,000,000 or about 6,000,000, or 7,000,000 or about 7,000,000, or 8,000,000 or about 8,000,000, or 9,000,000 or about 9,000,000, or 10,000,000 IU / m 2 It is administered at .

[0400] In some embodiments, IL-2 is administered at 1×10 6 IU / m 2 or about 1 x 10 6 IU / m 2 In some embodiments, IL-2 is administered at 2×10 6 IU / m 2 or about 2 x 10 6 IU / m 2 It is administered at .

[0401] In some embodiments, IL-2 is administered to a patient at a dose of 1×10 6 IU / m 2 It is administered in less than 100 mg / kg.

[0402] In some embodiments, IL-2 is administered to the patient in a flat dose, hi some embodiments, a flat dose of at or about 6,000,000 IU is administered to the patient.

[0403] In some embodiments, no IL-2 is administered to the patient.

[0404] E. Administration An "effective amount" is an amount sufficient to achieve a beneficial or desired result. For example, a therapeutic dose is an amount that achieves a desired therapeutic effect. Such an amount may be the same as or different from the amount required to prevent the onset of a disease or disease symptoms, i.e., a prophylactically effective amount. An effective amount may be administered in one or more administrations, applications, or dosages. The therapeutically effective amount (i.e., an effective dosage) of a therapeutic compound will depend on the therapeutic compound selected. The composition may be administered one or more times per day to one or more times per week, including once every two days. Those skilled in the art will recognize that certain factors may affect the dosage and duration required to effectively treat an individual, including, but not limited to, the severity of the disease or disorder, previous treatments, the individual's general health and / or age, and other diseases present. Accordingly, treating an individual with a therapeutically effective amount of a therapeutic compound described herein may include a single treatment or a series of treatments.

[0405] The dosage, toxicity, and therapeutic efficacy of therapeutic compounds can be determined in cell cultures or experimental animals by standard pharmaceutical procedures, for example, to determine the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose therapeutically effective in 50% of the population). The dose ratio between toxicity and therapeutic effect is the therapeutic index, which can be expressed as the ratio LD50 / ED50. Compounds with high therapeutic indices are preferred. Compounds with toxic side effects may be used, but care must be taken to design a system that targets delivery of such compounds to diseased tissue sites in order to minimize potential damage to non-infected cells and reduce side effects.

[0406] Data obtained from cell culture assays and animal studies can be used to formulate a dosage range for use in humans. The dosage of such compounds may lie within a circulating concentration range that includes the ED50 with little or no toxicity. Dosages may vary within this range depending on the dosage form employed and the route of administration utilized. For any compound used in the methods of the invention, the therapeutically effective amount can be initially estimated by cell culture assays. A dose can be formulated in animal models to achieve a circulating plasma concentration range that includes the IC50 (i.e., the concentration of the test compound that achieves half-maximal inhibition of symptoms), as determined in cell culture. Such information can be used to more accurately determine useful doses in humans. Plasma levels can be measured, for example, by high-performance liquid chromatography.

[0407] F. Combination Therapy In some embodiments, the methods include administering the NK cell and EGFR-targeting antibodies described herein in combination with other therapies, such as additional antibodies, NK cell engagers, antibody drug conjugates (ADCs), chemotherapeutic drugs, such as small molecule drugs, immune checkpoint inhibitors, and combinations thereof.

[0408] 1. Small molecule / chemotherapy drugs In some embodiments, the additional therapy is a small molecule drug. In some embodiments, the additional therapy is a chemotherapy drug. In some embodiments, the additional therapy is a small molecule chemotherapy drug. Such small molecule drugs can include current standard of care regimens to which adaptive NK cell therapy is added. In some cases, the use of NK cells as described herein can enhance the effect of small molecule drugs, such as by enhancing the efficacy of the small molecule drug, reducing the amount of small molecule drug required to achieve a desired effect, or reducing the toxicity of the small molecule drug.

[0409] In some embodiments, the drug is selected from the group consisting of:

[0410] In some embodiments, the drug is [(1S,2S,3R,4S,7R,9S,10S,12R,15S)-4-acetyloxy-1,9,12-trihydroxy-15-[(2R,3S)-2-hydroxy-3-[(2-methylpropan-2-yl)oxycarbonylamino]-3-phenylpropanoyl]oxy-10,14,17,17-tetramethyl-11-oxo-6-oxatetracyclo[11.3.1.0 3,10 .0 4,7 ]heptadec-13-en-2-yl]benzoate (docetaxel) or a pharmaceutically acceptable salt thereof.

[0411] In some embodiments, the drug is [(1S,2S,3R,4S,7R,9S,10S,12R,15S)-4,12-diacetyloxy-15-[(2R,3S)-3-benzamido-2-hydroxy-3-phenylpropanoyl]oxy-1,9-dihydroxy-10,14,17,17-tetramethyl-11-oxo-6-oxatetracyclo[11.3.1.0 3,10 .0 4,7 ]heptadec-13-en-2-yl]benzoate (paclitaxel) or a pharmaceutically acceptable salt thereof.

[0412] In some embodiments, the drug is 6-N-(4,4-dimethyl-5H-1,3-oxazol-2-yl)-4-N-[3-methyl-4-([1,2,4]triazolo[1,5-a]pyridin-7-yloxy)phenyl]quinazoline-4,6-diamine (tucatinib) or a pharmaceutically acceptable salt thereof.

[0413] In some embodiments, the drug is pentyl N-[1-[(2R,3R,4S,5R)-3,4-dihydroxy-5-methyloxolan-2-yl]-5-fluoro-2-oxopyrimidin-4-yl]carbamate (capecitabine) or a pharmaceutically acceptable salt thereof.

[0414] In some embodiments, the drug is an azanide; cyclobutane-1,1-dicarboxylic acid; platinum(2+) (carboplatin) or a pharmaceutically acceptable salt thereof.

[0415] In some embodiments, the drug is methyl(1R,9R,10S,11R,12R,19R)-11-acetyloxy-12-ethyl-4-[(12S,14R)-16-ethyl-12-methoxycarbonyl-1,10-diazatetracyclo[12.3.1.0 3,11 .0 4,9 ]octadeca-3(11),4,6,8,15-pentaen-12-yl]-10-hydroxy-5-methoxy-8-methyl-8,16-diazapentacyclo[10.6.1.0 1,9 .0 2,7 .0 16,19 ]nonadeca-2,4,6,13-tetraene-10-carboxylate (vinorelbine) or a pharmaceutically acceptable salt thereof.

[0416] In some embodiments, the drug is N-[3-chloro-4-[(3-fluorophenyl)methoxy]phenyl]-6-[5-[(2-methylsulfonylethylamino)methyl]furan-2-yl]quinazolin-4-amine (lapatinib) or a pharmaceutically acceptable salt thereof.

[0417] In some embodiments, the drug is (E)-N-[4-[3-chloro-4-(pyridin-2-ylmethoxy)anilino]-3-cyano-7-ethoxyquinolin-6-yl]-4-(dimethylamino)but-2-enamide (neratinib) or a pharmaceutically acceptable salt thereof.

[0418] In some embodiments, the drug is 6-acetyl-8-cyclopentyl-5-methyl-2-[(5-piperazin-1-ylpyridin-2-yl)amino]pyrido[2,3-d]pyrimidin-7-one (palbociclib) or a pharmaceutically acceptable salt thereof.

[0419] In some embodiments, the drug is 7-cyclopentyl-N,N-dimethyl-2-[(5-piperazin-1-ylpyridin-2-yl)amino]pyrrolo[2,3-d]pyrimidine-6-carboxamide (ribociclib) or a pharmaceutically acceptable salt thereof.

[0420] In some embodiments, the drug is N-[5-[(4-ethylpiperazin-1-yl)methyl]pyridin-2-yl]-5-fluoro-4-(7-fluoro-2-methyl-3-propan-2-ylbenzimidazol-5-yl)pyrimidin-2-amine (abemaciclib) or a pharmaceutically acceptable salt thereof.

