CAR T-Cell therapy in Korea
Ma rabtaa inaad iska diwaangeliso CAR T-Cell therapy gudaha Kuuriya?
Nala soo xiriir si aad u dhammaysato adeegyada concierge.
South Korea is paying a lot of attention to CAR T-cell therapy, which is a new kind of immunotherapy that has made a lot of progress. It involves changing the genes of a patient’s own T cells so they can make chimeric antigen receptors (CARs), which can find cancer cells and kill them. South Korea has done a lot of research and development on CAR T cell therapy, with a number of clinical trials and treatment centres devoted to this new method. Daaweynta unugyada CAR T has been successful in South Korea because of the country’s healthcare system and technological knowledge. This has given patients with kansarka dhiigga hope and paved the way for more personalized cancer treatments in the region.
Daaweynta CAR T-Cell ee Kuuriya - Horumarradii dhawaa
Juun 2023: Daaweynta CAR T-cell waxay noqotay hab cusub oo lagu daweeyo kansarka. Waxay beddeshay habka aan ula dagaalanno noocyada kala duwan ee kansarka. Sannadihii u dambeeyay, Kuuriyada Koonfureed waxay samaysay horumar badan oo dhinacan ah, taas oo muujinaysa sida ay ugu heellan tahay daraasadda iyo fikradaha cusub. Qaybtani waxa ay ka hadlaysaa qaar ka mid ah horumarka cusub ee gudaha Daaweynta CAR T-cell ee Kuuriya. Waxa ay diiradda saari doontaa isbeddellada dhulka la dhigay ee ka dhigay Kuuriyada Koonfureed meesha ugu sarreysa goobtan.
Tijaabooyin Caafimaad iyo Oggolaanshaha Nidaaminta: Kuuriyada Koonfureed waxay si firfircoon u daba-gashay tijaabooyinka bukaan-socodka ee daaweynta unugyada CAR T, abuurista jawi dhiirigeliya hal-abuurka iyo daryeelka diiradda saaraya bukaanka. Dalku waxa uu safka hore kaga jiray baadhista daawaynta cudurada dhiiga iyo burooyinka adag, iyo noocyada kale ee kansarka. Waxaa xusid mudan, tijaabooyinka caafimaadku waxay muujiyeen natiijooyin wax ku ool ah, taasoo keentay in daawaynta unugyada CAR T ay dawladdu u ogolaato isticmaalka qaar.
Horumarinta Dhismayaasha CAR ee Cusub: Cilmi-baarayaasha iyo saynisyahannada Kuuriyada Koonfureed ayaa si adag uga shaqaynayay samaynta dhismayaal cusub oo CAR ah oo ka dhigaya daawaynta unugyada CAR T mid waxtar iyo badbaado leh. Tan waxa ka mid ah samaynta hagaajinta habka loo sameeyo reseptors-kimeric antigen si unugyada CAR T ay si fiican u helaan, u hawlgeliyaan, una joogaan burooyinka. Isbeddelladani waxay keeneen natiijooyin daweyn oo wanaagsan iyo waxyeellooyin yar.
Daawaynta Isku-dhafka: Cilmi-baarayaasha Kuuriyada Koonfureed ayaa sidoo kale eegay suurtagalnimada in lagu qaso daaweynta unugyada CAR T iyo noocyada kale ee daaweynta, sida kuwa xakameynaya isbaarada difaaca iyo daawaynta la beegsaday. Cilmi-baadhayaashu waxay rabaan inay hagaajiyaan heerarka jawaab-celinta oo ay la socdaan dhibaatooyinka ay keenaan noocyada kala duwan ee burooyinka iyo sida ay uga dhuuntaan habka difaaca jirka.
Wax-soo-saarka iyo Ganacsiga: Kuuriyada Koonfureed waxay samaysay horumar badan oo ku saabsan abuurista habab lagu samaynayo daawaynta unugyada CAR T kuwaas oo xooggan oo la kordhin karo. Tani waxay sahashay in daawadaan suuqa la soo geliyo oo ay isticmaalaan dad badan, taasoo u sahlaysa dadka u baahan inay helaan.
