Ako Čína vedie vývoj terapie CAR T-bunkami?

Vývoj CAR T bunkovej terapie v Číne
Počet testov terapie CAR-T v Číne prekonal do roku 2018 počet štúdií v Spojených štátoch v dôsledku tohto prosperujúceho ekosystému. K júnu 2022 čínske spoločnosti vykonali 342 klinických skúšok CAR-T. Malignity línie B patrili medzi najčastejšie prejavy. Dva produkty CAR-T majú komerčné využitie, Yescarta v júni 2021 a Relma-cel v septembri 2021, medzi mnohými kandidátmi na lieky.

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2023 marca: CAR-T-cell therapy is a novel and effective cancer treatment modality that has revolutionized the treatment of cancer, particularly blood cancers. This therapy achieves a therapeutic effect or cures disease by repairing or reconstructing genetic materials that have been damaged. Since Roseberg first isolated tumour-infiltrating lymphocytes (TILs) to treat melanoma in 1986, the development of modified T cell therapy has gained significant momentum. Since the FDA approved the first CAR-T terapia, Kymriah, in 2017, the CAR-T market has grown rapidly. According to Frost & Sullivan, the global CAR-T market size is projected to increase from USD 10 million in 2017 to USD 1.08 billion in 2020, and then to USD 9.05 billion in 2025, with a compound annual growth rate (CAGR) of 55% from 2019 to 2025, making it the fastest-growing segment of the global cell and gene therapies (CGT) market.

CAR-T therapy is one of CGT therapy’s subsegments. On the basis of the origin of T cells, CAR-T therapy can be divided into two categories. Autologous CAR-T-cell therapy, which employs the patient’s own immune cells, and allogeneic CAR-T-cell therapy, which employs T cells from donor blood or occasionally umbilical cord blood,. The majority of CAR-T therapies are autologous CAR T-bunkové terapie, which typically involve the steps outlined below:

Možno si prečítate: CAR T bunková terapia v Číne

1) T bunky sa odoberú z pacientovej periférnej krvi;

2) Viral vectors such as AAV then modify T cells with CAR genes that are directed against a specific cell-surface protein on cancer cells;

3) The modified CAR-T cells population is expanded according to the patient’s weight;

4) The expanded CAR-T cells are then reinfused back into the patient. The entire manufacturing procedure lasts between one and three weeks and requires GMP compliance in an ultra-clean environment.

CAR-T therapy has reached a level of success that has never been seen before in treating B-cell cancers that are resistant to or refractory to chemotherapy, including R/R, B-ALL, NHL, and MM. The effectiveness of treating solid tumours is also currently under investigation. CD19-targeting and BCMA-targeting CAR-T therapies achieve the greatest clinical success among all CAR-T therapies. Four of the six CAR-T therapies approved by the FDA target CD19, while two target BCMA.

The most significant advantage over small and large molecule drugs is that patients can replace lifelong treatment of chronic disease with a limited number of doses, or even just one.

The United States pioneered the development of the CAR-T industry. However, by the middle of the 2010s, China had learned quickly and was catching up to the United States. Principally, the key drivers can be attributed to the Chinese government’s support for the development of a CGT ecosystem comprised of biotech companies, academics, healthcare providers, investors, and the government. Following the prioritization of biotechnology in the thirteenth five-year plan, the Chinese government emphasized its strategy to accelerate the innovation and development of biotech industries, including cell therapy. In addition, pertinent ministries have issued encouraging action regulations.

Po zverejnení stanovísk Štátnej rady k reforme systému hodnotenia, previerky a schvaľovania liekov a zdravotníckych pomôcok v roku 2015 sa aktivizoval aj kapitálový trh. Pri zloženom ročnom raste 45 % čínske spoločnosti zaoberajúce sa bunkovou terapiou získali v rokoch 2.4 až 2018 finančné prostriedky vo výške približne 2021 miliardy USD.

Možno si prečítate: Náklady na CAR T bunkovú terapiu v Číne

The number of CAR-T therapy trials in China surpassed those in the United States by 2018 as a result of this thriving ecosystem. As of June 2022, Chinese companies had conducted 342 clinical CAR-T trials. Malignancies in the B lineage were among the most prevalent manifestations. Two CAR-T products have commercial applications: Yescarta v júni 2021 a Relma-cel in September 2021, among numerous drug candidates.

Podľa Frost & Sullivan sa predpokladá, že domáci trh CAR-T vzrastie z 0.2 miliardy CNY v roku 2021 na 8 miliárd CNY v roku 2025 a potom na 28.9 miliardy CNY v roku 2030, pri CAGR 45 % od roku 2022 do roku 2030. Napriek tomu. skutočnosť, že čínsky trh CAR-T je stále v plienkach, existuje silná hnacia sila.

Although the two approved CAR-T products are from Sino-US joint ventures Fosun Kite and JW Terapeutics, domestic players have made breakthroughs and caught up to global players in recent years. Legend Biotech, IASO Biotherapeutics, and CARsgen Therapeutics all obtained NDA approval for their BCMA CAR-T products, establishing them as the leaders in BCMA CAR-T therapy. CD19 CAR-T products are a focus for Juventas Therapeutics, Gracell Biotechnologies, Hrain Biotechnology, ImunoPharm, Shanghai Cell Therapy Group, and numerous domestic companies. Juventas Therapeutics is the leader in Chinese CD19 CAR-T terapia now that the NMPA has accepted its NDA for CNCT19. CARsgen Therapeutics is a global leader in solid tumours, and CT041 is the first CAR-T candidate for treating solid tumours to enter Phase II klinických štúdiách. Bioheng Biotech a BRL Biotech (čínsky: ) vytvárajú nové alogénne trhy CAR-T.

Možno si prečítate: CAR T bunková terapia pre mnohopočetný myelóm v Číne

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Ľudská terapia CAR T-bunkami prináša revolúciu v liečbe rakoviny genetickou modifikáciou vlastných imunitných buniek pacienta, aby sa zamerali na rakovinové bunky a zničili ich. Využitím sily imunitného systému tela ponúkajú tieto terapie silnú a personalizovanú liečbu s potenciálom dlhotrvajúcej remisie pri rôznych typoch rakoviny.

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Syndróm uvoľňovania cytokínov (CRS) je reakcia imunitného systému, ktorá sa často spúšťa určitými spôsobmi liečby, ako je imunoterapia alebo terapia CAR-T bunkami. Zahŕňa nadmerné uvoľňovanie cytokínov, čo spôsobuje symptómy od horúčky a únavy až po potenciálne život ohrozujúce komplikácie, ako je poškodenie orgánov. Manažment si vyžaduje starostlivé monitorovanie a intervenčné stratégie.

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