[0421] In some embodiments, the drug is (1R,9S,12S,15R,16E,18R,19R,21R,23S,24E,26E,28E,30S,32S,35R)-1,18-dihydroxy-12-[(2R)-1-[(1S,3R,4R)-4-(2-hydroxyethoxy)-3-methoxycyclohexyl]propan-2-yl]-19,30-dimethoxy-15,17,21,23,29,35-hexamethyl-11,36-dioxa-4-azatricyclo[30.3.1.0] 4,9 ]Hexatriaconta-16,24,26,28-tetraene-2,3,10,14,20-pentone (everolimus) or a pharmaceutically acceptable salt thereof.

[0422] In some embodiments, the drug is (2S)-1-N-[4-methyl-5-[2-(1,1,1-trifluoro-2-methylpropan-2-yl)pyridin-4-yl]-1,3-thiazol-2-yl]pyrrolidine-1,2-dicarboxamide (alpelisib) or a pharmaceutically acceptable salt thereof.

[0423] In some embodiments, the drug is 4-[[3-[4-(cyclopropanecarbonyl)piperazine-1-carbonyl]-4-fluorophenyl]methyl]-2H-phthalazin-1-one (olaparib) or a pharmaceutically acceptable salt thereof.

[0424] In some embodiments, the drug is (11S,12R)-7-fluoro-11-(4-fluorophenyl)-12-(2-methyl-1,2,4-triazol-3-yl)-2,3,10-triazatricyclo[7.3.1.0 5,13 ]trideca-1,5(13),6,8-tetraen-4-one (talazoparib) or a pharmaceutically acceptable salt thereof.

[0425] In some embodiments, the drug is N-[2-[2-(dimethylamino)ethyl-methylamino]-4-methoxy-5-[[4-(1-methylindol-3-yl)pyrimidin-2-yl]amino]phenyl]prop-2-enamide (osimertinib) or a pharmaceutically acceptable salt thereof.

[0426] In some embodiments, the drug is N-(3-chloro-4-fluorophenyl)-7-methoxy-6-(3-morpholin-4-ylpropoxy)quinazolin-4-amine (gefitinib) or a pharmaceutically acceptable salt thereof.

[0427] In some embodiments, the drug is N-(3-ethynylphenyl)-6,7-bis(2-methoxyethoxy)quinazolin-4-amine (erlotinib) or a pharmaceutically acceptable salt thereof.

[0428] In some embodiments, the drug is (E)-N-[4-(3-chloro-4-fluoroanilino)-7-[(3S)-oxolan-3-yl]oxyquinazolin-6-yl]-4-(dimethylamino)but-2-enamide (afatinib) or a pharmaceutically acceptable salt thereof.

[0429] In some embodiments, the drug is azan; dichloroplatinum (cisplatin, platinol) or a pharmaceutically acceptable salt thereof.

[0430] In some embodiments, the drug is an azanide; cyclobutane-1,1-dicarboxylic acid; platinum(2+) (carboplatin) or a pharmaceutically acceptable salt thereof.

[0431] In some embodiments, the drug is 4-amino-1-[(2R,4R,5R)-3,3-difluoro-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]pyrimidin-2-one (gemcitabine) or a pharmaceutically acceptable salt thereof.

[0432] In some embodiments, the drug is (2S)-2-[[4-[2-(2-amino-4-oxo-3,7-dihydropyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]amino]pentanedioic acid (pemetrexed) or a pharmaceutically acceptable salt thereof.

[0433] In some embodiments, the drug is N,N-bis(2-chloroethyl)-2-oxo-1,3,2λ 5 -oxazaphosphinan-2-amine (cyclophosphamide) or a pharmaceutically acceptable salt thereof.

[0434] In some embodiments, the drug is (2R,3S,4S,5R)-2-(6-amino-2-fluoropurin-9-yl)-5-(hydroxymethyl)oxolane-3,4-diol (fludarabine) or a pharmaceutically acceptable salt thereof.

[0435] In some embodiments, the drug is (7S,9S)-7-[(2R,4S,5S,6S)-4-amino-5-hydroxy-6-methyloxan-2-yl]oxy-6,9,11-trihydroxy-9-(2-hydroxyacetyl)-4-methoxy-8,10-dihydro-7H-tetracene-5,12-dione (doxorubicin) or a pharmaceutically acceptable salt thereof.

[0436] In some embodiments, the drug is methyl(1R,9R,10S,11R,12R,19R)-11-acetyloxy-12-ethyl-4-[(13S,15S,17S)-17-ethyl-17-hydroxy-13-methoxycarbonyl-1,11-diazatetracyclo[13.3.1.0 4,12 .0 5,10 ]nonadeca-4(12),5,7,9-tetraen-13-yl]-8-formyl-10-hydroxy-5-methoxy-8,16-diazapentacyclo[10.6.1.0 1,9 .0 2,7 .0 16,19 ]nonadeca-2,4,6,13-tetraene-10-carboxylate (vincristine) or a pharmaceutically acceptable salt thereof.

[0437] In some embodiments, the drug is (8S,9S,10R,13S,14S,17R)-17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-6,7,8,9,12,14,15,16-octahydrocyclopenta[a]phenanthrene-3,11-dione (prednisone) or a pharmaceutically acceptable salt thereof.

[0438] In some embodiments, the drug is N,3-bis(2-chloroethyl)-2-oxo-1,3,2λ 5 -oxazaphosphinan-2-amine (ifosfamide) or a pharmaceutically acceptable salt thereof.

[0439] In some embodiments, the drug is (5S,5aR,8aR,9R)-5-[[(2R,4aR,6R,7R,8R,8aS)-7,8-dihydroxy-2-methyl-4,4a,6,7,8,8a-hexahydropyrano[3,2-d][1,3]dioxin-6-yl]oxy]-9-(4-hydroxy-3,5-dimethoxyphenyl)-5a,6,8a,9-tetrahydro-5H-[2]benzofuro[6,5-f][1,3]benzodioxol-8-one (etopside) or a pharmaceutically acceptable salt thereof.

[0440] In some embodiments, the drug is (8S,9R,10S,11S,13S,14S,16R,17R)-9-fluoro-11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-3-one (dexamethasone) or a pharmaceutically acceptable salt thereof.

[0441] In some embodiments, the drug is (8S,9R,10S,11S,13S,14S,16R,17R)-9-fluoro-11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-3-one (cytarabine) or a pharmaceutically acceptable salt thereof.

[0442] In some embodiments, the NK cells, e.g., the NK cells described herein, e.g., AB-101 cells, are administered in combination with a therapy selected from the group consisting of an EGFR-targeting antibody as well as a chemotherapeutic agent, a tyrosine kinase inhibitor, and combinations thereof.

[0443] In some embodiments, the chemotherapy drug is selected from the group consisting of cisplatin, docetaxel, carboplatin, gemcitabine, cisplatin, pemetrexed, or a combination thereof.

[0444] In some embodiments, the patient is refractory or has relapsed after treatment with a tyrosine kinase inhibitor, hi some embodiments, the tyrosine kinase inhibitor is selected from the group consisting of gefitinib, erlotinib, afatinib, osimertinib, and combinations thereof.

[0445] 2. NK cell engagers In some embodiments, the additional therapy is an NK cell engager, e.g., a bispecific or trispecific antibody. In some embodiments, the NK cell engager is a bispecific antibody directed against CD16 and a disease-associated antigen, e.g., a cancer-associated antigen, e.g., a cancer antigen described herein, e.g., EGFR. In some embodiments, the NK cell engager is a trispecific antibody directed against CD16 and two disease-associated antigens, e.g., cancer-associated antigens, e.g., an antigen described herein.

[0446] 3. Checkpoint inhibitors In some embodiments, the additional therapy is an immune checkpoint inhibitor.

[0447] In some embodiments, the immune checkpoint inhibitor is selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a CTLA-4 inhibitor, and combinations thereof.

[0448] In some embodiments, the immune checkpoint inhibitor is selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a CTLA-4 inhibitor, a VISTA inhibitor, a BTLA inhibitor, a TIM-3 inhibitor, a KIR inhibitor, a LAG-3 inhibitor, a TIGIT inhibitor, a CD-96 inhibitor, a SIRPα inhibitor, and combinations thereof.