Kuuriyada Koonfureed hadda waa hogaamiyaha adduunka ee daaweynta unugyada CAR T. Waxa ay tan samaysay iyada oo adeegsanaysa xirfadaheeda cilmi-baadhista, aqoonta caafimaad, iyo qaab-dhismeedka sharci si ay horumar la yaab leh uga samayso aaggan. U heellanaanta dalka ee hal-abuurka iyo jawiga cilmi-baarista ee iskaashiga ayaa horseeday abuurista dhismayaal cusub oo CAR ah, tijaabooyin caafimaad oo guul leh, iyo ganacsiyeynta daawayntan. Horumarradan cusubi waxay leeyihiin wax badan oo suurtagal ah si ay u beddelaan sida kansarka loo daweeyo oo loo hagaajiyo natiijooyinka bukaan-socodka, ma aha oo kaliya Koonfurta Kuuriya laakiin adduunka oo dhan. Kuuriyada Koonfureed waxay u badan tahay inay saameyn weyn ku yeelato mustaqbalka daaweynta unugyada CAR T maadaama beertu ay sii socoto isbeddelka.
CAR T-cell therapy, developed by Novartis and marketed under the brand name Kymriah, is currently being provided by the CAR T-cell Therapy Center to patients under the age of 25 who suffer from B-cell acute lymphoblastic leukaemia or diffuse large B-cell qanjiro. In addition, patients who have refractory diffuse large B-cell lymphoma are the focus of clinical trials being conducted for CRCO1, which was developed by a company based in Korea called Curocell. In addition, because Korea is widely recognised as the CAR T-cell Therapy hub in the world, clinical trials for the CAR T-cell therapy developed by Janssen are also currently being conducted for patients who have relapsed or refractory Meelo badan.
Kahor inta aan la bilaabin daaweynta, bukaanada qaadanaya daaweynta CAR T-cell ayaa looga baahan yahay inay isku dubaridaan dadaalkooda tiro ka mid ah waaxyo isbitaal oo kala duwan. Si aad u noqoto mid gaar ah, tiro badan oo khabiiro ah oo ku takhasusay qaybaha kuwaas oo si dhow ula xiriira cudurrada faafa, neerfaha, wadnaha, iyo daryeelka degdega ah ayaa ku lug leh maaraynta dhamaystiran ee dhacda daaweynta ka dib.
Xarunta daawaynta unugyada ee CAR T-cell waxay hadda ka qaybqaadanaysaa "Cisbitaalka R&D ee cilmi-baadhista" ee ay waddo Wasaaradda Caafimaadka iyo Daryeelka, waxaana la filayaa inay noqoto xarun daawaynta unugga oo hoggaamisa daaweynta unugyada heerka sare ah iyo daaweynta gaarka ah ee bukaanka. loogu talagalay bukaannada kansarka dhiigbaxa. Mashruucan waxaa hindisay wasaaradda caafimaadka iyo daryeelka.
Waa kuwee shirkado ku lug leh wax soo saarka CAR T-Cells ee Koonfurta-Korea?
Nofeembar 16, 2022, ViroMed, shirkad Kuuriyaan ah, ayaa ku dhawaaqday qorshe lagu horumarinayo daawada CAR-T. Tignoolajiyada kobcinta hidda-wadaha CAR, tignoolajiyada wax-soo-saarka vector, iyo tignoolajiyada ex vivo ee wareejinta hidda-sidaha iyo kordhinta unugyada ayaa dhamaantood diyaar u ah ganacsiga horumarinta dawooyinka CAR-T. Ka dib iibinta "VM801," ViroMed's technology CAR-T, US Bluebird Bio 56.8 bilyan ku guuleystay December 2015, shirkadu waxay qorsheyneysaa in ay soo saaraan saddex badeeco CAR-T.
Intaa waxaa dheer, AbClon waxay horumarinaysaa daaweynta kansarka dhiigga ee ku salaysan tignoolajiyada ay sameeyeen koox cilmi baaris ah oo uu hoggaaminayo borofisar Jung Jun-ho oo ka tirsan Jaamacadda Qaranka ee Seoul bishii Febraayo, taas oo ka ammaan badan daawooyinka CAR-T ee hadda jira. Tiknoolajiyada kooxda ayaa lagu yaqaanaa inay ka soocdo daawooyinka hadda jira iyagoo si weyn u yareynaya cytokine release syndrome (CRS), oo ah saameyn waxyeello leh oo dawooyinka CAR-T ah oo keeni kara hypotension, qandho, iyo xitaa dhimashada bukaanka.
