Maris 2022: Jami'ar Texas MD Anderson Masu binciken Cibiyar Cancer sun gano cewa axi-cel, mai karɓar anti-CD19 chimeric antigen receptor (CAR T-cell therapy), magani ne mai aminci kuma mai inganci ga marasa lafiya tare da babban haɗarin babban B-cell. lymphoma (LBCL), ƙungiyar da ke cikin matsananciyar buƙatar sabbin jiyya masu inganci.
An gabatar da waɗannan binciken ne a taron shekara-shekara na 2020 na Society of Hematology na Amurka.
A al'adance, kusan rabin marasa lafiya tare da LBCL mai haɗari mai haɗari, rukuni na cutar wanda marasa lafiya ke da lymphoma sau biyu ko sau uku ko ƙarin abubuwan haɗari na asibiti da aka gano ta International Prognostic Index (IPI), ba su sami ciwo na dogon lokaci ba. gafara tare da daidaitattun hanyoyin kulawa kamar chemoimmunotherapy.
Wannan gwaji yana wakiltar mataki zuwa yin CAR T cell far a first-line treatment option for patients with aggressive B-cell lymphoma,” said Sattva S. Neelapu, M.D., professor of lymphoma and Myeloma. “At the moment, patients with newly diagnosed aggressive B-cell lymphoma get chemotherapy for about six months. CAR T cell far, idan an yi nasara, na iya sanya shi jiko na lokaci ɗaya tare da magani da aka kammala a cikin wata ɗaya.
Dangane da mahimmin bincike na ZUMA-1, Axi-cel yana da lasisi a halin yanzu don kula da mutanen da ke da LBCL da suka koma baya ko kuma sun riga sun sami layi biyu ko fiye na tsarin jiyya. Gwajin ZUMA-12 shine alamar buɗewa na Phase 2, hannu ɗaya, gwaji mai yawa wanda ya gina akan binciken da aka yi na gwajin ZUMA-1 don tantance amfani da axi-cel a matsayin jiyya na farko ga marasa lafiya tare da babban haɗarin LBCL. .
Bisa ga binciken wucin gadi na ZUMA-12, kashi 85 cikin 74 na marasa lafiya da aka yi musu magani tare da axi-cel sun sami amsa gabaɗaya, kuma 9.3% sun sami cikakkiyar amsa. Bayan bin tsaka-tsaki na watanni 70, XNUMX% na marasa lafiya da aka ɗauka sun nuna ci gaba da amsawa a yanke bayanan.
Rage ƙididdige yawan adadin jinin jini, ƙwaƙwalwar ƙwaƙwalwa, anemia, da cytokine saki ciwo sune mafi yawan illolin da ke da alaƙa da maganin axi-cel. A lokacin da aka yi nazarin bayanan, an warware duk munanan abubuwan da suka faru.
Bugu da ƙari kuma, idan aka kwatanta da lokacin da aka samar da samfuran rigakafi daga marasa lafiya waɗanda suka riga sun karɓi layukan chemotherapy da yawa, matakin kololuwar ƙwayoyin CAR T da ke cikin jini, da kuma faɗaɗa tantanin CAR T na tsakiya, sun kasance mafi girma a cikin wannan gwaji na layin farko CAR T cell far.
Neelapu ya kara da cewa "Wannan lafiyar tantanin halitta ta T tana iya haɗawa da mafi girman tasirin warkewa, wanda ke haifar da mafi kyawun sakamakon haƙuri."
Bayan kyakkyawan sakamako na wucin gadi na ZUMA-12, masu binciken sun yi shirin ci gaba da bin diddigin majiyyatan don tabbatar da cewa halayensu na maganin sun dade.
“A randomised clinical trial would be required to definitely demonstrate that CAR T cell therapy is superior to existing standard of care with chemoimmunotherapy in these high-risk patients if the responses are persistent after prolonged follow-up,” Neelapu said. It also begs the question of whether CAR T cell treatment should be tested in intermediate-risk patients with big B-cell lymphoma.