[0449] In some embodiments, the immune checkpoint inhibitor is selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a CTLA-4 inhibitor, a LAG-3 (CD223) inhibitor, a TIM-3 inhibitor, a B7-H3 inhibitor, a B7-H4 inhibitor, an A2aR inhibitor, a CD73 inhibitor, an NKG2A inhibitor, a PVRIG / PVRL2 inhibitor, a CEACAM1 inhibitor, a CEACAM5 inhibitor, a CEACAM6 inhibitor, a FAK inhibitor, a CCL2 inhibitor, a CCR2 inhibitor, a LIF inhibitor, a CD47 inhibitor, a SIRPα inhibitor, a CSF-1 inhibitor, an M-CSF inhibitor, a CSF-1R inhibitor, an IL-1 inhibitor, an IL-1R3 inhibitor, an IL-RAP inhibitor, an IL-8 inhibitor, a SEMA4D inhibitor, an Ang-2 inhibitor, a CELVER-1 inhibitor, an Axl inhibitor, a phosphatidylserine inhibitor, and combinations thereof.

[0450] In some embodiments, the immune checkpoint inhibitor is selected from the agents listed in Table 8, or combinations thereof.

[0451] [Table 8]

[0452] In some embodiments, the immune checkpoint inhibitor is an antibody.

[0453] In some embodiments, the PD-1 is selected from the group consisting of pembrolizumab, nivolumab, toripalimab, cemiplimab-rwlc, sintilimab, and combinations thereof.

[0454] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of atezolizumab, durvalumab, avelumab, and combinations thereof.

[0455] In some embodiments, the CTLA-4 inhibitor is ipilimumab.

[0456] In some embodiments, the PD-1 inhibitor is selected from the group of inhibitors shown in Table 9.

[0457] [Table 9-1]

[0458] [Table 9-2]

[0459] [Table 9-3]

[0460] In some embodiments, the PD-L1 inhibitor is selected from the group of inhibitors shown in Table 10.

[0461] [Table 10-1]

[0462] [Table 10-2]

[0463] In some embodiments, the CTLA-4 inhibitor is selected from the group of inhibitors shown in Table 11.

[0464] [Table 11]

[0465] In some embodiments, the immune checkpoint inhibitor is a small molecule drug. Small molecule checkpoint inhibitors are described, for example, in WO2015 / 034820A1, WO2015 / 160641A2, WO2018 / 009505A1, WO2017 / 066227A1, WO2018 / 044963A1, WO2018 / 026971A1, WO2018 / 045142A1, WO2018 / 005374A1, WO2017 / 202275A1, WO2017 / 202273A1, WO2017 / 202276A1, W O2018 / 006795A1, WO2016 / 142852A1, WO2016 / 142894A1, WO2015 / 033301A1, WO2015 / 033299A1, WO2016 / 142886A2, WO2 016 / 142833A1, WO2018 / 051255A1, WO2018 / 051254A1, WO2017 / 205464A1, US2017 / 0107216A1, WO2017 / 070089A1, WO201 7 / 106634A1, US2017 / 0174679A1, US2018 / 0057486A1, WO2018 / 013789A1, US2017 / 0362253A1, WO2017 / 192961A1, WO20 17 / 118762A1, US2014 / 199334A1, WO2015 / 036927A1, US2014 / 0294898A1, US2016 / 0340391A1, WO2016 / 039749A1, WO201 7 / 176608A1, WO2016 / 077518A1, WO2016 / 100608A1, US2017 / 0252432A1, WO2016 / 126646A1, WO2015 / 044900A1, US2015 / 0125491A1, WO2015 / 033303A1, WO2016 / 142835A1, WO2019 / 008154A1, WO2019 / 008152A1 and WO2019023575A1.

[0466] In some embodiments, the PD-1 inhibitor is 2-[[4-amino-1-[5-(1-amino-2-hydroxypropyl)-1,3,4-oxadiazol-2-yl]-4-oxobutyl]carbamoylamino]-3-hydroxypropanoic acid (CA-170).

[0467] In some embodiments, the immune checkpoint inhibitor is (S)-1-(3-bromo-4-((2-bromo-[1,1′-biphenyl]-3-yl)methoxy)benzyl)piperidine-2-carboxylic acid.

[0468] In some embodiments, the immune checkpoint inhibitor is a peptide. See, e.g., Sasikumar et al., "Peptide and Peptide-Inspired Checkpoint Inhibitors: Protein Fragments to Cancer Immunotherapy," Medicine in Drug Discovery 8:100073 (2020).

[0469] VII. Mutants In some embodiments, the fusion proteins or components thereof described herein, or the NK cell genotypes described herein, are at least 80%, e.g., at least 85%, 90%, 95%, 98%, or 100% identical to the amino acid sequence of the exemplary sequences (e.g., provided herein), e.g., include mutations described herein, or in addition have up to 1%, 2%, 5%, 10%, 15%, or 20% differences, e.g., as residues of the exemplary sequences substituted with conservative mutations. In preferred embodiments, the variants retain the desired activity of the parent sequence.

[0470] To determine the sequence identity of two nucleic acid sequences, the sequences are aligned for optimal comparison (e.g., gaps are introduced into one or both of the first amino acid or nucleic acid sequence and the second amino acid or nucleic acid sequence for optimal alignment, and non-homologous sequences can be ignored for comparison purposes). The length of the reference sequence aligned for comparison purposes is at least 80% of the length of the reference sequence, and in some embodiments, at least 90% or 100%. Nucleotides are then compared at corresponding amino acid or nucleotide positions. If a position in the first sequence contains the same nucleotide as the corresponding position in the second sequence, the molecules are identical at that position (as used herein, nucleic acid "identity" is the same as nucleic acid "homology"). The percent identity between two sequences is a function of the number of identical positions shared by the sequences, taking into account the length of each gap and the number of gaps to be introduced for optimal alignment of the two sequences.

[0471] The percent identity between a subject polypeptide or nucleic acid sequence (i.e., query) and a second polypeptide or nucleic acid sequence (i.e., target) can be determined in a variety of ways within the skill in the art, for example, by Smith Waterman alignment (Smith, T F and M S Waterman (1981) J Mol Biol 147:195-7); GeneMatcher Plus TM"BestFit" (Smith and Waterman, Advances in Applied Mathematics, 482-489 (1981)), as incorporated in Schwarz and Dayhof (1979) Atlas of Protein Sequence and Structure, Dayhof, MO, Ed., pp. 353-358; the BLAST program (Basic Local Alignment Search Tool; (Altschul, S.F., W. Gish, et al. (1990) J. Mol. Biol215:403-10), BLAST-2, BLAST-P, BLAST-N, BLAST-X, WU-BLAST-2, ALIGN, ALIGN-2, CLUSTAL or Megalign (DNASTAR) software is used to determine the identity. In addition, those skilled in the art can determine the appropriate parameters for determining the alignment, such as any algorithm required to achieve maximum alignment over the entire length of the sequences being compared. Generally, for target proteins or nucleic acids, the comparison length can be any length of the target, up to the full length of the target, etc. (e.g., 5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or 100%). For the purposes of the present invention, the identity percentage is based on the full length of the query sequence.

[0472] For purposes of the present invention, alignment of two sequences and determination of percent identity may be accomplished using the Blossum62 scoring matrix, applying a gap penalty of 12, a gap extension penalty of 4, and a frameshift gap penalty of 5.

[0473] Conservative substitutions typically include substitutions within the following groups: glycine, alanine; valine, isoleucine, leucine; aspartic acid, glutamic acid, asparagine, glutamine; serine, threonine; lysine, arginine; and phenylalanine, tyrosine.

[0474] VIII.Definitions Unless otherwise specified, all technical terms, notations, and other technical and scientific terms or terminology used in this application are intended to have the same meaning as commonly understood by one of ordinary skill in the art to which the claimed subject matter belongs. In some cases, terms having commonly understood meanings are defined in this application for clarity and / or ease of reference, but the inclusion of such definitions in the present invention should not necessarily be construed as meaning a substantial difference from what is commonly understood in the art.

[0475] Throughout this application, various embodiments are presented in a range format. Descriptions in range format are primarily for convenience and brevity and should not be construed as inflexible limitations on the scope of the disclosure. Thus, whenever possible, range descriptions should be construed as specifically referencing all subranges as well as individual numerical values ​​within that range. For example, a description of a range such as 1 to 6 should be construed as specifically referencing subranges such as 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, 3 to 6, etc., as well as individual numerical values ​​within that range, e.g., 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.

