Devices and Manufacturing Equipment Used for Production of Immune Cell Therapy and Cell Expansion: Scientific/User Issues

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1 Devices and Manufacturing Equipment Used for Production of Immune Cell Therapy and Cell Expansion: Scientific/User Issues Bruce Levine, Ph.D. Department of Pathology and Laboratory Medicine University of Pennsylvania

2 Activated T Cell Therapy for Infection or Malignancy Cell Processing 6. Quality Control Reinfuse cells 1. Obtain cells from patient and enrich or isolate particular cells of interest Bead 5. Remove beads and wash cells 2. Stimulate cells to grow 4. Large scale cell expansion 3. Insert potentially therapeutic genes into cells

3 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with anti- CD3/anti-CD28 Dynal Beads, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

4 Patients enrolling in clinical trials or their donors undergo leukapheresis at the Hospital Blood Bank.

5 Particular populations of cells can be enriched or isolated in the laboratory.

6 Gambro Elutra

7 Increasing rate of Buffer Flow

8 Gambro Elutra for Monocyte Isolation

9 Gambro Elutra Procedure modified for optimal lymphocyte collection based on company experience with settings for optimal monocyte collection Company provided: multi-day technical training Feedback on data collected during validation runs Letter of cross-reference to DMF

10 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with anti- CD3/anti-CD28 Dynal Beads, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

11 T Cell Activation with Antibody Coated Beads J Immunol 1997; 159: 5921 Science 1997; 276: 273 Immunol.. Rev. 1997; 160: 43 Mol. Ther. 2004; 9; 9; 902

12 Polyclonal Replicative Potential of Adult CD4 T Cells In Vitro Total Cells 1E+20 1E+19 1E+18 1E+17 1E+16 1E+15 1E+14 1E+13 1E+12 1E+11 1E+10 1E+09 1E+08 1E+07 1E+06 IL-2 Added Day 49 No IL-2 Day 50 Exponential growth (days) Mean log10 growth (fold) 9-12 Mean Pop Doubling Day Nc xls

13 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with cell-based aapc s, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

14 Off-the-Shelf Dendritic Cell Substitute: reagent for the in vitro expansion of T lymphocytes

15 Polyclonal T Cell Stimulation with LV-aAPC 10,000 RADS CD28 28 TCR CD8 CD64 CD3 Polyclonal stimulation CD8 CD8 CD8 CD8 CD8 CD8 Polyclonal Stimulation LV LV library: library: costim costim molecules molecules cytokines cytokines 3 CD64 LV-aAPC (KT64)

16 Next Generation: Cell-Based Artificial APC LV-aAPC T Cell 2 microns Suhoski et al. Molecular Therapy 15:981-8, 2007

17 Baxter Lifecell Flasks- gas permeable bags

18 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with anti- CD3/anti-CD28 Dynal Beads, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

19 WAVE Biotech Bioreactor

20 WAVE Feed and Harvest via Perfusion

21

22 Small (0.1 to 5 liter) Wave Bioreactor SYSTEM 2/10

23 Wave 2/10 perfusion w/pinch valves

24

25 WAVE Parameters Day of seeding after transduction and vector wash Cell concentration Rock rate, rock angle Media perfusion rate Media formulation (ARV, foaming, IL-2, supplements Nutrient usage, metabolite production

26 Small Scale Flask vs WAVE Population Doubling Level Small Scale WAVE PDL Days of Culture

27 Lifecell Static vs WAVE Population Doubling Level PDL C1-Wave C2-Lifecell Day of Culture

28 WAVE Bioreactor Company provided: some technical training Protocols, manuals, references available on website Letter of cross-reference to DMF References directly applicable to CD3/CD28 stimulated T cells Hami LS, Green C, Leshinsky N, Markham E, Miller K, Craig S: GMP production and testing of Xcellerated T Cells for the treatment of patients with CLL. Cytotherapy (2004); 6(6): Hami L, et.al. Comparison of a Static Process and a Bioreactor-based Process for the GMP Manufacture of Autologous Xcellerated T Cells for Clinical Trials. BioProcessing (2003); 2(6):1-10.

29 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with anti- CD3/anti-CD28 Dynal Beads, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

30 Baxter MaxSep The magnetic beads used to grow the T cells must be removed prior to reinfusing the cells to the patient. The cell culture is passed Baxter MaxSep magnets where the beads are retained and the cells flow through.

31 Activated T Cell Processing Flow Day 0 Leukocyte Apheresis Gambro Elutra depletion of monocytes Day ~10 Remove Beads (Baxter Maxsep) Day 3 to 5 Seed WAVE Bioreactor Stimulation with anti- CD3/anti-CD28 Dynal Beads, seed Baxter gas permeable culture bag Harvester (Baxter Fenwal) QC Testing QA Review Final Activated T Cell Product

32 Fenwal (former subsidiary of Baxter) Harvester Built on apheresis machine CS3000 frame. Concentrates and washes cells at up to 700mls per minute continuous flow, we run at mls per minute to increase cell yield. cells per minute depends on starting concentration. If static 1E+06/ml = 3-7E+09 cells/minute, not including washes. If 10E+06/ml = 3-7E+09 cells/minute, not including washes. closed system disposable set. Cells concentrated in belt chamber, end volume ~250mls

33 Fenwal Harvester Reservoir set, Manifold set, and Harvester set

34 The volume of the cell culture can be as much as 10 liters (2.5 gallons) or more depending on cell dose. The cells are washed out of culture media, concentrated and resuspended into 250mls (8 oz) infusible solution.

35 Fenwal Harvester Company initially provided: some technical training Repair/PM service Manual Current status No longer manufactured (~10 years) No technical, scientific, regulatory support Kits no longer manufactured (mid-2008?) Absence of comparable devices

36 Autotransfusion devices as an alternative? Different requirements for 351 vs 361? Following validation, submit data in IND annual report or ammendment?

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