We thank members of our laboratories for helpful discussions. This work was partially supported by the Biomedical and Life Science Innovation and Cultivation Research Program of the Beijing Municipal Science and Technology Commission under Grant Agreement No. Z151100003915070 (project &#34;Preclinical study on a novel immune oncology anti-tumor drug BGB-A317&#34;), and it was also partially supported by internal company funding for preclinical research.

All procedures performed in studies involving human participants were in accordance with the ethical standards of BeiGene and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving animals were approved by the Internal Review Board at BeiGene. This protocol has been specifically adjusted for the evaluation of BGB-A317 (Tislelizumab) in humanized NOD/SCID mice.
1. Establishment of human PBMC-based model

<ol>
	<li>Myeloablation of NOD/SCID mice using cyclophosphamide: determination of optimal doses
	<ol>
		<li>Purchase female NOD/SCID mice (6-8 weeks). 
		NOTE: All mice involved in this study were female.</li>
		<li>Prepare cyclophosphamide (CP) at different doses (50, 100 and 150 mg/kg) in saline. Prepare disulfiram (DS) in 0.8% Tween-80 in saline at 125 mg/kg. 
		NOTE: Different concentrations of CP were prepared to enable administration of equal volumes of drug solution to mice getting different doses of CP.</li>
		<li>Treat the animals with CP (i.p.) and DS (p.o.) once a day for 2 days. Give DS (p.o.) 2 h after each dose of CP. 
		NOTE:&#160; DS decreases the urotoxicity of CP in mice, and CP combined with DS has been suggested to have longer-lasting neutropenia than animals treated with CP alone10&#160;The dose regimen of CP might need to be pre-determined prior to actual studies and was found to vary slightly between different immunodeficient mouse strains.</li>
		<li>Collect blood samples from the orbital venous sinus and transfer to EDTA-K coated tubes on ice on day 0 (1 h before the 1st dose), day 2 (24 h after the 2nd dose) and day 4 (72 h after the 2nd dose).</li>
		<li>Examine the myeloablation effect after CP and DS treatment by FACS. Use rat anti-mouse CD11b (M1/70), rat anti-mouse Ly6C (HK1.4, ) and rat anti-mouse Ly6G (1A8) &#160;for gating CD11b+ Ly6Ghigh as neutrophils, CD11b+Ly6Chigh as monocytes11,12.</li>
		<li>Record body weight and health conditions of the mice daily for one week. The optimal dose of CP and DS is determined as the regimen that results in maximum depletion of neutrophils and monocytes without causing severe toxicity to mice.</li>
	</ol>
	</li>
	<li>Human PBMC transplantation and tumor engraftment: model set-up
	<ol>
		<li>Isolate human PBMCs from healthy donors by density gradient centrifugation according to the manufacturer&#8217;s instructions.</li>
		<li>Pre-treat the mice with CP and DS as indicated by step 1.1.2 and 1.1.3 to increase transplantation efficiency.</li>
		<li>20 to 24 h after the second dose of CP and DS, inject human tumor cell line such as A431 cells (ATCC, 2.5 x 106) and 5 x 106 isolated PBMCs (mixed in a total of 200 &#956;L phosphate-buffered saline (PBS) containing 50% Matrigel), or tumor fragments (3 x 3 x 3 mm3, in a total volume of 200 &#956;L PBS containing 50% Matrigel) and 200 &#956;L of 5 x 106 PBMCs (100 &#956;L each to the left and right side of engrafted tumor fragment) (s.c.) subcutaneously in the right flank of the animals.</li>
		<li>Measure primary tumor volume and record twice a week for 4-6 weeks. 
		NOTE: The mice will be euthanized once their body weights lose over 20% or their tumor volume reaches 2,000 mm3 or the tumor is ulcerated.</li>
		<li>Euthanize the mice in gas chambers with carbon dioxide. Collect the whole tumor tissues in sacrificed mice with ophthalmic scissors and process them for histology and immunohistochemistry (IHC) analysis. Examine the Human CD8, PD-1 and PD-L1 expressions in these tissues. See protocol step 4.</li>
	</ol>
	</li>
</ol>

2. PBMC Donor Screen

<ol>
	<li>Screen a panel of PBMC donors due to the anticipated variations resulted from PBMCs collected from individuals. Use A431 cells co-injecting with PBMCs from different donors according to the procedures as indicated by step 1.2. 
	NOTE: Over 50 healthy PBMC donors were screened in the study in order to obtain enough number of suitable donors. Researchers who would like to adopt this protocol might decide on their own how many healthy PBMC donors to be screened, based on the design of the planned studies.</li>
	<li>Monitor tumor volume twice a week by measuring with a caliper. 
	NOTE: Tumor growth rate may vary with PBMC from different donors.</li>
	<li>Collect the tumor tissues at an average volume of 200-500 mm3 and process them for histology and immunohistochemistry (IHC) analysis. Examine human CD8, PD-1 and PD-L1 expressions. See step 4 for detailed protocol.</li>
	<li>Select PBMC donors that result in moderate tumor growth (tumor volume &#62; 200 mm3 14 days post inoculation) and relatively high PD-1, PD-L1 and CD8 expressions (mean IHC scores &#62; 2). See step 4 for detailed IHC scoring protocol.</li>
</ol>