[0476] As used in this specification and claims, the singular forms "a," "an," and "the" include plural references unless the context clearly dictates otherwise. For example, the term "sample" includes a plurality of samples, including a mixture of samples.

[0477] The terms "ascertain," "measure," "assess," "determine," "assay," and "analyze" are often used interchangeably herein to refer to types of measurement. These terms include determining (e.g., detecting) the presence or absence of an element. These terms can encompass quantitative, qualitative, or quantitative and qualitative determinations. Assessment can be relative or absolute. "Detecting the presence of" can encompass determining the amount of something present, as well as confirming its presence or absence, depending on the context.

[0478] The terms "individual," "person," or "patient" are often used interchangeably herein.

[0479] The term "in vivo" is used to refer to phenomena that take place in the body of an individual.

[0480] The term "in vitro" is used to refer to phenomena that occur outside of an individual's body. An in vitro analysis is not performed on an individual. Rather, it is performed on a sample isolated from an individual. An example of an in vitro analysis performed on a sample is an "in vitro" analysis.

[0481] The term "in vitro" is used to refer to phenomena carried out in a container for holding experimental reagents such that the material is separated from the biological source from which it is obtained. In vitro analysis can encompass cell-based analysis using living or dead cells. In vitro analysis can also encompass acellular analysis, which does not use intact cells.

[0482] As used herein, the term "about" in reference to a number means adding or subtracting 10% of that number from that number. The term "about" in reference to a range means from the lowest value minus 10% to the highest value of the range.

[0483] As used herein, the term "buffer solution" refers to an aqueous solution consisting of a mixture of a weak acid and its counter base, or vice versa.

[0484] As used herein, the term "cell culture medium" refers to a mixture for in vitro cell growth and proliferation that contains factors essential for cell growth and proliferation, such as sugars, amino acids, various nutrients, inorganic substances, etc.

[0485] A buffer solution as used herein is not a cell culture medium.

[0486] As used herein, the term "bioreactor" refers to a culture device that allows continuous control of a range of conditions that affect cell culture, such as dissolved oxygen concentration, dissolved carbon dioxide concentration, pH, and temperature.

[0487] As used herein, the term "vector" refers to a nucleic acid molecule capable of amplifying another nucleic acid to which it is linked. This term encompasses vectors as self-replicating nucleic acid structures as well as vectors that integrate into the genome of a host cell into which they are introduced. Some vectors are suitable for transferring the nucleic acid molecules or polynucleotides of the present invention. Some vectors are capable of directing the expression of a nucleic acid to which they are operably linked. Such vectors are referred to herein as expression vectors.

[0488] The term "operably linked" refers to two or more nucleic acid sequences or polypeptide elements that are typically physically linked and are in a functional relationship to each other. For example, a promoter is operably linked to a coding sequence if it is capable of initiating or regulating the transcription or expression of the coding sequence; in this case, the coding sequence is understood to be "under the control of" the promoter.

[0489] The terms "host cell," "host cell line," and "host cell culture" are used interchangeably and refer to cells into which exogenous nucleic acid has been introduced, including the progeny of such cells. Host cells encompass "engineered cells," "transformants," and "transformed cells," encompassing the primary engineered (e.g., transformed) cell and its derived progeny, regardless of the number of subcultures. The progeny may not be completely identical in nucleic acid makeup to the parent cell and may contain mutations. Mutant progeny that have the same function or biological activity as selected or identified from the originally transformed cell are also included in the present invention.

[0490] Where appropriate, host cells can be stably or transiently transfected with a polynucleotide encoding a fusion protein as described herein.

[0491] The section headings used herein are for organizational purposes only and should not be construed as limiting the scope of the described invention. [Example]

[0492] IX. Working Example The following examples are included for illustrative purposes only and are not intended to limit the scope of the invention.

[0493] Example 1: Off-the-shelf NK cell therapy platform An example of a method for expanding and stimulating NK cells is shown in FIG. High-affinity variants of the receptor CD16 (158V / V variant, see e.g., Koene et al., "FcγRIIIa-158V / F Polymorphism Influences the Binding of IgG by Natural Killer Cell FcγRIIIa, Independently of the FcγRIIIa-48L / R / H Phenotype," Blood 90:1109-14 (1997)) and KIR-B genotype (KIR B alleles of the KIR receptor system, see e.g., Hsu et al., "The Killer Cell Immunoglobulin-Like Receptor (KIR) Genomic Region: Gene-Order, Haplotypes and Allelic Polymorphism," Immunological Review 190:40-52 (2002); and Pyo et al., "Different Patterns of Evolution in the Centromeric and Telomeric Regions of Group A and B Haplotypes of the Human Killer Cell FDA-approved frozen umbilical cord blood single units bearing the Ig-like Receptor Locus (see "Ig-like Receptor Locus," PLoS One 5:e15115 (2010)) were selected as the NK cell source.

[0494] The cord blood units were thawed and centrifuged to remove the freezing medium. Cell preparations were then T-cell depleted using a QuadroMACS cell sorting system (Miltenyi) and CD3 (T cell) MicroBeads. Total nucleated cells (TNC) were 6 x 10. 8 Populations were labeled with MicroBeads and separated using a QuadroMACS instrument and buffer. After T cell depletion, the remaining cells, primarily monocytes and NK cells, were washed and collected in antibiotic-free medium (CellgroSCGM). Cell preparations were subsequently analyzed for total nucleated cell count, viability, and % CD3+ cells. Cord blood NK cells were CD3-depleted as shown in Figure 1.

[0495] CD3- cell preparations were seeded into gas-permeable cell expansion bags containing growth medium. Cells were cocultured with replication-defective engineered HuT-78 (eHUT-78) feeder cells to enhance expansion against a master cell bank (MCB) population. CellgroSCGM culture medium was initially supplemented with anti-CD3 antibody (OKT3), human plasma, glutamine, and IL-2.

[0496] As shown in Figure 1, during one of the co-culture steps, the NK cells were selectively engineered to introduce a CAR into the NK cells, for example, using a lentiviral vector.

[0497] The cells were grown as static cultures at 37°C in a 5% CO2-balanced air atmosphere for 12-16 days, with additional medium changes every 2-4 days. When the cultures were expanded 100-fold or more, the cultured cells were harvested, suspended in freezing medium, and packed into cryobags. In this case, 10 cells per bag or vial were used during such co-culture. 8 Eighty individual bags or vials were produced. The cryobags were frozen in a vapor-phase liquid nitrogen (LN2) tank at temperatures below -150°C using a controlled rate freezer. These cryopreserved NK cells derived from FDA-cleared umbilical cord units were used as a master cell bank (MCB).

[0498] To produce the drug product, the frozen cell bags obtained from the MCB were thawed, and the freezing medium was then removed. The thawed cells were inoculated into disposable culture bags and co-cultured with feeder cells, e.g., eHUT78 feeder cells, to produce the drug product. In this case, the cells were cultured in a 50 L bioreactor to produce thousands of drug products per cord blood unit (e.g., 4,000-8,000 frozen vials, each containing 100 ml). 9 The cells / vial are mixed with a cryopreservation composition and then frozen in multiple storage containers such as cryovials. The drug product is an off-the-shelf infusion ready product available for direct infusion. Each drug product lot can be infused into hundreds to thousands of patients (e.g., 100-1,000 patients, e.g., a target dose of 4 x 10 cells / vial). 9 cell).

[0499] Example 2: Feeder cell expansion As an example, suitable feeder cells, e.g., eHut-78 cells, were thawed from frozen stock and expanded and cultured in a 125 ml flask in a culture medium containing 89% v / v RPMI 1640 (Life Technologies), 10% v / v inactivated fetal bovine serum (FBS) (Life Technologies), and 2 mM glutamine (hyclone) at or about 37°C under 3-7% CO2 or about 3-7% CO2 for 18-24 days or about 18-24 days. The cells were split into 125 ml-2 L flasks every 2-3 days. The cells were harvested by centrifugation and gamma-irradiated. The collected and irradiated cells were mixed with cryopreservation medium (Cryostor CS10) in a 2 ml cryovial and then frozen in a controlled-rate freezer at a cooling rate of approximately 15°C per 5 minutes to a final temperature of -90°C or approximately -90°C. They were then transferred to a liquid nitrogen tank or freezer and cooled to a final temperature of -150°C or approximately -150°C.

