Immunoterapie in die behandeling van kanker
Cancer CAR-NK therapy has an effective rate of 73%, and is being recruited in domestic clinical trials.
Immunotherapy has revolutionized the way cancer is treated. Cancer immunotherapy is divided into two categories: one is immune checkpoint inhibitors, and PD-1, PD-L1 and CTLA-4 have been approved for the treatment of a variety of cancers. And the 2018 Nobel Prize in Physiology or Medicine awarded the contribution of the development of immune checkpoint inhibitors to humans.
Die ander is sellulêre immunoterapie, waarin die chimeric antigen receptor CAR-T therapy is the most rapidly progressing one. In 2017, the US Food and Drug Administration (FDA) approved two CAR-T cell therapies, Yescarta and Kymriah, which mainly target hematological tumors, leukemias and limfome.
CAR T-selterapie
CAR-T therapy has a long way to go to treat solid tumors, so scientists have begun to seek other cellular immunotherapies to treat cancer, and natural killer (NK) cell therapy is one of the most promising methods. The success of CAR-T cell therapy has stimulated enthusiasm for modifying NK cells with CAR genes to enhance their tumor-killing ability.
Recently, the results of a phase I / IIa trial of the MD Anderson Cancer Center in the United States announced that CD19-targeted umbilical cord blood chimeric antigen receptor natural killer cell therapy (CAR-NK) has achieved a clinical response. No major toxicities were observed in patients with refractory or refractory nie-Hodgkin se limfoom (NHL) and chronic lymphocytic leukemia (CLL).
CAR-NK selterapie navorsingsdata
Die resultate van die verhoor is gister in die New England Journal of Medicine gepubliseer. Van die 11 pasiënte wat aan die studie deelgeneem het, het 8 (73%) op die behandeling gereageer, en 7 van hulle het volledig gereageer, wat beteken dat hulle nie meer tekens van kanker getoon het tydens 'n mediaanopvolg van 13.8 maande nie en dat geen pasiënte selle ervaar het nie Faktorvrystellingsindroom of neurotoksisiteit.
Die reaksie op CD19 CAR-NK selterapie was beduidend binne 1 maand na die infusie, en die aanhoudendheid van hierdie selle is steeds binne 1 jaar na die infusie opgespoor.
Korrespondentskrywer Katy Rezvani, professor in stamseloorplanting en selterapie, het gesê: “Ons word aangemoedig deur die resultate van die kliniese proef, wat verdere kliniese studies sal uitvoer om die potensiaal van allogene CAR-NK-selle afkomstig van koordbloed te bestudeer as 'n pasiënt in nood Behandelingsopsies. '
By die MD Anderson Cancer Center is NK-selle geïsoleer van geskenkte naelstringbloed en geneties ontwerp om die vereiste CAR uit te druk, wat kanker-spesifieke teikens kan identifiseer. CAR-NK-selle moet ook "toegerus" word met IL-15, 'n immuun seinmolekule wat ontwerp is om die verspreiding en oorlewing van die sel te verbeter.
In hierdie studie is CAR-NK-selle allogenies, wat beteken dat hierdie selle geneem word van gesonde skenkers wat nie met die pasiënt verband hou nie, nie van die pasiënt self nie. Daarom kan CAR-NK-selle vooraf vervaardig en geberg word vir onmiddellike gebruik. Daarenteen moet CAR-T-selle wat tans in die handel beskikbaar is, 'n kweekproliferasieproses van meer as een week gebruik om T-selle te produseer wat geneties vervaardig is op grond van die pasiënt se eie gene.
CAR-NK-selle het veelvuldige voordele bo CAR-T-selle
First, unlike CAR-T cells, CAR-NK cells retain the inherent ability to recognize and target tumor cells through their natural receptors, so that when CAR-NK targeted therapy is used, tumor cells are less likely to escape killing.
Second, CAR-NK cells do not undergo immune rejection for days to weeks. As a result, they have not shown the same safety issues in many CAR-T clinical trials, such as the absence of sitokienvrystellingsindroom.
Uiteindelik benodig NK-selle nie streng HLA-aanpassing nie en het dit nie die potensiaal om graft-versus-gasheer-siekte te veroorsaak nie, wat 'n belangrike risiko vir CAR-T-immunoterapie is.
