Successful culture and selection of cytokine gene-modified human dermal fibroblasts for the biologic therapy of patients with cancer.

Human autologous dermal fibroblasts have been cultured, transduced with the interleukin-4 (IL-4) gene and used as a vaccine together with irradiated autologous tumor cells in patients with cancer participating in a phase I/II clinical trial at the University of Pittsburgh Cancer Institute. In support of this clinical trial, methods have been devised to facilitate isolation of fibroblasts from freshly harvested skin specimens, to enhance their outgrowth in large-scale cultures, and to assay cytokine (IL-4) production following transduction with the cytokine gene +/- irradiation. Fibroblasts were isolated from skin specimens by enzymatic digestion, grown in primary cultures, and transduced with a retroviral vector containing the gene for human IL-4 and the NeoR gene as a selectable marker. Following selection in G418, the irradiated, IL-4-producing fibroblasts were administered to patients in a vaccine containing irradiated autologous tumor cells. Seventy-eight specimens of human skin were processed to obtain fibroblast suspensions. Cultures of fibroblasts were established from 68 of the 78 specimens (87%). Of 33 transduced and selected fibroblast cultures, 21 produced at least 1,000 units of IL-4/24 hours per 10(6) cells, as determined by ELISA, and 17/33 or 51% were used for therapy. The primary cultures were typically maintained for up to seven or eight passages. The mean +/- SD overall time for obtaining a required number of transduced, selected cells was 53 +/- 4 days. The fibroblasts continued to produce IL-4 in culture for 3 weeks even after irradiation. Similar results have been obtained with a retroviral vector encoding IL-12. This study shows that human dermal fibroblasts can be consistently and reproducibly expanded and genetically modified to serve as a source of cytokines or other gene products for gene therapy trials.