[0500] After freezing, cell viability should be greater than 70% of the original cell number (wherein the number of cells is at least 1.0 × 10 8 viable cells / ml), more than 85% of the cells expressed mTNF-α, more than 85% of the cells expressed mbIL-21+, and more than 85% of the cells expressed 4-1BBL.

[0501] Example 3: Expansion and stimulation of NK cells As an example, suitable NK cells can be produced using HuT-78 cells transduced to express 4-1BBL, membrane-bound IL-21, and mutant TNFα ("eHut-78P cells") as feeder cells. The feeder cells were suspended in 1% (v / v) CellGro medium and irradiated with 20,000 cGy using a gamma ray irradiation device. Seed cells (e.g., CD3-depleted PBMCs or CD3-depleted umbilical cord blood cells) were cultured on the feeder cells in CellGro medium containing human plasma, glutamine, IL-2, and OKT-3 at 37°C as static cultures. Cells were split every 2-4 days. The total culture time was 19 days. NK cells were collected by centrifugation and cryopreserved. Thawed NK cells are administered to patients in an infusion medium composed of: phosphate buffered saline (PBS 1x, FujiFilm Irvine) (50% v / v), albumin (human) (20% v / v OctaPharma albumin solution: human albumin ≥ 96% protein 200 g / l, sodium 130-160 mmol; ≤ 2 mmol potassium, 0.064-0.096 mmol / g protein N-acetyl-DL-tryptophan, 0.064-0.096 mmol / g protein, caprylic acid, ad. 1000 ml water), dextran 40 / dextrose (25% v / v Hospira dextran 40 / dextrose injection, USP containing: 10 g / 100 ml dextran 40 and 5 g / 100 ml aqueous dextrose). hydrous) aqueous solution) and dimethyl sulfoxide (DMSO) (5% v / v Avantor DMSL solution, density 1.101 g / cm 3 , 20℃).

[0502] In some cases, the seed cells are CD3-depleted cord blood cells. The cell fraction can be depleted of CD3 cells by immunomagnetic sorting using the CliniMACS T cell depletion set (LS Depletion set (162-01) Miltenyi Biotec).

[0503] Preferably, the cord blood cells are selected to express CD16 with F158 V / V polymorphism (Fc gamma RIIIa-158 V / V genotype) (Musolino et al. 2008 J Clin Oncol 26:1789). Preferably, the cord blood cells are KIR-B haplotype.

[0504] Example 4: Umbilical cord blood as a source of NK cells NK cells comprise 5-15% of peripheral blood lymphocytes. Traditionally, peripheral blood has been used as a source of NK cells for therapeutic applications. However, as noted herein, umbilical cord blood-derived NK cells have approximately 10-fold higher expansion potential in the culture system described herein compared to peripheral blood-derived methods, and do not experience premature cell exhaustion or senescence. Expression of target receptors on the surface of NK cells, such as receptors that participate in NK cell activation in tumor cell engagement, has been confirmed to be more consistent between donors in umbilical cord blood NK cells compared to peripheral blood NK cells. Utilizing the manufacturing process described herein, NK cells in umbilical cord blood are consistently activated in a donor-independent manner, achieving large-scale production of active and consistent NK cells.

[0505] In preclinical studies, cord blood-derived NK cells (CB-NK) showed approximately 10-fold higher proliferation in culture than peripheral blood-derived NK cells (PB-NK), as shown in Figure 2. As shown in Figure 3, the expression of activating immunoreceptors on tumor-engaging NK cells was superior and more consistent in cord blood-derived cells compared with peripheral blood-engaged cells.

[0506] Example 5: Phenotype of expanded and stimulated NK-cells As an example, NK cells derived from umbilical cord blood units were expanded and stimulated with eHut-78 cells using the expansion and stimulation steps described in Example 1. As shown in Figure 4, the resulting population of expanded and stimulated NK cells consistently exhibited high CD16(158V) and activating NK cell receptor expression.

[0507] Example 6: AB-101 AB-101 is a universal, standardized, cryopreserved, allogeneic cord blood-derived NK cell therapy product containing ex vivo expanded and activated effector cells designed to enhance ADCC anti-tumor responses in patients, e.g., those treated with monoclonal antibodies or NK cell engagers. AB-101 is composed of cord blood-derived mononuclear cells (CBMCs) enriched for NK cells by T lymphocyte depletion and co-cultured with engineered replication-deficient T cell feeder cells supplemented with IL-2 and anti-CD3 antibody (OKT3).

[0508] AB-101 is an FDA-approved, cord blood-derived, allogeneic NK-cell product specifically designed for use in combination with therapeutic monoclonal antibodies (mAbs) to treat hematologic and solid tumors. The AB-101 manufacturing process produces an NK cell product with the following attributes:

[0509] Consistent NK cell profile. High expression of antibody-bound surface receptors such as CD16 and tumor antigen-binding / activating receptors, e.g., NKG2D, NKp46, Nkp30, and NKp44.

[0510] KIR-B haplotype. KIR-B haplotypes are associated with improved clinical outcomes in the haploidentical transplant setting and higher therapeutic potential in the allogeneic setting.

[0511] CD16 F158V polymorphism. The high-affinity CD16 F158V variant that binds to mAb Fc appears to promote improved antibody-dependent cellular cytotoxicity (ADCC).

[0512] Non-transformed NK cells. Genetic enhancement or gene editing is not required for or part of the AB-101 drug product.

[0513] The components and composition of AB-101 are listed in Table 12. AB-101 inhibits NK cells (CD16) that express the natural cytotoxicity receptors NKp30 and NKp46, representing mature NK cells. + , CD56 + ) AB-101 is composed of T cells, B cells, and macrophages (≤0.2% CD3 + , ≤1.0% CD19 + , ≤1.0% CD14 + The residual rate of eHuT-78P feeder cells used in culturing AB-101 is ≦0.2% of this drug.

[0514] [Table 12]

[0515] Initial stability studies indicate that AB-101 is stable for up to six months in vapor-phase liquid nitrogen. Long-term stability studies to evaluate product stability beyond six months are underway, and updated stability information will be included in the Certificate of Analysis.

[0516] The creation of the AB-101 drug consists of the following core steps (Figure 5): · FDA-cleared umbilical cord blood unit (Hemacord, BLA125937) thawed. Removal of cryopreservation medium from cord blood units (CBUs) CD3 depletion using the FDA-cleared Vario MACS cell sorting system (Miltenyi) Expanding and co-cultivating cells in bags using engineered feeder cells (eHuT-78 cells) Testing and cryopreservation of AB-101 master cell bank (approximately 200 bags) Co-culture with thawed (1 bag), amplified, and engineered HuT-78 cells Further amplification in bioreactors ·Collecting and filling (1×10 9 NK cells / vial) · AB-101 Pharmaceutical frozen storage (approximately 150 vials) Extensive characterization to confirm concentration, purity, potency and stability.

[0517] Such a production process reproducibly produces large quantities of highly pure and active AB-101 therapeutic NK cells, as shown in Table 13. Data points represent results from three independent cord blood units.

[0518] [Table 13]

[0519] Identity (CD3-, CD56+) The identity of AB-101 drug is analyzed using the frequency of CD3-, CD56+ cells. AB-101 drug samples are thawed and resuspended in staining buffer. The resuspended sample is added to a fluorophore-labeled antibody that binds to CD3+ and CD56+ surface antigens. Flow cytometry measurements are used to confirm the % CD3-, CD56+ population as a measure of product identity.

[0520] Identity (CD56+, CD16+) The identity of AB-101 drug is analyzed using the frequency of CD56+, CD16+ cells. AB-101 drug samples are thawed and resuspended in staining buffer. The resuspended sample is added to a fluorophore-labeled antibody that binds to CD56+ and CD16+ surface antigens. Flow cytometry measurements are used to confirm the % CD56+, CD16+ population as a measure of product identity.

[0521] Purity (CD3+) The measurement of CD3+ expressing cells is used to assess the purity of AB-101 drug product. A flow cytometry measurement method is used to determine the purity of CD3+ expressing cells in the drug product. The % of CD3+ cell population is used as a measure of product purity.