3. Human Cancer Cell Line and PDX Screen

<ol>
	<li>Screen cell lines and PDXs according to the procedures stated in step 1.2, to evaluate tumor growth rate, human PD-L1 expression of the tumors and immune cell infiltrations. 
	NOTE: Over 30 human cancer cell lines and over 20 PDXs of different cancer types were screened by the authors. Data of selected tumor models were shown in the results section.</li>
</ol>

4. Immunohistochemistry (IHC)

<ol>
	<li>Harvest as indicated by step 1.2.5 and fix tumor tissues by immersing in formalin. Dehydrate and embed fixed tissues in paraffin. Section the fixed tissues at 3 &#956;m and place them on polylysine-coated slides.</li>
	<li>Deparaffinize in xylenes three times 7 min each. Hydrate the sections through graded alcohols: 100% ethanol twice for 3 min each, followed by 90%, 80% and 70% ethanol in turn for 3 min each. Rinse by deionized H2O three times and remove excess liquid from the slides.</li>
	<li>Perform antigen retrieval by placing the slides in a container and cover with 10 mM sodium citrate buffer (pH 6.0), or Tris-EDTA (pH 9.0). Heat the slides container by microwave for 3 min. Boil in a water bath at 95 &#176;C for 30 min and then cool down to room temperature. Rinse by deionized H2O three times and aspirate excess liquid from the slides.</li>
	<li>Block the sections by 3% bovine serum albumin in PBS for 1 h and 0.3% H2O2 solution in PBS for 10 min. Stain by antibodies against human CD8 (EP334), PD-1 (NAT105,) and PD-L1 (E1L3N) at 4 &#176;C overnight, and HRP conjugated 2nd antibodies at RT for 1 h. Drop the substrate DAB (3,3&#39;-diaminobenzidine) onto the slides and control the reaction time (seconds to minutes) by monitoring the brown color from microscope.</li>
	<li>Cover the slides with neutral balsam after immersing the slides in 0.5% hydrochloric acid alcohol and 0.5% ammonia water in turn for 5 s each, then in 80%, 90% and 100% ethanol in sequence for 3 min each, and finally in xylenes using three changes for 5 min each. Detect the antibodies by observing the brown color of DAB using microscope. 
	NOTE: Human CD8 and PD-1 expression on tumor-infiltrating leucocytes (TIL) were assessed by assigning an expression score on a 5-point scale (IHC score, range 0-4) at high objective magnification (20x, 40x). 0, absent; 1, weak intensity/ less than 20% cells; 2, weak-to-moderate intensity/ 20%-50% cells; 3, moderate-to-strong intensity/ 50%-80% cells; 4, strong intensity/ more than 80% cells. Human PD-L1 staining within tumor cells was scored using an adjusted scoring system on a 5-point scale (IHC score, range 0-4) because of its relatively diffused signal. 0, absent; 1, weak intensity/ less than 10% cells; 2, weak-to-moderate intensity/10%-30% cells; 3, moderate/ 30%-50% cells; 4, strong intensity/ more than 50% cells.</li>
</ol>

5. In Vivo efficacy and Pharmacodynamics Studies in Humanized PBMC-NOD/SCID Xenograft Models

<ol>
	<li>Pre-treat NOD/SCID mice as indicated by step 1.1.3. In brief, treat the mice with 100 mg/kg CP (i.p.) and 125 mg/kg DS (p.o.) once a day for 2 days.</li>
	<li>20 to 24 h after the second dose, inject subcutaneously (s.c.) with indicated number of human cancer cells and 2.5-5 x 106 PBMCs (a total of 200 &#956;L cell mixture in 50% Matrigel) in the right front flank of animals. 
	NOTE: The number of PBMC used for any individual mouse in one single study should be the same. However, due to variations in the availability of total isolated PBMC at the time of each study, the authors have chosen to use 2.5 x 106, 4 x 106, or 5 x 106 PBMC at different studies. Although this 2-fold difference in the administered amount of PBMCs might affect the degree of humanization, the authors do not observe significant differences in evaluating anti-tumor efficacies of the tested immunotherapies.</li>
	<li>For PDXs engraftment, inject subcutaneously tumor fragments (3 x 3 x 3 mm3) in the right front flank of animals. Inject subcutaneously 200 &#956;L of 5 x 106 PBMCs (100 &#956;L each side) to the left and right of engrafted tumor fragment. 
	NOTE: PDX tumor tissues were administered in a Matrigel solution, same as described for the cell line models.</li>
	<li>On the day of cell inoculation, randomly group the animals and treat as the planned study protocol. &#160;Assess the anti-tumor activity of candidate drugs, BGB-A317 (QW, i.p.) in this case, at the indicated doses in various tumor models. 
	NOTE: The three human cancer cell lines (i.e., A431 (epidemoid carcinoma), SKOV3 (ovarian cancer) and SK-MES-1 (lung cancer)), as well as two PDX models (i.e., BCLU-054 (lung cancer) and BCCO-028 (colon cancer)), are considered good tumor models for I-O therapy evaluation in this humanized mouse model.</li>
	<li>Measure primary tumor volume twice every week, using a caliper. 
	NOTE: Gand body weights loss were observed around 4-6 weeks post PBMC engraftment in our studies, allowing a 1-2 months window for therapeutic efficacy evaluations.</li>
	<li>For the pharmacodynamics analysis of tumor infiltrated immune cells, cut the tumor tissues into small pieces and digest them with collagenase type I (1 mg/mL) and DNase I (100 &#956;g/mL) in RPMI1640 plus 5% fetal bovine serum (FBS) for 30 min at 37 &#176;C. Pass the digested tissues through 40 &#956;m cell strainers to obtain single cell suspensions.</li>
	<li>Wash the cells and adjust cell number to a concentration of 1 x 107 cells/mL in ice cold FACS Buffer (PBS, 1% FBS) in 96-well round bottom plates. Wash the cells by centrifuging and block them by adding 20 &#956;g/mL human IgG for 30 min, followed by staining with anti-human CD3 (HIT3a), CD8 (OKT8) and PD-1 (MIH4) antibodies at 4 &#176;C for 30 min. Then subject the stained samples to flow cytometry and analyze using guavaSoft 3.1.1.&#160;</li>
</ol>

