TIL Therapy Combined With Pembrolizumab for Advanced or Metastatic Refractory Stomach and Esophageal Cancer

Inclusion criteria

• Age: 16 years to 90 years
• Histologically diagnosed as primary/relapsed/metastasized Cancer
• Expected life span more than 3 months
• Karnofsky≥60% or ECOG score 0-2
• Test subjects have failed standard treatment regimens, or there are no standard treatment regimens available.
• Test subjects must have tumor regions eligible for biopsy or resection, or malignant body fluid where TILs can be isolated
• At least 1 evaluable tumor lesion
• Hematology and Chemistry（within 7 days prior to enrollment）:
• Absolute count of white blood cells≥2.5×10\^9/L
• Absolute count of neutropils≥1.5×10\^9/L
• Absolute count of lymphocytes ≥0.7×109/L
• Platelet count≥100×10\^9
• hemoglobin≥90 g/L
• Activated partial thromboplastin time (APTT) ≤1.5xULN (Unless received anticoagulant therapy within the previous 3 days)
• International normalized ratio (INR) ≤1.5xULN (Unless received anticoagulant therapy within the previous 3 days)
• Serum creatinine ≤1.5mg/dL(or ≤132.6μmol/L), or clearance rate≥50mL/min
• Serum ALT/AST ≤3×ULN(subjects with liver metastasis ≤3×ULN)
• Totol bilirubin≤1.5×ULN
• No absolute or relative contraindications to operation or biopsy
• Test subjects with child-bearing potential must be willing to practice approved highly effective methods of contraception at the time of informed consent and continue within 1 year after the completion of lymphodepletion
• Any malignant tumor-targeting therapies, including radiotherapy, chemotherapy, and biologics must cease 28 days before obtaining TILs
• Be able to understand and sign the informed consent document;
• Be able to stick to the follow-up visit plan and other requirements in the agreement.

Exclusion criteria

• Need glucocorticoid treatment, and daily dose of Prednisone greater than 15mg (or equivalent doses of hormones) or outoimmune diseases requiring immunomodulatory treatment
• Forced expiratory volume in one second (FEV1) less than 2L, diffusing capacity of the lung for carbon monoxide (DLCO) (calibrated) less than 40%
• Significant cardiovascular anomalies according to any of the following definitions:
• New York Heart Association (NYHA) Grade III or IV congestive heart failure, clinically significant
• Low blood pressure, uncontrollable symptomatic coronary artery diseases, or ejection fraction less than 35%; Severe cardiac rhythm and conduction anomaly, such as ventricular arrhythmia requiring clinical intervention, second-third degree atrioventricular conductive block, etc.
• Human immunodeficiency virus (HIV) infection or anti-HIV antibody positive, active HBV or HCV infection (HBsAg positive and/or anti-HCV positive), syphilis infection or Treponema pallidum antibody positive.
• Severe physical or mental diseases;
• Have a systemic active infection requiring treatment, or have positive blood cultures(or imaging evidence of infection).
• Having been treated within a month or being treated now with other medicines, or other biologic therapy, chemo-or radiotherapy.
• History of allergy to chemical compounds consisting of chemical and biological substances resembling cell therapy.
• Having received immunotherapy and developed an irAE level greater than Level 3.
• Previous anti-tumor treatment AE did not return to CTCAE5.0 version grade 1 or below (toxicity considered by the investigator as non-safety concerns like alopecia excluded).
• Females in pregnancy or lactation. History of organ transplantation, allogeneic stem cell transplantation, and renal replacement therapy.
• Researchers consider the test subject as having a history of other severe systemic diseases, or other reasons inappropriate for the clinical study.