Imdhíteiripe i gcóireáil ailse
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.
Is é an ceann eile immunotherapy cheallacha, ina bhfuil an 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 limféime.
CAR T Teiripe cille
CAR-T therapy has a long way to go to treat solid tumors, so scientists have begun to seek other cellular imdhíteiripe 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 liomfóma neamh-Hodgkin (NHL) and chronic lymphocytic leukemia (CLL).
Sonraí taighde teiripe cille CAR-NK
Foilsíodh torthaí na trialach inné san New England Journal of Medicine. As na 11 othar a ghlac páirt sa staidéar, d’fhreagair 8 (73%) an chóireáil, agus d’fhreagair 7 gcinn acu go hiomlán, rud a chiallaíonn nár léirigh siad comharthaí ailse a thuilleadh ag meántréimhse leantach de 13.8 mí, agus nach raibh cealla ag aon othar Siondróm scaoileadh fachtóra nó néarthocsaineacht.
Bhí an fhreagairt ar theiripe cille CD19 CAR-NK suntasach laistigh de mhí tar éis an insileadh, agus braitheadh marthanacht na gcealla seo fós laistigh de bhliain amháin tar éis an insileadh.
Dúirt an t-údar comhfhreagrach Katy Rezvani, Ollamh le Trasphlandú Gaschealla agus Teiripe Cealla: “Táimid spreagtha ag torthaí na trialach cliniciúla, a dhéanfaidh staidéir chliniciúla bhreise chun staidéar a dhéanamh ar acmhainneacht cealla CAR-NK díorthaithe fola corda allogeneic mar othar i ngátar Roghanna cóireála. “
Ag Ionad Ailse MD Anderson, rinneadh cealla NK a scaradh ó fhuil chorda imleacáin deonaithe agus rinneadh innealtóireacht ghéiniteach orthu chun an CAR riachtanach a chur in iúl, ar féidir leo spriocanna a bhaineann go sonrach le hailse a aithint. Ní mór cealla CAR-NK a bheith “feistithe” le IL-15, móilín comharthaíochta imdhíonachta atá deartha chun iomadú agus marthanacht cille a fheabhsú.
Sa staidéar seo, tá cealla CAR-NK uilechineálach, rud a chiallaíonn go dtógtar na cealla seo ó dheontóirí sláintiúla nach bhfuil gaolmhar leis an othar, ní leis an othar féin. Dá bhrí sin, tá an cumas ag cealla CAR-NK a mhonarú agus a stóráil roimh ré lena n-úsáid láithreach. I gcodarsnacht leis sin, ní mór do chealla CAR-T atá ar fáil go tráchtála faoi láthair próiseas iomadú cultúir il-seachtaine a úsáid chun cealla T a tháirgeadh a ndéantar innealtóireacht ghéiniteach orthu bunaithe ar ghéinte an othair féin.
Tá buntáistí iomadúla ag cealla CAR-NK thar chealla CAR-T
First, unlike CAR-T cells, CAR-NK cells retain the inherent ability to recognize and target meall 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 siondróm scaoileadh cytokine.
Mar fhocal scoir, ní éilíonn comhoiriúnú docht HLA do chealla NK agus níl an cumas acu galar graft-versus host a chur faoi deara, atá ina riosca tábhachtach d’imdhíoniteiripe cille CAR-T.
