2024 waxay wax ka beddeshay daawaynta CAR T-Cell ee Shiinaha! Ka marag furo sheekooyinka guusha ee cajiibka ah ee tijaabooyinka caafimaadka, sahamiso horumarka, oo baro caqabadaha hadhay. Kaalay ogow mustaqbalka daawaynta kansarka ee jabinaysa taasoo malaayiin qof siisa rajo mar kale!
Saynisku wuxuu sameeyay koboc la yaab leh oo dhanka daawada ah. Dhowrkii sano ee la soo dhaafay, waxaan aragnay daaweyno iyo dawooyin badan oo cusub kuwaas oo faa'iido u ah bukaannada qaba cudurrada halista ah sida kansarka. Kansarka ayaa weli ah khatar caafimaad oo caalami ah oo la taaban karo, taasoo saamaysa malaayiin nolosha ah sannad kasta.
Ururka Kansarka Mareykanka (ACS) ayaa ku qiyaasay 1,958,310 xaaladood oo kansar cusub sanadka 2023, marka laga reebo kansarka maqaarka ee aan melanoma ahayn. Nasiib darrose, in ka badan 609,820 dhimasho oo kansar ah ayaa la tiriyey isla sanadkaas.
Daawaynta unugyada CAR-T waa mid horumarsan immunotherapy kaas oo u tababara habka difaacaaga si uu u aqoonsado oo u burburiyo unugyada kansarka si sax ah.
Tani maaha khiyaali saynis; waa xaqiiqada kama dambaysta ah ee daaweynta unugyada CAR T, habka difaaca ku salaysan ee kacaanka kaas oo abuuraya farxad aad u weyn oo la dagaallanka kansarka.
Iyadoo wali ay ku jirto marxaladaheedii hore, Daaweynta unugyada CAR T waxay muujisay ballan-qaad cajiib ah oo lagu daweynayo kansarrada dhiigga ee gaarka ah, iyadoo cilmi-baaris joogto ah lagu eegayo awoodda ay u leedahay in lagu daweeyo noocyada kala duwan ee burooyinka.
Maqaalkan, waxaan ku sahamin doonaa daawaynta unug ee CAR T-da tijaabada caafimaadka Shiinaha, meelaha ugu waaweyn ee diiradda la saaro, oo ka wada hadla caqabadaha iyo fursadaha xiisaha leh ee qaabeynaya mustaqbalka daaweynta kacaanka.
Halkan ka akhri: Furaha Guusha CAR-T waxay ku jirtaa Doorashada Bukaan-socodka - Ma adiga ayaa ku habboon?
Dhacdooyinka Taariikheed ee CAR T Cell Therapy ee Shiinaha
Socdaalka CAR T Therapy ee Shiinaha waxay u egtahay tartan ka soo bilaw bilawga, oo leh horumar iyo himilo aan caadi ahayn.
Horumarka Hormarinta (2013): Shiinaha ayaa sheegay markii ugu horeysay CAR T-cell daaweynta loogu talagalay B-ALL oo lagu beegsanayo CD19 sanadka 2013, taasoo calaamad u ah horumarka ugu horreeya ee waddanku qaatay ee tignoolajiyada CAR T-cell.
Kobcinta degdega ah (2017-2019): Dhammaadkii 2017, Shiinuhu wuxuu u soo baxay inuu yahay waddan leh tirada ugu badan ee tijaabooyinka bukaan-socodka ee unugyada CAR-T, oo muujinaya horumar degdeg ah iyo maalgelin weyn oo lagu sameeyo habkan daaweynta.
Horumar joogto ah (2022): Sanadihii la soo dhaafay, CAR T daawaynta unugyada kansarka ee Shiinaha waxay muujisay waxtarka gaarka ah ee daaweynta kansarka dhiigbaxa, taasoo muujinaysa horumar joogto ah.
