Maarso 2022: Habka kacaanka ee Daaweynta CAR-T Cell waxa uu awood u leeyahay in uu rogo waxa noqday axiom-caafimaad: in daawaynta saamaynta cajiibka leh ee burooyinka ay ku timaaddo kharashka khataraha la taaban karo ee badbaadada bukaanka.
Bukaannada lagu daweeyay nooc wax yar laga beddelay oo ah CAR-T oo la ansixiyay waxay la kulmeen faa'iidooyin u dhigma daraasadihii hore, laakiin la'aanteed waxyeellooyinka caadiga ah ee mararka qaarkood u dira bukaannada cusbitaalka oo u baahan daawayn dheeraad ah oo qaali ah.
Sida laga soo xigtay xogta la sii daayay dhawaan, tijaabada ayaa kaliya ka diiwaan gashan 25 qof gudaha Shiinaha. Khubaradu waxay rumaysan yihiin in haddii natiijooyinka la koobi karo, tinkering yar oo unugyadu ay ka dhigi karto CAR-T mid badbaado leh oo diyaar ah.
"Tani waxay u muuqataa mid rajo leh," ayay tiri Jill O'Donnell-Tormey, maamulaha Machadka Cilmi-baarista Kansarka, oo ah urur aan faa'iido doon ahayn. "Sida iska cad, waa horaantii ciyaarta, laakiin jawaabta ay ka heleen 25 qof oo ay ilaa hadda arkeen waa wax lala yaabo."
Daawaynta CAR-T waxaa lagu sameeyaa iyada oo la qaato unugyada difaaca ee bukaanka, iyada oo qaab ahaan wax looga beddelo iyaga si loo beegsado burooyinka, ka dibna lagu duro walxaha dhiirigeliya difaaca dabiiciga ah ee jidhka si uu ugu biiro dagaalka. Saynis yahanadu waxay diiradda saareen wejiga ugu dambeeya ee habka si loo abuuro daawo ammaan ah.
Waxay ku bilaabeen Novartis' Kymriah, kaas oo loo oggolaaday in lagu daweeyo laba nooc oo xumaanta dhiigga ah, ka dibna waxay abuureen analogues iyaga u gaar ah, oo mid kastaa lagu tolo isku xigxiga amino acid xoogaa ka duwan. Waxay dareemeen wax xiiso leh markii ay isku dayeen isbeddelladan jiirarka: Mid ka mid ah CAR-T-yada la beddelay wuxuu awooday inuu dilo unugyada kansarka iyada oo aan la kicin jawaab celin difaac ah oo qandho ah ama dhalinaysa bararka maskaxda, kuwaas oo ah laba ka mid ah dhibaatooyinka ugu caansan ee daaweynta unugyada.
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, oo ah borofisar immunology ka dhiga Jaamacadda Koonfurta California ahna qoraaga aasaasiga ah ee wargeyska, ayaa yidhi, “Taasi runtii aad ayay noogu yaabisay.” Shaqaalihii Chen ayaa sidoo kale la yaabay.
CAR-T-da la beddelay waxay u muuqatay inay heshay bar macaan oo difaaca jirka ah, oo soo jiidatay cytokines ku filan si ay saameyn ugu yeelato kansarka iyada oo aan wax dhibaato ah geysan. Si kastaba ha ahaatee, ma cadda sababta arrintani u dhacday. Waa suurtogal in CAR-T-yada shatiga leh sida Kymriah iyo Sayniska Gilecaad ee Yescarta ay aad u awood badan yihiin, iyo in daawaynta ka yar ay ku gaadhi karto natiijooyin isku mid ah oo leh khatar yar. Waxa kale oo ay noqon kartaa arrin fursad ah.
Dr. Loretta Nastoupil, chief of the qanjiro 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.
Waxa kale oo jirta arrin ku saabsan jiritaanka muddada-dheer, taas oo ka baxsan sayniska aasaasiga ah. CAR-T-yada la ansixiyay waxay inta badan keenaan cafisyo waqti dheer ah. Dr. Michel Sadelain, oo ah khabiir ku takhasusay difaaca jirka oo jooga Memorial Sloan Kettering Cancer Center, ayaa sheegay in istiraatiijiyadda Chen ay u muuqato mid badbaado leh muddada gaaban, laakiin waa in la arko haddii saameyntu ay sii jiri doonto.
"Dhibaatada ayaa ah haddii aad daciifto CAR, taasi waa wax aad u xun haddii aad yareyso wax soo saarka cytokine, laakiin ma yareyn kartaa saameynta daaweynta?" Sadelain ayaa sharaxay. "Halkan waa meesha su'aasha weyni ay ku taal. "Waqtiga kaliya ayaa sheegi doona," ayuu yiri sheeko-yaqaanku.
Marka laga reebo walaacyadaas, rajada CAR-T ee badbaado leh waxay si weyn u ballaarin kartaa helitaanka daawaynta hadda laga heli karo xarumaha waaweyn ee kansarka. Dhibaatooyinka daawaynta ayaa had iyo jeer u baahan daryeel takhasus leh iyo khibrad aan laga heli karin cosbitaalada beesha, taas oo xaddidaysa tirada bukaannada la daweyn karo.
Markaa waxaa jira qiimihiisu. Qiimaha daawaynta CAR-T waa in ka badan $370,000 daawayn kasta, in kasta oo aanay taasi ku jirin kharashka isbitaal dhigista ama daawooyinka difaaca difaaca. Sida laga soo xigtay Avery Posey, an immunotherapy cilmi-baare ka tirsan Jaamacadda Pennsylvania, kharashka kama dambaysta ah ee kiisaska ugu daran ayaa had iyo jeer ku dhawaad $ 1 milyan.
"Waxay dadka deggan Penn ugu yeeraan 'CAR-Tastrophy'," Posey wuxuu yiri isku darka saameynta xun ee tallaalka iyo neerfayaasha.
