March 2022: Chimurenga nzira kuti CAR-T Cell kurapa ine mukana wekupidigura izvo zvave zvekurapa axiom: kuti kurapwa kunoshamisa mhedzisiro pamamota kunouya nekurasikirwa kwenjodzi dzakakura kuchengetedzeka kwemurwere.
Varwere vakarapwa neshanduro yakagadziridzwa zvishoma yeCAR-T yakatenderwa vakawana zvakanakira zvakafanana nezvidzidzo zvekare, asi pasina zvinowanzoitika zvinokonzeresa izvo dzimwe nguva zvinoendesa varwere kuchipatara zvinoda kurapwa kunodhura.
Zvinoenderana nedata rakaburitswa nguva pfupi yadarika, kutongwa kwakangonyoresa vanhu makumi maviri nevashanu muChina. Vanamazvikokota vanotenda kuti kana zvakawanwa zvichigona kudzokororwa, kutenderera zvishoma kwema molecular kunogona kuita kuti CAR-T ive yakachengeteka uye kuwanikwa zviri nyore.
"Izvi zvinoita kunge zvinovimbisa," akadaro Jill O'Donnell-Tormey, CEO weCancer Research Institute, sangano risingabatsiri. "Zviripachena, kwave kutanga kwemutambo, asi mhinduro yavakawana kubva kuvanhu makumi maviri nevashanu vavakaona kusvika pari zvino inoshamisa."
Mishonga yeCAR-T inoitwa nekutora masero emuviri emurwere, achiachinja kuti anange mamota, woabaya jekiseni nezvinhu zvinokurudzira kuzvidzivirira kwemuviri kupinda muhondo. Vesainzi vakatarisa pachikamu chekupedzisira mumaitiro ekugadzira mushonga wakachengeteka.
Vakatanga neNovartis 'Kymriah, iyo yakatenderwa kurapa marudzi maviri eropa, uye ndokugadzira iwo ega analogues, imwe neimwe yakasonanidzwa pamwe neinoti siyanei amino acid kutevedzana. Vakaona chimwe chinhu chinonakidza pavakayedza shanduko idzi mumakonzo: Imwe yeCAR-Ts yakagadziridzwa yakakwanisa kuuraya maseru egomarara pasina kukonzeresa mhinduro yekudzivirira muviri kana kuunza kuzvimba kwehuropi, izvo zviviri zvezvakanyanya kukosha mhedzisiro yekurapwa kwesero.
It also passed human testing. The altered Kymriah caused no major cases of cytokine release syndrome, an immune flareup frequent in CAR-T cells, and no neurotoxicity, according to the study published in Nature Medicine. In Novartis’ published research, however, more than half of the patients had cytokine release, and around a quarter had neurological issues.
Dr. Si-Yi Chen, purofesa weimmunology paYunivhesiti yeSouthern California uye munyori mukuru webepa, akati, "Ichi chakatishamisa zvikuru kwatiri." Vaishanda naChen vakashamiswawo nazvo.
Iyo yakagadziridzwa CAR-T yaitaridzika kunge yakawana imunological inotapira nzvimbo, inokwezva inongokwana macytokines kuti ave nemhedzisiro pagomarara pasina kukonzeresa. Nekudaro, hazvizivikanwe kuti sei zvakadaro. Zvinogoneka kuti maCAR-T ane rezinesi akaita seKymriah neGiriyedhi Sainzi 'Yescarta ane simba rakawandisa, uye kuti kurapa kushoma kunogona kuwana mhedzisiro imwe chete nenjodzi shoma. Inogonawo kunge iri nyaya yetsaona.
Dr. Loretta Nastoupil, chief of the lymphoma department at MD Anderson Cancer Center in Houston, said, “I would look at this with a bit of caution, or cautious hope.” “Understanding the processes behind its efficacy will be crucial.
Kune zvakare nyaya yekugara kwenguva refu, iyo inodarika iyo yakakosha sainzi. Yakatenderwa CAR-Ts inowanzokonzera kuregererwa kwenguva refu. Dr. Michel Sadelain, chiremba wekudzivirira zvirwere paChirangaridzo Sloan Kettering Cancer Center, akati nzira yaChen inoratidzika kunge yakachengeteka munguva pfupi, asi inofanira kuonekwa kana migumisiro yacho icharamba iripo.
"Dambudziko nderekuti kana ukadzikisira CAR, zvakaipa kana ukadzikisa kugadzirwa kwe cytokine, asi ungaderedza kurapa?" Sadelain akatsanangura. “Pano ndipo pane mubvunzo mukuru. “Nguva chete ndiyo ichataura,” anodaro munyori wacho.
Kunze kwezvinetswa izvi, tarisiro yeCAR-T yakachengeteka inogona kuwedzera zvakanyanya kuwaniswa kwekurapa kunowanikwa chete kumahombe egomarara. Mamiriro ekurapwa anowanzoda rubatsiro rwenyanzvi nehunyanzvi husingawanikwe muzvipatara zvemunharaunda, izvo zvinoganhurira huwandu hwevarwere vanogona kurapwa.
Zvadaro pane mutengo. Mutengo wekurapwa kweCAR-T unopfuura $370,000 pakurapa, kunyangwe izvo zvisingasanganisire mutengo wekuchipatara kana mishonga inodzvinyirira. Maererano naAvery Posey, an immunotherapy muongorori paYunivhesiti yePennsylvania, mutengo wekupedzisira mumatambudziko akanyanya kazhinji unosvika $1 miriyoni.
"Zvinonzi nevagari vekuPenn 'CAR-Tastrophy,'" Posey akadaro nezve musanganiswa weimmunological adverse effects uye neurotoxicity.