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All authors have ownership interest in BeiGene. Tong Zhang and Kang Li are inventors on a patent covering BGB-A317 described in this study.

Our knowledge of cancer development and progression has advanced significantly in recent years, with focus on a comprehensive understanding of both the tumor cells and its associated stroma. Harnessing the host immune mechanisms could induce a greater impact against cancer cells, representing a promising treatment strategy. Murine models with intact mouse immune systems, such as syngeneic and GEM models, have been widely used to study checkpoint-mediated immunity. Efficacy assessments using these models depend largely on...

Immuno-oncology (I-O) is a rapidly expanding field of cancer treatment. Researchers have recently started to appreciate the therapeutic potential of modulating functions of the immune system to attack tumors. Immune checkpoint blockades have demonstrated encouraging activities in a variety of cancer types, including melanoma, renal cell carcinoma, head and neck, lung, bladder and prostate cancers1,2. Contrary to targeted therapies that directly kill &#160;cancer cells, I-O therapies potentiate the body&#8217;s immune system to attack tumors3.
To date, numerous relevant I-O animal models have been established. These include: 1) mouse tumor cell lines or tumor homograft in syngeneic mice; 2) spontaneous tumors derived from genetically engineered mouse (GEM) or carcinogen-induction; 3) chimeric GEMs with the knock-in of human drug target(s) in a functional murine immune system; and 4) mice with reconstituted human immunity transplanted with human cancer cells or patient-derived xenografts (PDXs). Each of these models have obvious advantages as well as limitations, which have been described and reviewed extensively elsewhere4.
Reconstitution of human immunity in immunodeficient mice have been growingly appreciated as a clinically relevant approach for translational I-O research. This is usually achieved through either 1) engraftment of adult immune cells (e.g., peripheral blood mononuclear cells (PMBC))5,6, or 2) engraftment of hematopoietic stem cells (HSC) from, for example, umbilical cord blood or fetal liver7,8. These humanized mice could support the growth of human tumors, thus allowing the assessment of I-O therapies in the context of both human immunity and human cancers. Despite the advantages, applications of humanized mice in I-O research were usually hindered by several concerns, such as long model development time and considerably high cost.
Here, we describe a human PBMC-based model that could be widely applied for translational I-O studies. This model is comparatively time- and cost-effective with high reproducibility in efficacy studies. It has been used in-house for the evaluations of several I-O therapeutics currently under preclinical and clinical development. BGB-A317 (Tislelizumab), an investigational humanized anti-PD-1 antibody9 , is used as the example to discuss model development, characterization, and possible applications for anti-tumor efficacy analyses.