Waa inuu akhriyaa: Doorka Immunotherapy ee Daaweynta Lymphoma - CancerFax
Tijaabooyinka Daawaynta Unug ee CAR T ee bilaashka ah ee Shiinaha: Rajo u ah Dhammaan
Hindise cusub, Shiinuhu hadda wuu bixinayaa daawaynta kansarka bilaashka ah ee Shiinaha, siinta rajo cusub bukaanka la dagaallama noocyada kansarka qaarkood. Isbitaalada caanka ah sida Peking University Cancer Hospital, Sun Yat-sen University Cancer Center, West China Hospital, First Affiliated Hospital ee Jaamacadda Zhengzhou, Beijing Gorboad Boren Hospital, iyo qaar kaloo badan ayaa si firfircoon uga qayb qaadanaya tijaabooyinkan.
Daraasadaha kiliinikada waxaa loogu talagalay in lagu daweeyo Meelo badan, B-cell acute lymphoblastic leukemia (ALL), iyo B-unuggu waxay faafiyaan lymphoma B-cell (DLBCL). Bukaanka qaba noocyadan gaarka ah ee kansarka hadda waxay sahamin karaan daawaynta unugyada CAR T ee horumarsan iyada oo aan culays dhaqaale la saarin. Hindisahani maaha oo kaliya balaadhinta helitaanka daawaynta cusub laakiin sidoo kale waxay Shiinaha ka dhigaysaa hogaamiye caalami ah cilmi baarista iyo daaweynta kansarka.
Natiijooyinka Cilmi-baadhiseed ee ugu dambeeyay ee CAR T Tijaabooyinka Daawaynta Unug ee Shiinaha
Cilmi-baadhis ku saabsan daaweynta unugyada CAR T ayaa si degdeg ah ugu socota Shiinaha, halkaas oo tijaabooyin badan oo caafimaad ay sahamiyaan awoodda daaweynta ee noocyada kala duwan ee kansarka. Mid ka mid ah meelaha xiisaha leh waa unugyada CAR T oo laba-bartilmaameedsada, isku darka weerarrada antigens-ka kansar ee badan si loo kordhiyo waxtarka.
Tijaabooyinkii hore ee CD19/20 lala beegsaday qanjiro waxay muujiyeen heerar jawaab celineed oo heersare ah, taasoo u gogol xaareysa sahan dheeri ah.
Cilmi-baarista wajiga-2 ee ka-hortagga CD19 iyo ka-hortagga CD22 CAR T unugyada ka soo horjeeda unugyada B-unugga lymphoblastic leukemia ba'an (ALL) helay heer aad u fiican 88% guud ahaan heerka jawaab celinta dhuuxa lafta iyo 85% habka dhexe ee neerfayaasha.
Marka laga reebo bartilmaameedka caadiga ah ee CD19, cilmi-baarayaashu waxay sahamiyaan meelaha aan la sahamin. Tijaabooyin ay ku jiraan BCMA, CD20, iyo GPC3 ayaa soo saaraya natiijooyin rajo leh oo ku saabsan noocyada kala duwan ee kansarrada, oo muujinaya la qabsiga habkan daaweynta.
Si kastaba ha ahaatee, badbaadada ayaa weli ah walaac weyn. Calaamadaha sii deynta Cytokine (CRS) waxay noqon kartaa dhib weyn, riixaya cilmi-baarayaasha si ay u soo jeediyaan xalalka sida naqshadeynta CAR ee la hagaajiyay iyo daaweynta isku dhafan si loo hagaajiyo maamulka.
In kasta oo Shiinuhu uu hoggaamiyo marka la eego tijaabooyinka socda, kaliya laba daawaynta CAR T ayaa la ansixiyay: axicabtagene ciloleucel iyo relmacabtagene autoleucel, oo muujinaya caqabadaha gelitaanka sababtoo ah caqabadaha sharciga iyo dhaqaalaha.
Shiinuhu waxa uu hormuud ka yahay hal-abuurka daawaynta CAR T-cell, wax ka qabashada walaacyada badbaadada, iyo baadhista bartilmaameedyada cusub iyo bar-tilmaameedka laba-geesoodka ah. In kasta oo ay weli jiraan caqabado hortaagan helitaanka bukaan-socodka ballaaran, mustaqbalka daawaynta beddelka ciyaarta ayaa dhalaalaya.
Kasbashada Aragtida: U Quuso Qoto Dheer ee Daawaynta Unug ee CAR T: Sidee U Shaqeeya?