Si kor loogu qaado, Green Cross Cell, oo hoos timaada Green Cross, ayaa hubinaysa oo xaqiijinaysa musharraxiinta dawada CAR-T ee daaweynta kansarka adag. Shirkaddu waxay rabta inay samayso cilmi baadhis si ay u bilawdo tijaabo caafimaad kahor sanadka soo socda. Tan iyo markii loo magacaabay Son Ji-woong madaxa Qaybta Ganacsiga Sayniska Nolosha bishii Febraayo, LG Chem ayaa la sheegay inuu ka fikirayay hirgelinta tignoolajiyada la xidhiidha dawooyinka CAR-T, iyada oo soo saarista dawooyinka sonkorowga iyo dawooyinka ka hortagga kansarka ay yihiin Hadafka R&D ee muhiimka ah ee shirkadda.
Curoceel, bilawga cilmiga bayoolajiga ee Kuuriyada Koonfureed kaas oo hormood ka ahaa daawaynta unugyada CAR-T, ayaa qorshaynaysa in ay bilawdo tijaabo caafimaad oo daawaynta unugyada cusub ee CAR-T taas oo beegsanaysa kansarka dhiiga iyo burooyinka adag labadaba.
Curocell ayaa dhawaan soo gudbisay codsiga IND ee tijaabada caafimaad ee daawaynta unugga ee CAR-T ee Kuuriya, iyo madaxa fulinta ee shirkadda Kim Gun-soo ayaa u sheegay wargeyska Maeil Business Newspaper in Wasaaradda Cuntada iyo Dawooyinka la filayo inay ansixiso bishan.
Curocell waxay horeba ula samaysatay isbahaysi istiraatiiji ah Xarunta Caafimaadka ee Samsung si ay u bilowdo tijaabada isla marka la ansixiyo, sida uu qabo Kim, kaas oo rajaynaya inuu u helo daawaynta kansarka aasaasiga ah bukaanka Kuuriya sida ugu dhakhsaha badan.
CAR-T is an immunotherapy that is programmed to identify and destroy cancer cells. T cells from a single patient are genetically engineered in a lab to produce cancer-specific chimeric antigen receptors in order to create this treatment. After that, the cancer-fighting cells are re-infused into the patient’s body.
Daawaynta unugyada CAR-T ayaa la muujiyay inay ka guul badan tahay daawaynta kansarka ee kale ee hadda la heli karo. Sida laga soo xigtay Kim, inkastoo ay ku guuldareysteen daaweynta kale, 82 boqolkiiba bukaannada leukemia ba'an iyo 32-36 boqolkiiba bukaannada lymphoma waxay noqdeen kuwo aan kansar lahayn oo leh faleebo unug CAR-T ah.
Si kastaba ha ahaatee, natiijooyinka waxtarka sare ee CART waxay ku xaddidan yihiin daaweynta unugyada kansarka dhiigga mana lagu soo celin karo burooyinka adag sababtoo ah soo-dhoweeyaha isbaarada difaaca (PD-1) ee laga helo unugyada difaaca ee bukaanka kansarka adag, kaas oo xannibaya dhaqdhaqaaqa unugyada difaaca.
Receptor-ka isbaarada difaacu waxa uu u adeegaa sidii bareeg ku saabsan awoodda ay unugyada difaaca jirka u shaqeeyaan. Marka soo-dhoweeyayaasha isbaarada difaaca sida PD-1 ay si xad dhaaf ah u muujiyaan, awoodda unugyada difaaca si ay uga saaraan unugyada kansarka ayaa hoos u dhacda, taasoo ka dhigaysa ka saarista burada mid aad u adag.
Tignoolajiyada Curocell's OVIS (Ka Gudub Xakamaynta Immune Immune) ayaa ka gudubta xannibaaddan, taasoo u oggolaanaysa daawaynta unugyada CAR-T in lagu daweeyo burooyinka adag. OVIS waa tignoolajiyada injineernimada hidaha oo adeegsata beddelka hidda-socodka unugyada difaaca si loo xakameeyo soo-dhoweeyaha RNA (ribonucleic acid). Daawaynta unugga cusub ee CAR-T oo lagu hirgeliyey tignoolajiyadan ayaa aad uga guulaystey daawaynta hadda jirta ee CAR-T ee qaabka xayawaanka, sida uu qabo Kim.
