March 2022: Yunivhesiti yeTexas MD Anderson Cancer Center vaongorori vakawana kuti axi-cel, autologous anti-CD19 chimeric antigen receptor (CAR T-cell therapy), yakachengeteka uye inoshanda yekutanga-mutsara kurapa kune varwere vane njodzi yakakura B-cell. lymphoma (LBCL), boka rinoda zvikuru mishonga mitsva uye inoshanda.
Izvi zvakawanikwa zvakaunzwa kuAmerican Society of Hematology's chaiyo 2020 Yepagore Musangano.
Sechinyakare, inenge hafu yevarwere vane njodzi yakanyanya LBCL, chikamu chidiki chechirwere umo varwere vane kaviri- kana katatu-yakarova lymphoma kana mamwe makiriniki enjodzi anoonekwa neInternational Prognostic Index (IPI), havana kuwana chirwere chenguva refu. kuregererwa nemaitiro akajairwa ekurapa akadai sechemoimmunotherapy.
Muedzo uyu unomiririra danho rekuita CAR T cell kurapa 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 kurapa, kana ikabudirira, inogona kuita kuti ive imwe-nguva infusion nekurapa kunopedzwa mumwedzi mumwe chete.
Zvichienderana netsvakiridzo yakakosha yeZUMA-1, Axi-cel parizvino ine rezenisi rekurapa vanhu vane LBCL yakadzokororwa kana kuti refractory vakatove nemitsara miviri kana kupfuura yemishonga inorongwa. ZUMA-12 muyedzo iPhase 2 open-label, single-arm, multicenter muyedzo unobva pane zvakawanikwa muyedzo yeZUMA-1 yekuongorora kushandiswa kweaxi-cel senzira yekutanga kurapwa kune varwere vane njodzi yakanyanya LBCL. .
Sekureva kweongororo yenguva pfupi yeZUMA-12, 85 muzana yevarwere vakarapwa neaxi-cel vaive nemhinduro yese, uye 74% vaive nemhinduro yakakwana. Mushure mekutevera kwepakati kwemwedzi ye9.3, 70% yevarwere vakanyorerwa vakaratidza kuenderera mberi kwemhinduro pakubviswa kwedata.
Kuderedzwa kwemasero machena eropa, encephalopathy, anemia, uye cytokine release syndrome ndiwo aive akajairika mhedzisiro akabatanidzwa neaxi-cel kurapwa. Nenguva iyo data yakaongororwa, zviitiko zvose zvakashata zvakanga zvagadziriswa.
Uyezve, kana ichienzaniswa neapo zvigadzirwa zve immunotherapy zvakagadzirwa kubva kuvarwere vakange vatogamuchira mitsara yakawanda yekemotherapy, nhamba yepamusoro yemasero eCAR T aripo muropa, pamwe chete nekuwedzera kweCAR T cell, yakanga yakakwirira mukuedzwa uku. mutsara wekutanga CAR T cell kurapa.
"Iyi T cell fitness inogona kubatanidzwa nekubudirira kukuru kwekurapa, zvichiita kuti pave nemigumisiro iri nani yevarwere," Neelapu akawedzera.
Kutevera mhedzisiro yakanaka yenguva pfupi yeZUMA-12, vaongorori vanoronga kuenderera mberi nekutevera varwere kuti vaone kuti maitiro avo pamushonga anogara kwenguva refu.
“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.