Meelaha Muhiimka ah ee Horumarka ee Chimeric Antigen Receptor T-Cell Therapy ee Shiinaha
Bartilmaameedka Burooyinka Adag
Tartanka: Dhaqan ahaan, daawaynta CAR T waxay muujiyeen guul weyn kansarka dhiigga ka badan burooyinka adag ay sabab u tahay buro microenvironments adag iyo antigen heterogeneity.
Horumarka: Tijaabooyin dhowr ah oo Shiinees ah ayaa eegaya habab cusub oo lagu beegsanayo burooyinka adag.
Tijaabooyin lagu qiimeeyo unugyada CAR T ee muujiya laba reseptors oo kala duwan oo bartilmaameedsanaya dhowr antigens buro si loo kordhiyo waxtarka (tusaale, BCMA/CD19 ee myeloma badan, GD2/NGFR neuroblastoma).
Daraasaduhu waxay eegayaan unugyada CAR T ee TIL-ku-salaysan ee ku habboon buro kasta oo bukaan-socod ah, taasoo dhiirigelinaysa natiijooyinka hore ee kansarka sanbabada iyo melanoma.
Isku darka unugyada CAR T ee daaweynta dheeraadka ah sida isbaarada isbaarada ama shucaaca ayaa awood u leh inay hagaajiyaan jawaabta oo ay ka gudbaan caabbinta burooyinka adag.
Tusaale ahaan: Tijaabada Wajiga I (NCT05424241) iyadoo la adeegsanayo laba-unug CAR T oo beegsanaya BCMA iyo CD19 ee soo noqnoqda/dib-u-celinta badan ee myeloma waxay heshay dhiirigelinta badbaadada iyo natiijooyinka waxtarka, oo ay ku jiraan jawaabaha buuxa ee bukaannada qaarkood.
Ka Gudbinta Caqabadaha Sunta
ChallengeCytokine release syndrome (CRS) iyo neurotoxicity waa waxyeellooyin daran oo daawaynta CAR T oo kor u qaadaysa welwelka badbaadada.
HorumarkaCilmi-baarayaasha Shiinaha ayaa helaya farsamooyin lagu daweynayo laguna dhimayo suntan:
Tijaabooyin ayaa lagu sameeyaa unugyada CAR T oo leh isbeddello ay ka mid yihiin "genes-is-dilid" si loogu oggolaado in si sahlan loo saaro haddii waxyeellooyin muhiim ah ay soo baxaan.
Daawooyinka lagu beegsanayo dariiqyo gaar ah oo ku lug leh CRS ama neurotoxicity ayaa lagu tijaabiyaa iyadoo lagu daray daawaynta CAR T si loo yareeyo falcelinta daran.
Si loo yareeyo khataraha sunta, qiyaasaha unugyada CAR T iyo qorshooyinka daawaynta ayaa lagu saleeyay sifada bukaanka gaarka ah.
Tusaale ahaan, tijaabada Wajiga I / II (NCT04552054) iyadoo la adeegsanayo unug CAR T-da ee BCMA-da oo leh " hiddo-wadaha is-dilka " ee bukaanno badan oo myeloma ah ayaa muujiyay badbaado rajo leh iyo CRS la xakameyn karo, iyo sidoo kale dhiirigelinta natiijooyinka waxtarka leh.
Helitaanka Jawaabo Waara
Tartanka: Daawaynta unugyada CAR T waxay sii wadaa inay la kulanto caqabadaha ilaalinta kontoroolka burada ee muddada dheer iyo ka hortagga soo noqoshada.
Horumarka: Dadaallada ayaa socda si loo hagaajiyo joogtaynta iyo cimriga unugyada CAR T:
Tijaabooyin ayaa lagu sameeyaa unugyada CAR T oo wax laga beddelay si loo dhiso shaqada xusuusta, taas oo horseedi karta waxqabadyo ka hortagga burooyinka oo waaraya.
Hababka lagu kiciyo ballaarinta unugga CAR T gudaha jirka bukaanka ka dib faleebo ayaa la baarayaa si loo hagaajiyo adkaysigooda iyo waxtarkooda.
Cilmi-baarayaashu waxay eegayaan isku-darka unugyada CAR T iyo daawooyinka kale ee difaaca-kiciya si ay u bixiyaan jawaab-celin ka-hortagga buro-dheer oo dheer.