[0522] Purity (CD14+) The measurement of CD14+ expressing cells is used to assess the purity of AB-101 drug product. A flow cytometry measurement method is used to determine the purity of CD14+ expressing cells in the drug product. The % of CD14+ cell population is used as a measure of product purity.

[0523] Purity (CD19+) The measurement of CD19+ expressing cells is used to assess the purity of AB-101 drug product. A flow cytometry measurement method is used to determine the purity of CD19+ expressing cells in the drug product. The % of CD19+ cell population is used as a measure of product purity.

[0524] Purity: eHuT-78P residue (eHuT-78P cell residue) The eHuT-78P cell residues in the AB-101 drug product were measured by flow cytometry (FACS). The eHuT-78 residues in the AB-101 drug product were detected by quantifying live CD3+4-1BBLhigh+ eHuT-78P using FACS. Because eHuT-78 is derived from the HuT-78 cell line, which expresses CD3 as a cutaneous T lymphocyte, a FACS gating strategy (see Figure 1) was used to sequentially gate singlets, 7-AAD, and CD3+4-1BBL+. The HuT-78 cell line was transduced with 4-1BB ligand (4-1BBL), membrane tumor necrosis factor-α (mTNF-α), and membrane-bound IL-21 (mbIL-21). Single eHuT-78 cells strongly expressing these three genes were selected and sequentially established as research, master, and working cell banks. Of these three genes, 4-1BBL was identified as the most highly expressed in the AB-101 cell bank and the final drug product, and was therefore used in the FACS gating strategy.

[0525] Potency (cytotoxicity in AB-101 DP cells:K562 cells 10:1) The efficacy of AB-101 drug was determined by assessing its cellular cytotoxicity against K562 tumor cells. Drug cytotoxicity was assessed by fluorimetric analysis. K562 tumor cells were stained with 30 μM calcein-AM (Molecular probes) for 1 hour at 37°C. Drug samples and labeled tumor cells were co-cultured in triplicate in a 96-well plate at 37°C and 5% CO2 for 4 hours in the dark. To provide spontaneous maximum release, RPMI 1640 medium supplemented with 10% FBS or 2% Triton-X100 was added to the wells. To determine background fluorescence, RPMI 1640 medium supplemented with 10% FBS or 2% Triton-X100 was added to each well. Fluorescence was measured using a fluorescence reader at excitation 485 nm and emission 535 nm. Specific cytotoxicity % was calculated using the following formula:

[0526]

number

[0527] Potency (cytotoxicity in AB-101 DP cells:Ramos cells 10:1) The same methods and calculations described above will be used to determine the efficacy of the AB-101 drug by assessing its cellular cytotoxicity potential against Ramos tumor cells. Details for this test are currently being confirmed.

[0528] Example 7: Phenotypic Characterization of AB-101 The purity as well as the expression of antibody-engaging CD16 and activating, inhibitory and chemokine receptors in various AB-101 batches was determined by flow cytometry.

[0529] AB-101 purity was measured using cell surface markers: the AB-101 batch was observed to contain >99% CD3-CD56+ NK cells and <0.1% CD3+, CD14+, and CD19+ cells. CD16 expression was measured in AB-101. 95.11±2.51% of AB-101 cells were CD16+, and the mean and median MFI of CD16 were 15,311±6,186 and 13,097±5,592, respectively. NK cells are known to express a variety of NK-specific activating and inhibitory receptors. In the various AB-101 batches tested, >80% of cells expressed CD16, NKG2A, NKG2D, CD94, NKp30, 2B4, Tim-3, and CD44; 40–70% of cells expressed NKp44, NKp46, and DNAM-1; approximately 30% of cells expressed CD161 and CD96; 15% of cells expressed CXCR3; and <5% of cells expressed other activation inhibitory receptors.

[0530] Two GMP batches of AB-101 were included in this study to evaluate the phenotypic characteristics of cells at three distinct stages of the production process: umbilical cord blood cells after CD3+ cell depletion; an intermediate product, the Master Cell Bank (MCB); and the AB-101 DP. Purity and NK cell receptor activity were measured for the CD3-depleted cells, MCB, and DP, respectively. The results initially confirmed that CB-derived NK cells exhibited an immature NK phenotype. The NK phenotype matured during the production process. At the MCB stage, over 90% of the cells expressed phenotypic characteristics already seen in mature NK cells, with other cell type markers represented at <0.1%. Expression levels of most NK cell-specific receptors increased throughout the production process, from CD3-depleted cells to the MCB and finally to the DP.

[0531] The purity of AB-101 is expressed as CD3-CD56+ cells for NK cells, CD3+ cells for T cells, CD14+ cells for monocytes, and CD19+ cells for B cells. Purity was measured for nine batches of AB-101. The results were 99.27 ± 0.59% (mean ± SD) for CD3-CD56+ cells, 0.02 ± 0.03% for CD3+ cells, 0.10 ± 0.12% for CD14+ cells, and 0.02 ± 0.04% for CD19+ cells (Figure 6). Therefore, AB-101 was verified to be composed of highly pure NK cells with almost no other cell types present as impurities.

[0532] Comparison of the purity of CD3-depleted cells, MCB and DP, produced under GMP conditions

[0533] Two GMP batches of AB-101 were used to analyze the purity of the AB-101 starting material (CD3-depleted cells), intermediate product (master cell bank, MCB), and final drug product (DP). In the CD3-depleted cell fraction, 50-60% of the cells were NK cells, and this percentage increased to over 90% in the MCB and DP. Twenty-three percent of the CD3-depleted cell fraction were CD14+ and CD19+ cells, and these cell percentages decreased to less than 0.1% in the MCB and DP, demonstrating the purity of the AB-101 MCB and the final drug product (Figure 7, Table 14).

[0534] [Table 14]

[0535] Comparison of NK cell receptors in CD3-depleted cells, MCB and DP produced under GMP conditions Using a GMP batch of AB-101, we further analyzed the expression of various NK cell receptors in the AB-101 starting material (CD3-depleted cells), intermediate product (master cell bank, MCB), and final drug product (DP). We observed that several NK cell and activating receptors, such as CD16, NKG2D, NKG2C, NKp30, NKp44, NKp46, and DNAM-1, were expressed at higher levels in the MCB and final drug product compared to the AB-101 starting material (CD3-depleted cells). CD57 expression was lower in the MCB and final drug product compared to the AB-101 starting material (CD3-depleted cells) (Figure 8, Table 15). Overall, the data showed increased expression of NK cell activating receptors in the MCB and final drug product, implying that AB-101 is effective against tumors.

[0536] [Table 15]

[0537] Conclusion The use of surface marker analysis confirmed the identity, purity, and batch-to-batch consistency of the AB-101 product. Furthermore, extensive evaluation of NK-specific activating and inhibitory cell surface markers established a consistent profile of the AB-101 product after the production amplification process. Compared to peripheral blood (PB)-derived NK cells, CB-derived NK cells have an immature phenotype, characterized by high expression of NKG2A and low expression of NKG2C, CD62L, CD57, IL-2R, CD16, and DNAM-1. CB-derived NK cells with an immature phenotype are known to have reduced cytotoxicity against tumor cells. The data from this experiment demonstrate that the allogeneic umbilical cord blood (CB)-derived NK cell product, i.e., AB-101, expresses high levels of key activating receptors, potentially indicating superior cytotoxicity against tumor cells.

[0538] Example 8: AB-101 Pharmacokinetics and Biodistribution The biodistribution and pharmacokinetics (PK) of AB-101 were investigated using the NSG (NOD scid gamma) mouse model. A single dose of AB-101 cells (0.5 × 10 cells / mL) containing 0.5% ethanol (0.01%) was administered in a 24-well plate containing 0.5% ethanol (0.01%) of AB-101 cells (0.01%). 7 Cells / mouse, 2 x 10 7 The AB-101 cells / mouse were administered intravenously (0.25 ml / mouse) a total of eight times. After the last dose, animals in the vehicle and AB-101 groups were sacrificed at 4 hours, 1 day, 3 days, 7 days, 14 days, and 78 days (n = 3 male mice, n = 3 female mice per time point).