Marka laga reebo daawaynta Curocell, midkoodna daawaynta unug ee CAR-T ee hadda la heli karo ama tijaabooyinka kiliinikada laguma beegsan doono labadaba kansarka dhiigga iyo burooyinka adag, sida uu qabo Curocell.
Sidee looga codsadaa daawaynta CAR T-Cell gudaha Kuuriya?
U soo dir warbixinnadaada caafimaad info@cancerfax.com ama WhatsApp ku soo dir +1-213 789-56-55. U soo dir warbixinnada soo socda ra'yi iyo qiyaas:
1) Kooban caafimaad
2) Warbixinnada dhiigga ee ugu dambeeyay
3) Biopsy
4) Baaritaanka PET ee ugu dambeeyay
5) Ka-qaadista dhuuxa lafta (Haddii la heli karo)
6) Warbixino iyo baaritaanno kale oo khuseeya
Once our team receives your medical reports, we analyze them and send it to hospitals that are performing CAR T-Cell therapy with that type of cancer and marker. We send reports to the concerned specialist and get his opinion. Report analysis is followed by an online video consultation with the specialist. We also get estimate from the hospital on complete treatment. This helps you in planning for the entire treatment duration.
Marka aad go'aansato inaad soo booqato daawaynta, waxaan kuu diyaarinaa warqad fiisaha caafimaadka iyo dukumeentiyada kale ee lagama maarmaanka ah ee isbitaalka. Waxa aanu sidoo kale ku caawinay oo ku hagaya codsiga fiisaha caafimaadka ee safaarada Kuuriya. Marka fiisaha la diyaariyo waxaanu kaa caawinaynaa oo ku hagaya u diyaar garowga safarka iyo tigidhada duulimaadka. Waxaan sidoo kale kuu qabanqaabineynaa hoteelkaaga iyo guriga martida, haddii loo baahdo South-Korea. Marka uu yimaado magaalada daawaynta wakiilkeena ayaa kugu soo dhawayn doona garoonka diyaaradaha.
Wakiilkayagu wuxuu kuu qabanqaabin doonaa ballan dhakhtar oo wuxuu kuu dhammaystiri doonaa habraacyada diiwaangelinta lagama maarmaanka ah. Waxa uu sidoo kale kaa caawin doonaa gelitaankaaga cisbitaalka iyo caawimada kale ee degaanka ee loo baahan yahay. Ka dib markii daawadu dhammaato waxaanu kuu diyaarin doonaa la-talintaada la-talinta dhakhtarka daawaynta.
Isbitaalada ugu sarreeya ee CAR T-Cell therapy ee Kuuriya
Xarunta caafimaadka Asan
Xarunta caafimaadka ee Kuuriyada Koonfureed ee Asan ayaa safka hore kaga jirta adeegsiga tignoolajiyada cusub ee lagu daweynayo kansarka dhiigga, iyada oo ujeedadu tahay in la wanaajiyo natiijooyinka bukaannada iyo tayada nolosha. Xaruntu waxay maalgelisay tignoolajiyada casriga ah sida taxanaha jiilka soo socda (NGS) ee khariidaynta saxda ah ee hidde-sideyaasha burooyinka, taas oo suurtogal ka dhigaysa in bukaan kasta si gaar ah loo daweeyo. Xarunta caafimaadka ee Asan ayaa sidoo kale soo kordhisay daawayn cusub, sida daawaynta unugga CAR T, taas oo u adeegsata habka difaaca bukaanka si ay u weerarto unugyada kansarka. Qalabkani waxa ay beddeleen sida loo helo kansarka dhiigga, loola socdo, iyo daawaynta, taas oo gelisay bukaannada rajo cusub iyo in Xarunta Caafimaadka ee Asan ay hormuud ka noqoto la dagaallanka kansarka dhiigga.
Waa maxay qiimaha daawaynta CAR T-Cell ee Kuuriya?
Qiimaha CAR T-Cell therapy South-Korea wuxuu ka bilaabmaa $ 450,000 USD wuxuuna gaari karaa ilaa $ 500,000 USD iyadoo ku xiran nooca iyo baaxadda cudurka iyo culeyska uu ku leeyahay jirka. Waxaa muhiim ah in maskaxda lagu hayo in qiyaastani ay tahay qiyaas guud oo keliya iyo in xaalado gaar ahi ay isbeddeli karaan. Nooca saxda ah ee daawaynta CAR-T, qallafsanaanta habsocodka, kharashyada isbitaalka, daryeelka taageerada, iyo baadhitaanada ogaanshaha dheeraadka ah ayaa dhamaantood ah doorsoomayaal saamayn kara qiimaha. Si loo xakameeyo kharashyada la xidhiidha daawaynta unugyada CAR-T, waxa lagula talinayaa bukaanada inay la hadlaan xirfadlayaasha daryeelka caafimaadka oo ay eegaan caymiska ama barnaamijyada kaalmada dhaqaale.