<table border="0" cellpadding="0" cellspacing="0" style="width:955px;" width="955">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">PBMC separation /cell culture</td>
			<td style="width:211px;"></td>
			<td style="width:193px;"></td>
			<td style="width:143px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Histopaque-1077</td>
			<td style="width:211px;">Sigma</td>
			<td style="width:193px;">10771</td>
			<td style="width:143px;">Cell isolation</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">DMEM</td>
			<td style="width:211px;">Corning</td>
			<td style="width:193px;">10-013-CVR</td>
			<td style="width:143px;">Cell culture</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">DPBS</td>
			<td style="width:211px;">Corning</td>
			<td style="width:193px;">21-031-CVR</td>
			<td style="width:143px;">Cell culture</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">FBS</td>
			<td style="width:211px;">Corning</td>
			<td style="width:193px;">35-076-CV</td>
			<td style="width:143px;">Cell culture</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Penicillin-Streptomycin, Liquid</td>
			<td style="width:211px;">Gibco</td>
			<td style="width:193px;">15140-163</td>
			<td style="width:143px;">Cell culture</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Trypsin-EDTA (0.25%), phenol red</td>
			<td style="width:211px;">Gibco</td>
			<td style="width:193px;">25200-114</td>
			<td style="width:143px;">Cell culture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">Matrigel</td>
			<td style="width:211px;">Corning</td>
			<td style="width:193px;">356237</td>
			<td style="width:143px;">CDX inoculation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">FACS analysis</td>
			<td style="width:211px;"></td>
			<td style="width:193px;"></td>
			<td style="width:143px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Deoxyribonuclease I from bovine pancreas</td>
			<td style="width:211px;">Sigma</td>
			<td style="width:193px;">DN25</td>
			<td style="width:143px;">Sample preparation</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Collagenase Type I</td>
			<td style="width:211px;">Sigma</td>
			<td style="width:193px;">C0130</td>
			<td style="width:143px;">Sample preparation</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-mouse/human CD11b (M1/70) antibody</td>
			<td style="width:211px;">BioLegend</td>
			<td style="width:193px;">101206</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-mouse Ly-6C (HK1.4) antibody</td>
			<td style="width:211px;">BioLegend</td>
			<td style="width:193px;">128008</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-mouse Ly-6G (1A8) antibody</td>
			<td style="width:211px;">BioLegend</td>
			<td style="width:193px;">127614</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human CD8 (OKT8) antibody</td>
			<td style="width:211px;">Sungene Biotech</td>
			<td style="width:193px;">H10082-11H</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human CD279 (MIH4) antibody</td>
			<td style="width:211px;">eBioscience</td>
			<td style="width:193px;">12-9969-42</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human CD3 (HIT3a) antibody</td>
			<td style="width:211px;">4A Biotech</td>
			<td style="width:193px;">--</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">Guava easyCyte 8HT Benchtop Flow Cytometer</td>
			<td style="width:211px;">Millipore</td>
			<td style="width:193px;">0500-4008</td>
			<td style="width:143px;">FACS</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">Tumor/PDX implantation /dosing / measurement</td>
			<td style="width:211px;"></td>
			<td style="width:193px;"></td>
			<td style="width:143px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Cyclophosphamide</td>
			<td style="width:211px;">J&#38;K</td>
			<td style="width:193px;">Cat#419656, CAS#6055-19-2</td>
			<td style="width:143px;">In vivo efficacy</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Disulfiram</td>
			<td style="width:211px;">J&#38;K</td>
			<td style="width:193px;">Cat#591123, CAS#97-77-8</td>
			<td style="width:143px;">In vivo efficacy</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Syringe</td>
			<td style="width:211px;">BD</td>
			<td style="width:193px;">300841</td>
			<td style="width:143px;">CDX inoculation</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Hypodermic needles (14G)</td>
			<td style="width:211px;">Shanghai SA Mediciall &#38; Plastic Instruments Co., Ltd.</td>
			<td style="width:193px;">0.7*32 TW SB</td>
			<td style="width:143px;">PDX inoculation</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Vernier Caliper (MarCal)</td>
			<td style="width:211px;">Mahr</td>
			<td style="width:193px;">16ER</td>
			<td style="width:143px;">Tumor measurement</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">IVC individual ventilated cages</td>
			<td style="width:211px;">Lingyunboji Ltd.</td>
			<td style="width:193px;">IVC-128</td>
			<td style="width:143px;">Animal facility</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">IHC</td>
			<td style="width:211px;"></td>
			<td style="width:193px;"></td>
			<td style="width:143px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Leica ASP200 Vacuum tissue processor</td>
			<td style="width:211px;">Leica</td>
			<td style="width:193px;">ASP200</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:408px;">Leica RM2235 Manual Rotary Microtome for Routine Sectioning</td>
			<td style="width:211px;">Leica</td>
			<td style="width:193px;">RM2235</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Leica EG1150 H Heated Paraffin Embedding Module</td>
			<td style="width:211px;">Leica</td>
			<td style="width:193px;">EG1150 H</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Ariol-Clinical IHC and FISH Scanner</td>
			<td style="width:211px;">Leica</td>
			<td style="width:193px;">Ariol</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human CD8 (EP334) antibody</td>
			<td style="width:211px;">ZSGB-Bio</td>
			<td style="width:193px;">ZA-0508</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human PD1 [NAT105] antibody</td>
			<td style="width:211px;">Abcam</td>
			<td style="width:193px;">ab52587</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:408px;">Anti-human PD-L1 (E1L3N) antibody</td>
			<td style="width:211px;">Cell Signaling Technology</td>
			<td style="width:193px;">13684S</td>
			<td style="width:143px;">IHC</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:408px;">Polink-2 plus Polymer HRP Detection System</td>
			<td style="width:211px;">ZSGB-Bio</td>
			<td style="width:193px;">PV-9001/9002</td>
			<td style="width:143px;">IHC</td>
		</tr>
	</tbody>
</table>

a human peripheral blood mononuclear cell (pbmc) engrafted humanized xenograft model for translational immuno-oncology (i-o) research

The discovery and development of immuno-oncology (I-O) therapy in recent years represents a milestone in the treatment of cancer. However, treatment challenges persist. Robust and disease-relevant animal models are vital resources for continued preclinical research and development in order to address a range of additional immune checkpoints. Here, we describe a human peripheral blood mononuclear cell (PBMC) &#8212; based humanized xenograft model. BGB-A317 (Tislelizumab), an investigational humanized anti-PD-1 antibody in late-stage clinical development, is used as an example to discuss platform set-up, model characterization and drug efficacy evaluations. These humanized mice support the growth of most human tumors tested, thus allowing the assessment of I-O therapies in the context of both human immunity and human cancers. Once established, our model is comparatively time- and cost-effective, and usually yield highly reproducible results. We suggest that the protocol outlined in this article could serve as a general guideline for establishing mouse models reconstituted with human PBMC and tumors for I-O research.