[0539] Starting 4 hours post-dose, AB-101 was detected primarily in highly perfused tissues (lungs, spleen, heart, and liver) and the injection site for up to 3 days (day 53) after the last dose of AB-101. At 7 days (day 57) after the last dose, AB-101 was detected in the lungs (3 of 6 samples), spleen (5 of 6 samples), and injection site (5 of 6 samples). At 14 and 28 days (days 64 and 78, respectively) after the last dose, AB-101 was detected in 2 and 1 injection site samples, respectively. The sporadic results and low concentrations observed in injection site samples at days 64 and 78 may not indicate systemic persistence of the AB-101 test compound.

[0540] Results obtained from biodistribution experiments indicate that in vivo AB-101 distribution is consistent with the intravenous route of administration, and that cells exhibit tissue clearance after 7 days, with no evidence of permanent engraftment and no potential for long-term persistence.

[0541] Example 9: AB-101 Toxicology The non-clinical toxicity of AB-101 was evaluated in a GLP study in NSG mice. The study was designed to evaluate the acute and delayed toxicity profile of AB-101. AB-101 was administered at two dose levels: 0.5 × 10 7 and 2 × 10 7 The cells / animals tested in this study were: 9The product was designed to provide a level of exposure greater than the highest human equivalent dose planned to be delivered at 0.5 x 10 cells / dose. Based on the relative growth factor (Nair 2016), 7 14 x 10 cells / mouse 9 Cells / human equivalent: 2 x 10 7 Cells / mouse: 56 x 10 9 The doses are equivalent to cells / humans, but are extrapolated to a patient weighing 70 kg. AB-101 was administered intravenously via the tail vein once weekly for 8 weeks. Acute toxicity of AB-101 was assessed 3 days after the 8th (i.e., final) dose. Late toxicity was assessed at the end of a 28-day recovery period after the 8th dose. Survival, body weight, clinical observations, and palpation were recorded for each animal throughout the life of the study. All animals underwent gross necropsy at the time of euthanasia, with samples collected for blood analysis, clinical chemistry, and histopathological analysis.

[0542] Each group consisted of 20 animals, 10 of each sex, to evaluate findings in both sexes and for powered statistical analysis. A vehicle-treated control group was included for comparison with the AB-101-treated groups. To minimize treatment bias, animals were assigned to dose groups by computer-generated (weight-order) randomization, with separate randomization for females and males. This study adhered to GLP guidelines, including data recording.

[0543] No deaths or adverse clinical observations were recorded related to AB-101 administration at any of the dose levels evaluated. All minor observations that emerged were typical of mice and were not considered related to AB-101 administration. Body and organ weight changes were similar between dose groups and at the date of post-treatment evaluation (53 days for the acute toxicity group and 78 days for the delayed toxicity group). There were no AB-101-related changes in hematology and clinical chemistry parameters or gross necropsy findings identified in animals at the time of euthanasia in either the acute or delayed toxicity groups. Regardless of statistical significance, all variations between individuals and mean clinical chemistry values ​​were considered sporadic, consistent with biological and procedure-related variations, and / or minor in size, and therefore unrelated to AB-101 administration. There were no AB-101-related microscopic findings. In conclusion, the results of the GLP toxicity study demonstrated a significant correlation between AB-101 administration and AB-101 administration for animals up to 2 × 10 7 This suggests that AB-101 is well tolerated in NSG mice following repeated cell / dose / animal administration.

[0544] Example 10: Cryopreservation of NK cells AB-101 cells were prepared according to the steps shown in Figure 5. At the end of the culture period, Sartorius kSep (R) Cells were harvested using a 400-ml disposable automated centrifuge at a relative centrifugal force (RCF) of 800–1200 g at a flow rate of 60–120 ml / min and washed twice with phosphate buffered saline (PBS). After washing, cells were diluted to a target concentration of 1 × 10 with (1) human albumin; (2) dextran 40; (3) DMSO; and (4) PBS. 8 AB-101 cells were formulated at 1000 cells / ml (Cryopreservation Composition Example #1, Table 4). The suspension formulation was placed in a 10 ml AT-Closed vial. (R) After filling to a target volume of 11 ml, the tubes were labeled and placed in a controlled rate freezer for frozen storage at ≦−135°C.

[0545] Stability studies were performed at time = 0 for initial release testing data. The stability storage freezer was a validated vapor-phase LN2 storage freezer set to maintain a temperature ≤ -135°C. At the sterility time point, 10% of the batch size or 4 vials, whichever was greater, was tested. Tests were thawed at 37°C to mimic clinical thawing conditions.

[0546] As shown in Table 16, it was confirmed that the viability and activity of cryopreserved AB-101 was preserved for at least 9 months.

[0547] [Table 16]

[0548] A "bedside" short-term stability study was conducted to characterize the stability of AB-101 during handling immediately prior to administration. Samples were thawed, transferred to 10 ml syringes, filtered, and the contents were stored in Falcon tubes and allowed to stand at the indicated temperatures for the indicated times. The harvested product was analyzed. Short-term stability data for two AB-101 lots are shown in Table 17.

[0549] [Table 17]

[0550] Example 11: Cord blood NK cells sorted for KIR-B and CD16 158V / V express low CD38 after expansion NK cells were expanded as described in Example 6 to generate AB-101 cells using two umbilical cord blood samples from different donors selected for KIR-B and CD16 158 v / v, as well as one unselected donor umbilical cord blood sample (control group). The cell purity (CD56+CD3-%) measured by flow cytometry is shown in Figure 9. As shown in Figures 10 and 11, CD38 expression was lower in KIR-B / 158 v / v NK cells collectively (% positive, Figure 10) and individually (mean fluorescence intensity of positive cells, Figure 11) compared to unselected NK cells.

[0551] Example 12: Surface protein expression of AB-101 NK cells were expanded as described in Example 6. Surface protein expression of the starting NK cell source (umbilical cord blood gated for CD56+ / CD3- expression, n=3) was compared with the expanded NK cells (n=16). As shown in Figure 12, CD16 expression was high in the resulting cells and increased compared to the starting cells. Expression of NKG2D, CD94, NKp30, NKp44, and NKp46 was also increased, whereas expression of CXCR4 and CD122 was decreased.

[0552] Example 13: Combination of AB-101 with Cetuximab The short-term and long-term cytotoxicity of the combination of AB-101 and cetuximab against various cancer cell line types was determined.

[0553] Short-term cytotoxicity (4 hours) in head and neck squamous cell carcinoma (HNSCC) was examined using various E:T ratios and antibody concentrations. As shown in Figure 13, the combination of cetuximab and AB-101 (CTX) at an E:T ratio of 3:1 demonstrated dose-dependent cytolysis in three cell lines (CAL-27, CAL-33, and SAT), outperforming AB-101 alone (No) and the combination of AB-101 with IgG (IgG) in terms of % cytolysis. It also outperformed antibody alone at 1 μg / ml (CTX alone). As shown in Figure 14, the combination of AB-101 and cetuximab (NK+CTX) was more effective than AB-101 alone (NK alone) and AB-101+IgG (NK+hIgG) at various E:T ratios (n=2) when cetuximab was administered at 1 μg / ml.

[0554] Colorectal cancer (CRC): Short-term (4 h) and long-term (72 h) cytotoxicity against various EGFR+ cell lines harboring EGFR gene amplification was examined using an E:T ratio of 3:1 (short-term and long-term) or 1:1 (short-term) and a cetuximab concentration of 1 μg / ml (short-term cytotoxicity: SW48, HCT-116, SW480, and HT-29; long-term cytotoxicity: HCT-116 and HT-29). As shown in Figure 15, the short-term cytotoxicity of the combination of AB-101 and cetuximab was similar to that of AB-101 alone or control IgG. The same pattern was observed for long-term cytotoxicity (Figure 16), but it was significantly higher with AB-101 alone or IgG / cetuximab compared to cetuximab alone, with little or no cytolysis observed for all cell lines tested.

[0555] Breast cancer: Short-term and long-term cytotoxicity (4 hours), as well as intracellular CD107a and cytokine staining, were examined against the EGFR+ cell line MDA-MB-468. As shown in Figure 17, at a concentration of 1 μg / ml, the combination of AB-101 and cetuximab (CTX) demonstrated slightly higher cytolysis in terms of % cytolysis compared with AB-101 alone (No) and AB-101 + IgG (IgG). As shown in Figure 18, after co-culture with MDA-MB-468 cells + cetuximab (MDA-MB-468 + CTX), the expression levels of CD107a, IFN-γ, and TNF-α were also increased in AB-101 cells compared with AB-101 alone (MDA-MB-468) or untreated (-). As shown in Figure 19, long-term killing (120 hours, n=3) was increased in AB-101 and cetuximab (AB-101+CTX) treated cells compared to AB-101+IgG (AB-101+IgG), AB-101 alone (AB-101), cetuximab alone (CTX), IgG alone (IgG), and no treatment (No(MDA-MB-468 alone)).