Tusaale ahaan, tijaabada Wajiga I/II ee (NCT04418739) oo lagu qiimaynayo unugga CAR T ee CD19-ku-talagalka ah ee leh awoodaha xusuusta ee unugyada leukemia-ga ee B-unugyada ayaa shaaca ka qaaday jawaab-celin dhammaystiran oo joogto ah oo tiro badan oo bukaanno ah ka dib 12 bilood, taas oo muujinaysa waxtarka muddada-dheer ee wanaagsan.
Horumarinta Daryeelka Kansarka ee CARsgen Iyadoo Bartilmaameedsanaysa Borootiinka Burooyinka Adag ee Kala duwan
CARsgen Therapeutics Holdings Limited ayaa dhawaan shaaca ka qaaday horumarro waaweyn oo ku saabsan daawaynta CAR T-cell ee kacaanka, CT041, ee 2024 Society American of Clinical Oncology Symposium.
Shirkaddu waxay daaha ka qaaday natiijooyin wanaagsan oo ka soo baxay cilmi-baarista Wajiga 1b ELIMYN18.2, kaas oo diiradda saaray satricabtagene autoleucel (satri-cel), musharaxa badeecada CAR-T ee autologous ee loogu talagalay in lagu weeraro Claudin18.2, borotiinka laga helay qaar ka mid ah burooyinka adag.
CARsgen waxay carrabka ku dhufatay badbaadada iyo waxtarka satri-cel, taasoo muujinaysa muuqaal rajo leh. Qiyaasta lagu taliyey ee Wajiga 2 (RP2D) ayaa la go'aamiyay waxayna hadda ku jirtaa Wajiga 1b/2 tijaabooyin caafimaad si loogu daweeyo isgoysyada gastric/gastroesophageal horumaray (GC/GEJ) iyo kansarka ganaca.
Daraasaddan caafimaad waxay diiradda saartay astaanta badbaadada togan, la'aanta waxyeellooyin halis ah, iyo waxtarka dhiirigelinta, oo leh natiijooyin la taaban karo oo bukaannada qaba GC/GEJ iyo PC.
Kartida Satri-cel ee ah daawaynta horudhaca ah ee kansarradan adag ayaa si isa soo taraysa u muuqda, taasoo calaamadaynaysa tallaabo muhiim ah oo hore loogu qaaday dhinaca daawaynta CAR T-cell.
Mustaqbalka CAR T Tijaabooyinka Daawaynta Unugyada ee Shiinaha
Mustaqbalka daawaynta unugga CAR T ee Shiinaha waxay u muuqataa mid dhalaalaya, oo ay horseed ka tahay tijaabooyin badan iyo ballanqaad hal-abuurnimo. Iyadoo ay hadda jiraan in ka badan 100 cilmi-baaris caafimaad oo lagu beegsanayo lymphoma oo keliya, cilmi-baarayaashu waxay sii ballaarinayaan kansarka dhiigga, iyada oo 2024 tijaabooyin lagu daweynayo burooyinka adag iyadoo la adeegsanayo habab kala duwan sida naqshadaha CAR-da labadaba iyo shakhsi ahaan Daaweynta TIL.
Cilmi-baarayaasha Shiinaha ayaa hormuud u ah hiddo-sidaha wax-ka-beddelka ah ee "genes-is-dilka" iyo faragelinta dawooyinka ee la beegsaday, iyada oo natiijooyinkii hore ay muujinayaan astaamaha badbaadada wanaagsan. Qiimaha ayaa weli ah caqabad, laakiin unugyada CAR T ee gudaha laga soo saaray iyo hababka cusub ee wax soo saarka ayaa bixiya rajo helitaan weyn.
Wadashaqeynta wadamada kale, iyo dowladda Shiinaha ayaa wada horumarkan, iyadoo Shiinuhu uu qorsheynayo inuu 10% ku biiriyo dhammaan dawooyinka cusub ee CAR T adduunka marka la gaaro 2030.
Habkan dhammaystiran, oo ay weheliso horumar degdeg ah, ayaa muujinaya mustaqbal ifaya oo loogu talagalay bukaannada kansarka ma aha oo kaliya Shiinaha laakiin adduunka oo dhan.