Following the procedures presented here, a PBMC-based humanized xenograft model was successfully established. In brief, CP myeloablation effects in NOD/SCID mice was determined by flow cytometry analysis of neutrophil and monocyte populations post CP and DS treatment (Figure 1). 100 mg/kg CP plus 125 mg/kg DS was determined as the optimal dose and used in later studies as the regimen results in maximum depletion of neutrophils and monocytes without causing severe toxicity to mice. Next, huma...

Watch this Scientific Journal Video about A Human Peripheral Blood Mononuclear Cell PBMC Engrafted Humanized Xenograft Model for Translational Immuno-oncology I-O Research at JoVE.com

A Human Peripheral Blood Mononuclear Cell PBMC Engrafted Humanized Xenograft Model for Translational Immuno-oncology I-O Research

We describe a human peripheral blood mononuclear cell (PBMC) &#8212; based humanized xenograft mouse model for translational immuno-oncology research. This protocol could serve as a general guideline for establishing and characterizing similar models for I-O therapy assessment.

A Human Peripheral Blood Mononuclear Cell (PBMC) Engrafted Humanized Xenograft Model for Translational Immuno-oncology (I-O) Research

The discovery and development of immuno-oncology (I-O) therapy in recent years represents a milestone in the treatment of cancer. However, treatment ...

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Research

JoVE Journal

Cancer Research

14.0K Views.  BeiGene (Beijing) Co., Ltd.. We describe a human peripheral blood mononuclear cell (PBMC) — based humanized xenograft mouse model for translational immuno-oncology research. This protocol could serve as a general guideline for establishing and characterizing similar models for I-O therapy assessment.

Video: A Human Peripheral Blood Mononuclear Cell PBMC Engrafted Humanized Xenograft Model for Translational Immuno-oncology I-O Research

A Mouse Model of Fatigue Induced by Peripheral Irradiation

Cancer-related fatigue (CRF) is a distressing and costly condition that often affects patients receiving cancer treatments, including radiation therapy. Here we describe a method using targeted peripheral irradiation to induce fatigue-like behavior in mice. With appropriate shielding, the irradiation targets the lower abdominal/pelvic region of the mouse, sparing the brain, in an effort to model radiation treatment received by individuals with pelvic cancers. We deliver an irradiation dose that is sufficient to induce fatigue-like behavior in mice, measured by voluntary wheel-running activity (VWRA), without causing obvious morbidity. Since wheel running is a normal, voluntary behavior in mice, its use should have little confounding effect on other behavioral tests or biological measures. Hence, wheel running can be used as a feasible outcome measure in understanding the behavioral and biological correlates of fatigue. CRF is a complex condition with frequent comorbidities, and likely has causes related both to cancer and its various treatments. The methods described in this paper are useful for investigating radiation-induced changes that contribute to the development of CRF and, more generally, to explore the biological networks that can explain the development and persistence of a peripherally-triggered but centrally-driven behavior like fatigue.

We describe a method using targeted peripheral irradiation to induce fatigue-like behavior in mice. The selected non-lethal irradiation dose leads to a week-long reduction in voluntary wheel-running activity.

Cancer-related fatigue (CRF) is a distressing and costly condition that often affects patients receiving cancer treatments, including radiation therapy. ...

Tumor Engraftment in a Xenograft Mouse Model of Human Mantle Cell Lymphoma

B lymphocytes are key players in immune cell circulation and they mainly home to and reside in lymphoid organs. While normal B cells only proliferate when stimulated by T lymphocytes, oncogenic B cells survive and expand autonomously in undefined organ niches. Mantle cell lymphoma (MCL) is one such B cell disorder, where the median survival rate of patients is 4 - 5 years. This calls for the need of effective mechanisms by which the homing and engraftment of these cells are blocked in order to increase the survival and longevity of patients. Therefore, the effort to develop a xenograft mouse model to study the efficacy of MCL therapeutics by blocking the homing mechanism in vivo is of utmost importance. Development of animal recipients for human cell xenotransplantation to test early stage drugs have long been pursued, as relevant preclinical mouse models are crucial to screen new therapeutic agents. This animal model is developed to avoid human graft rejection and to establish a model for human diseases, and it may be an extremely useful tool to study disease progression of different lymphoma types and to perform preclinical testing of candidate drugs for hematologic malignancies, like MCL. We established a xenograft mouse model that will serve as an excellent resource to study and develop novel therapeutic approaches for MCL.

Mantle cell lymphoma (MCL) is a difficult to treat B cell disorder and it is equally difficult to establish a xenograft mouse model of primary MCL to study and develop therapeutics. Here, we describe the successful establishment of MCL xenografts in mice to help understand its underlying biology.

B lymphocytes are key players in immune cell circulation and they mainly home to and reside in lymphoid organs. While normal B cells only proliferate when ...