[0556] [Table 18-1]

[0557] [Table 18-2]

[0558] [Table 18-3]

[0559] Other embodiments While the present invention has been described in detail, it should be understood that the above description is by way of example only and is not intended to limit the scope of the invention as defined by the appended claims. Other aspects, advantages, and modifications are within the scope of the appended claims.

Claims

1. A combination pharmaceutical comprising as active ingredients a population of natural killer cells (NK cells) and an antibody targeted to human EGFR in the same or separate compositions, wherein the NK cells are allogeneic to the patient, are KIR-B haplotype and homozygous for CD16 158V polymorphism, for treating a patient with EGFR+ cancer.

2. 2. The pharmaceutical combination of claim 1, wherein the cancer is selected from the group consisting of glioblastoma, lung adenocarcinoma, non-small cell lung cancer, low grade glioma, colorectal adenocarcinoma, high grade glioma, multiple myeloma, breast adenocarcinoma, pilocytic astrocytoma, and combinations thereof.

3. The pharmaceutical combination of claim 1 or 2, wherein the patient relapsed after treatment with an anti-EGFR antibody.

4. The pharmaceutical combination of claim 1, wherein the patient has transitioned to disease progression following treatment with autologous stem cell transplant or chimeric antigen receptor T-cell therapy (CAR-T).

5. NK cells 1×10 ８ ~1×10 １０ The pharmaceutical combination according to claim 1 , comprising 6. The pharmaceutical combination of claim 1, wherein the antibody is administered to the patient at 100-500 mg / m2.

7. The pharmaceutical combination of claim 1 , wherein the antibody is cetuximab.

8. The pharmaceutical combination of claim 1, wherein the patient is administered lymphodepleting chemotherapy prior to treatment.

9. The pharmaceutical combination of claim 8, wherein the lymphodepleting chemotherapy is a non-myeloablative chemotherapy.

10. The pharmaceutical combination according to claim 8 or 9, wherein the lymphodepleting chemotherapy comprises treatment with one or more of cyclophosphamide and fludarabine.

11. The cyclophosphamide is administered at a dose of 100-500 mg / m ２ The pharmaceutical combination according to claim 10, wherein the administration is on a daily basis.

12. The fludarabine is 10-50 mg / m ２ The pharmaceutical combination according to claim 10, wherein the administration is on a daily basis.

13. The pharmaceutical combination according to claim 1, which additionally comprises IL-2.

14. The IL-2 is 1 x 10 ６ IU / m ２ The pharmaceutical combination according to claim 13, wherein the pharmaceutical combination is administered 15. The combination pharmaceutical of claim 13, wherein the IL-2 is administered at 6,000,000 IU.

16. The pharmaceutical combination according to any one of claims 13 to 15, wherein the administration of IL-2 is performed within 1-4 hours of the administration of the NK cells.

17. The pharmaceutical combination of claim 1 , wherein the NK cells are not genetically modified.

18. The pharmaceutical combination of claim 1, wherein the NK cells are at least 70% CD56+ and CD16+.

19. The pharmaceutical combination of claim 1, wherein the NK cells are at least 85% CD56+ and CD3-.

20. The pharmaceutical combination of claim 1, wherein no more than 1% of the NK cells are CD3+, no more than 1% of the NK cells are CD19+, and no more than 1% of the NK cells are CD14+.

21. Each administration of NK cells contains 1×10 NK cells. ９ ~5×10 ９ The pharmaceutical combination according to claim 1 , wherein each of the two is administered individually.

22. The pharmaceutical combination of claim 1 , wherein the patient is administered a dose of an antibody targeting EGFR prior to the first administration of NK cells.

23. The pharmaceutical combination of claim 1, wherein the natural killer cells are expanded cord blood natural killer cells.

24. The pharmaceutical combination of claim 1 , wherein the population of natural killer cells comprises at least 60% CD16+ cells.

25. The pharmaceutical combination of claim 1, wherein the population of natural killer cells comprises at least 60% NKG2D+ cells.

26. The pharmaceutical combination of claim 1 , wherein the population of natural killer cells comprises at least 60% NKp46+ cells.

27. The pharmaceutical combination of claim 1 , wherein the population of natural killer cells comprises at least 60% NKp30+ cells.

28. The pharmaceutical combination of claim 1, wherein the population of natural killer cells comprises at least 60% DNAM-1+ cells.

29. The pharmaceutical combination of claim 1, wherein the population of natural killer cells comprises at least 60% NKp44+ cells.

30. The pharmaceutical combination of claim 1, wherein the population of natural killer cells contains less than 20% or no CD3+ cells.

31. The pharmaceutical combination of claim 1, wherein the population of natural killer cells contains less than 20% or no CD14+ cells.

32. The pharmaceutical combination of claim 1, wherein the population of natural killer cells contains less than 20% or no CD19+ cells.

33. The pharmaceutical combination of claim 1, wherein the population of natural killer cells contains less than 20% or no CD38+ cells.

34. The pharmaceutical combination of claim 1 , wherein the natural killer cells do not contain the CD16 transgene.

35. The pharmaceutical combination according to claim 1 , wherein the natural killer cells do not express exogenous CD16 protein.

36. The pharmaceutical combination of claim 1 , wherein the natural killer cells are not genetically engineered.

37. The pharmaceutical combination of claim 1 , wherein the natural killer cells are derived from the same umbilical cord blood donor.

38. 2. The pharmaceutical combination of claim 1, wherein the population of NK cells is produced by a method comprising: (a) obtaining seed cells comprising natural killer cells from umbilical cord blood; (b) depleting the seed cells of CD3+ cells; (c) expanding the natural killer cells by culturing the depleted seed cells with a first plurality of Hut78 cells engineered to express membrane-bound IL-21, mutant TNFα, and a 4-1BBL gene to produce expanded natural killer cells; This produces an expanded population of natural killer cells.

39. 2. The pharmaceutical combination of claim 1, wherein the population of NK cells is produced by a method comprising: (a) obtaining seed cells comprising natural killer cells from umbilical cord blood; (b) depleting the seed cells of CD3+ cells; (c) expanding the natural killer cells by culturing the depleted seed cells with a first plurality of Hut78 cells engineered to express membrane-bound IL-21, mutant TNFα, and the 4-1BBL gene to produce a master cell bank population of expanded natural killer cells; and (d) expanding the master cell bank population of expanded natural killer cells by culturing with a second plurality of Hut78 cells engineered to express membrane-bound IL-21, mutant TNFα, and 4-1BBL genes to produce expanded natural killer cells; This produces an expanded population of natural killer cells.

40. The population of NK cells, after step (c), (i) freezing the master cell bank population of the expanded natural killer cells in multiple containers; and (ii) a method further comprising the step of thawing a container containing an aliquot of the master cell bank population of amplified natural killer cells; 40. The pharmaceutical combination of claim 38 or 39, wherein in step (d), expanding the master cell bank population of amplified natural killer cells comprises expanding an aliquot of the master cell bank population of amplified natural killer cells.

41. The pharmaceutical combination of claim 38 or 39, wherein the cord blood is from a donor who is KIR-B haplotype and homozygous for the CD16 158V polymorphism.

42. A composition for treating a patient suffering from an EGFR cancer comprising as an active ingredient a population of natural killer cells (NK cells), said population of NK cells being administered in combination with an antibody targeting human EGFR, said NK cells being allogeneic to the patient, being of the KIR-B haplotype and being homozygous for the CD16 158V polymorphism.

43. A composition for treating a patient suffering from EGFR cancer comprising as an active ingredient an antibody targeting human EGFR, said antibody targeting human EGFR being administered in combination with a population of natural killer cells (NK cells), said NK cells being allogeneic to the patient, being of the KIR-B haplotype, and being homozygous for the CD16 158V polymorphism.

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