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

The crosstalk between tumor cells and bone cells in the bone microenvironment is crucial to understanding the mechanism of bone metastasis formation. We developed an in vitro fully human preclinical model of a co-culture of breast cancer cells and monocytes undergoing differentiation towards osteoclasts. We optimized a model of osteoclastogenesis starting from a sample of peripheral blood collected from healthy donors. Peripheral blood mononuclear cells (PBMCs) were first separated by density gradient centrifugation, seeded at a high density and induced to differentiate by adding two growth factors (GFs): receptor activator of nuclear factor-&#954;B ligand (RANKL) and macrophage colony-stimulating factor (MCSF). The cells were left in culture for 14 days and then fixed and analyzed by downstream analysis. In osteolytic bone metastases, one of the effects of cancer cell arrival in bone is the induction of osteoclastogenesis. We thus challenged our model with co-cultures of breast cancer cells to study the differentiation power of cancer cells with respect to GFs. A straightforward way of studying cancer cell-osteoclast interaction is to perform indirect co-cultures based on the use of conditioned medium collected from breast cancer cell cultures and mixed with fresh medium. This mixture is then used to induce osteoclast differentiation. We also optimized a method of direct co-culture in which cancer cells and monocytes undergoing differentiation share the medium and exchange secreted factors. This is a significant improvement over the original indirect co-culture method as researchers can observe the reciprocal interactions of the two cell types and perform downstream analyses for both cancer cells and osteoclasts. This method enables us to study the effect of drugs on the metastatic bone microenvironment and to seed cell lines other than those derived from breast cancer. The model can also be used to study other diseases such as osteoporosis or other bone conditions.

This protocol describes development of an in vitro human preclinical model of osteoclastogenesis from peripheral blood monocytes cultured with breast cancer cell lines to mimic the cancer cell-osteoclast interaction. The model could be used to further our understanding of bone metastasis formation and improve therapeutic options.

The crosstalk between tumor cells and bone cells in the bone microenvironment is crucial to understanding the mechanism of bone metastasis formation. We ...

Automated Multiplex Immunofluorescence Panel for Immuno-oncology Studies on Formalin-fixed Carcinoma Tissue Specimens

Continued developments in immuno-oncology require an increased understanding of the mechanisms of cancer immunology. The immunoprofiling analysis of tissue samples from formalin-fixed, paraffin-embedded (FFPE) biopsies has become a key tool for understanding the complexity of tumor immunology and discovering novel predictive biomarkers for cancer immunotherapy. Immunoprofiling analysis of tissues requires the evaluation of combined markers, including inflammatory cell subpopulations and immune checkpoints, in the tumor microenvironment. The advent of novel multiplex immunohistochemical methods allows for a more efficient multiparametric analysis of single tissue sections than does standard monoplex immunohistochemistry (IHC). One commercially available multiplex immunofluorescence (IF) method is based on tyramide-signal amplification and, combined with multispectral microscopic analysis, allows for a better signal separation of diverse markers in tissue. This methodology is compatible with the use of unconjugated primary antibodies that have been optimized for standard IHC on FFPE tissue samples. Herein we describe in detail an automated protocol that allows multiplex IF labeling of carcinoma tissue samples with a six-marker multiplex antibody panel comprising PD-L1, PD-1, CD68, CD8, Ki-67, and AE1/AE3 cytokeratins with 4&#8242;,6-diamidino-2-phenylindole as a nuclear cell counterstain. The multiplex panel protocol is optimized in an automated IHC stainer for a staining time that is shorter than that of the manual protocol and can be directly applied and adapted by any laboratory investigator for immuno-oncology studies on human FFPE tissue samples. Also described are several controls and tools, including a drop-control method for fine quality control of a new multiplex IF panel, that are useful for the optimization and validation of the technique.

A detailed protocol for a six-marker multiplex immunofluorescence panel is optimized and performed, using an automated stainer for more consistent results and a shorter procedure time. This approach can be directly adapted by any laboratory for immuno-oncology studies.

Continued developments in immuno-oncology require an increased understanding of the mechanisms of cancer immunology. The immunoprofiling analysis of ...

Patient-derived Orthotopic Xenograft Models for Human Urothelial Cell Carcinoma and Colorectal Cancer Tumor Growth and Spontaneous Metastasis

Cancer patients have poor prognoses when lymph node (LN) involvement is present in both high-grade urothelial cell carcinoma (HG-UCC) of the bladder and colorectal cancer (CRC). More than 50% of patients with muscle-invasive UCC, despite curative therapy for clinically-localized disease, will develop metastases and die within 5 years, and metastatic CRC is a leading cause of cancer-related deaths in the US. Xenograft models that consistently mimic UCC and CRC metastasis seen in patients are needed. This study aims to generate patient-derived orthotopic xenograft (PDOX) models of UCC and CRC for primary tumor growth and spontaneous metastases under the influence of LN stromal cells mimicking the progression of human metastatic diseases for drug screening. Fresh UCC and CRC tumors were obtained from consented patients undergoing resection for HG-UCC and colorectal adenocarcinoma, respectively. Co-inoculated with LN stromal cell (LNSC) analog HK cells, luciferase-tagged UCC cells were intra-vesically (IB) instilled into female non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mice, and CRC cells were intra-rectally (IR) injected into male NOD/SCID mice. Tumor growth and metastasis were monitored weekly using bioluminescence imaging (BLI). Upon sacrifice, primary tumors and mouse organs were harvested, weighed, and formalin-fixed for Hematoxylin and Eosin and immunohistochemistry staining. In our unique PDOX models, xenograft tumors resemble patient pre-implantation tumors. In the presence of HK cells, both models have high tumor implantation rates measured by BLI and tumor weights, 83.3% for UCC and 96.9% for CRC, and high distant organ metastasis rates (33.3% detected liver or lung metastasis for UCC and 53.1% for CRC). In addition, both models have zero mortality from the procedure. We have established unique, reproducible PDOX models for human HG-UCC and CRC, which allow for tumor formation, growth, and metastasis studies. With these models, testing of novel therapeutic drugs can be performed efficiently and in a clinically-mimetic manner.

This protocol describes the generation of patient-derived orthotopic xenograft models by intra-vesically instilling high-grade urothelial cell carcinoma cells or intra-rectally injecting colorectal cancer cells into non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mice for primary tumor growth and spontaneous metastases under the influence of lymph node stromal cells, which mimics the progression of human metastatic diseases.

Cancer patients have poor prognoses when lymph node (LN) involvement is present in both high-grade urothelial cell carcinoma (HG-UCC) of the bladder and ...

Patient-derived Heterogeneous Xenograft Model of Pancreatic Cancer Using Zebrafish Larvae as Hosts for Comparative Drug Assessment

Patient-derived tumor xenograft (PDX) and cell-derived tumor xenograft (CDX) are important techniques for preclinical assessment, medication guidance and basic cancer researches. Generations of PDX models in traditional host mice are time-consuming and only working for a small proportion of samples. Recently, zebrafish PDX (zPDX) has emerged as a unique host system, with the characteristics of small-scale and high efficiency. Here, we describe an optimized methodology for generating a dual fluorescence-labeled tumor xenograft model for comparative chemotherapy assessment in zPDX models. Tumor cells and fibroblasts were enriched from freshly-harvested or frozen pancreatic cancer tissue at different culture conditions. Both cell groups were labeled by lentivirus expressing green or red fluorescent proteins, as well as an anti-apoptosis gene BCL2L1. The transfected cells were pre-mixed and co-injected into the 2 dpf larval zebrafish that were then bred in modified E3 medium at 32 &#176;C. The xenograft models were treated by chemotherapy drugs and/or BCL2L1 inhibitor, and the viabilities of both tumor cells and fibroblasts were investigated simultaneously. In summary, this protocol allows researchers to quickly generate a large amount of zPDX models with a heterogeneous tumor microenvironment and provides a longer observation window and a more precise quantitation in assessing the efficiency of drug candidates.

This protocol describes optimization procedures in a virus-based dual fluorescence-labeled tumor xenograft model using larval zebrafish as hosts. This heterogeneous xenograft model mimics the tissue composition of pancreatic cancer microenvironment in vivo and serves as a more precise tool for assessing drug responses in personalized zPDX (zebrafish patient-derived xenograft) models.

Patient-derived tumor xenograft (PDX) and cell-derived tumor xenograft (CDX) are important techniques for preclinical assessment, medication guidance and ...

A Melanoma Patient-Derived Xenograft Model

Accumulating evidence suggests that molecular and biological properties differ in melanoma cells grown in traditional two-dimensional tissue culture vessels versus in vivo in human patients. This is due to the bottleneck selection of clonal populations of melanoma cells that can robustly grow in vitro in the absence of physiological conditions. Further, responses to therapy in two-dimensional tissue cultures overall do not faithfully reflect responses to therapy in melanoma patients, with the majority of clinical trials failing to show the efficacy of therapeutic combinations shown to be effective in vitro. Although xenografting of melanoma cells into mice provides the physiological in vivo context absent from two-dimensional tissue culture assays, the melanoma cells used for engraftment have already undergone bottleneck selection for cells that could grow under two-dimensional conditions when the cell line was established. The irreversible alterations that occur as a consequence of the bottleneck include changes in growth and invasion properties, as well as the loss of specific subpopulations. Therefore, models that better recapitulate the human condition in vivo may better predict therapeutic strategies that effectively increase the overall survival of patients with metastatic melanoma. The patient-derived xenograft (PDX) technique involves the direct implantation of tumor cells from the human patient to a mouse recipient. In this manner, tumor cells are consistently grown under physiological stresses in vivo and never undergo the two-dimensional bottleneck, which preserves the molecular and biological properties present when the tumor was in the human patient. Notable, PDX models derived from organ sites of metastases (i.e., brain) display similar metastatic capacity, while PDX models derived from therapy naive patients and patients with acquired resistance to therapy (i.e., BRAF/MEK inhibitor therapy) display similar sensitivity to therapy.

Patient-derived xenograft (PDX) models more robustly recapitulate melanoma molecular and biological features and are more predictive of therapy response compared to traditional plastic tissue culture-based assays. Here we describe our standard operating protocol for the establishment of new PDX models and the characterization/experimentation of existing PDX models.

Accumulating evidence suggests that molecular and biological properties differ in melanoma cells grown in traditional two-dimensional tissue culture ...

Establishment of Gastric Cancer Patient-derived Xenograft Models and Primary Cell Lines

The use of preclinical models to advance our understanding of tumor biology and investigate the efficacy of therapeutic agents is key to cancer research. Although there are many established gastric cancer cell lines and many conventional transgenic mouse models for preclinical research, the disadvantages of these in vitro and in vivo models limit their applications. Because the characteristics of these models have changed in culture, they no longer model tumor heterogeneity, and their responses have not been able to predict responses in humans. Thus, alternative models that better represent tumor heterogeneity are being developed. Patient-derived xenograft (PDX) models preserve the histologic appearance of cancer cells, retain intratumoral heterogeneity, and better reflect the relevant human components of the tumor microenvironment. However, it usually takes 4-8 months to develop a PDX model, which is longer than the expected survival of many gastric patients. For this reason, establishing primary cancer cell lines may be an effective complementary method for drug response studies. The current protocol describes methods to establish PDX models and primary cancer cell lines from surgical gastric cancer samples. These methods provide a useful tool for drug development and cancer biology research.

The current protocol describes methods to establish patient-derived xenograft (PDX) models and primary cancer cell lines from surgical gastric cancer samples. The methods provide a useful tool for drug development and cancer biology research.

The use of preclinical models to advance our understanding of tumor biology and investigate the efficacy of therapeutic agents is key to cancer research. ...

Isolating Human Peripheral Blood Mononuclear Cells and CD4+ T cells from S&#233;zary Syndrome Patients for Transcriptomic Profiling

Cutaneous T-cell lymphomas (CTCL) are derived from the transformation and uncontrolled proliferation of mature skin-homing T cells, and mycosis fungoides (MF) and S&#233;zary syndrome (SS) represent the most common subtypes. Despite a number of studies on characterizing gene expression, genetic alterations, and epigenetic abnormalities of CTCL, the molecular pathogenesis of MF/SS remains unclear. MF refers to the more common CTCL with a skin-predominance, and is usually limited to skin, whereas&#160;SS is an aggressive leukemic variant of CTCL with widespread skin involvement and is characterized by neoplastic distribution mainly involving blood, skin, and lymph node. Focusing on clinical practice, the identification of gene expression biomarkers has&#160;enormous potential to improve diagnosis and treatment of MF/SS. Indeed, recent transcriptomic studies have identified potential diagnostic biomarkers from differences in gene expression between normal and malignant T cells, which may improve our understanding of SS biology, and reveal potential therapeutic targets. This manuscript describes a detailed reproducible protocol for the isolation of peripheral blood mononuclear cells from fresh whole blood from patients diagnosed with SS, selection of CD4+ memory T cells (CD4+CD45RO+ T cells), chemical stimulation, and preparation of RNA suitable for transcriptomic profiling to discover novel prognostic molecular markers to gain additional insight in disease etiology. The stimulation using chemical agonist to activate nuclear regulation provides more specific assessment for pathways important in the dynamic transcription regulation and gene expression and eliminates confounding defects that may arise from upstream signaling defects arising from TCR antigen loss at the cell membrane. The data obtained from comparison of transcriptome of unstimulated to stimulated SS T cells unmasks functional regulatory gene expression defects not evident from analysis of quiescent unstimulated cells. Furthermore, the method outlined from this approach can be adapted for studying T cell gene expression defects in other T cell immune diseases.

We present a simple protocol for the isolation of peripheral blood mononuclear cells from whole blood obtained from patients diagnosed with S&#233;zary Syndrome, followed by selection of CD4+ T cells, their stimulation with phorbol12-myristate13-acetate and A23187 ionophore, and preparation of RNA for transcriptomic profiling.

Cutaneous T-cell lymphomas (CTCL) are derived from the transformation and uncontrolled proliferation of mature skin-homing T cells, and mycosis fungoides ...

Circulating Tumor Cell Lines: an Innovative Tool for Fundamental and Translational Research

Metastasis is a leading cause of cancer death. Despite improvements in treatment strategies, metastatic cancer has a poor prognosis. We thus face an urgent need to understand the mechanisms behind metastasis development, and thus to propose efficient treatments for advanced cancer. Metastatic cancers are hard to treat, as biopsies are invasive and inaccessible. Recently, there has been considerable interest in liquid biopsies including both cell-free circulating deoxyribonucleic acid (DNA) and circulating tumor cells from peripheral blood and we have established several circulating tumor cell lines from metastatic colorectal cancer patients to participate in their characterization. Indeed, to functionally characterize these rare and poorly described cells, the crucial step is to expand them. Once established, circulating tumor cell (CTC) lines can then be cultured in suspension or adherent conditions. At the molecular level, CTC lines can be further used to assess the expression of specific markers of interest (such as differentiation, epithelial or cancer stem cells) by immunofluorescence or cytometry analysis. In addition, CTC lines can be used to assess drug sensitivity to gold-standard chemotherapies as well as to targeted therapies. The ability of CTC lines to initiate tumors can also be tested by subcutaneous injection of CTCs in immunodeficient mice.
Finally, it is possible to test the role of specific genes of interest that might be involved in cancer dissemination by editing CTC genes, by short hairpin ribonucleic acid (shRNA) or Crispr/Cas9. Modified CTCs can thus be injected into immunodeficient mouse spleens, to experimentally mimic part of the metastatic development process in vivo.
In conclusion, CTC lines are a precious tool for future research and for personalized medicine, where they will allow prediction of treatment efficiency using the very cells that are originally responsible for metastasis.

Culturing CTCs allows a deeper functional characterization of cancer, through assaying specific marker expression, and assessing drug resistance and the ability to colonize the liver among other possibilities. Overall, CTC culture could be a promising clinical tool for personalized medicine to improve patient outcome.

Metastasis is a leading cause of cancer death. Despite improvements in treatment strategies, metastatic cancer has a poor prognosis. We thus face an ...