Waa maxay daaweynta CAR T-cell?
Chimeric antigen reseptor T-cell therapy, oo inta badan loo yaqaan CAR T-cell therapy, waa immunotherapy-jabin ah oo gebi ahaanba beddelay habka loo daweeyo kansarka. Waxay siisaa bukaanada qaba kansarrada qaarkood rajo oo markii hore loo arki jiray inay yihiin kuwo aan la daweyn karin ama leh dhowr dawo oo daaweyn ah.
Daawadu waxay ka kooban tahay isticmaalka unugyada difaaca jirka ee bukaanka - si gaar ah, unugyada T-iyo shaybaadhka wax ka beddelka iyaga si kor loogu qaado awooddooda si ay u ogaadaan oo ay u burburiyaan unugyada kansarka. Si taas loo sameeyo, unugyada T-da waxa la siiyaa reseptor-ka-kimeric antigen (CAR), kaas oo siinaya awood ay ku beegsadaan borotiinno gaar ah, ama antigens, oogada unugyada kansarka.
Unugyada T ee bukaanka ayaa marka hore laga saaraa, ka dibna si hidde ahaan wax looga beddelo si ay u muujiyaan CAR. Shaybaadhka, unugyadan la beddelay ayaa la badiyo si ay u soo saaraan tiro badan oo ah unugyada CAR T, kuwaas oo dib loogu celiyo dhiigga bukaanka.
Isla marka ay gudaha jidhka ku jiraan, unugyada CAR T waxay helayaan unugyo kansar oo muujiya antigen-ka la rabo, ku dheggan, oo kiciya jawaab celin difaac oo xooggan. Unugyada CAR T ee la hawlgeliyay way bataan oo waxay weerar ku qaadaan unugyada kansarka, iyaga oo dila.
Sidee ayuu u shaqeeyaa CAR T-Cell therapy?
Marka loo isticmaalo daawaynta cudurrada dhiigga qaarkood sida leukemia ba'an ee lymphoblastic (ALL) iyo noocyada gaarka ah ee lymphoma, daawaynta CAR T-cell waxay muujisay natiijooyin aan caadi ahayn. Waxay soo saartay heerar jawaab celin oo muuqda iyo bukaannada qaarkood, xitaa cafisyo waara.
Daawaynta CAR T-cell, si kastaba ha ahaatee, waa hab daawayn casri ah oo gaar ah oo laga yaabo inay leedahay khataro iyo saamayn xun. Cytokine release syndrome (CRS), falcelin difaaceed baahsan oo ka dhalan karta calaamado hargab oo kale ah iyo, xaaladaha daran, xubnaha oo fashilma, waxaa laga yaabaa inay la kulmaan dadka qaarkood. Waxa kale oo jiray warbixino ku saabsan saamaynta xun ee neerfaha, si kastaba ha ahaatee inta badan waa la daweyn karaa.
Despite these difficulties, CAR T-cell therapy is a significant advancement in the fight against cancer and shows great potential for the future. Current studies are focused on enhancing its efficacy and safety profile as well as extending its uses to different cancer types. CAR T-cell daaweynta has the ability to change the face of cancer treatment and give patients everywhere new hope with further advancements.
Nidaamka
Habka daawaynta CAR-T, oo qaadata dhowr toddobaad, waxay ku lug leedahay tillaabooyin badan:
Unugyada T waxaa laga soo saaraa dhiiggaaga iyadoo la isticmaalayo tuubo la geliyo xididka cududda. Tani waxay qaadataa dhowr saacadood.
Unugyada T waxaa loo qaadaa xarun ay ku maraan beddelka hidde-sidaha si ay u noqdaan unugyo CAR-T. Laba ilaa saddex toddobaad ayaa ku dhammaanaya tan.
Unugyada CAR-T ayaa dib loogu soo celinayaa dhiiggaaga iyadoo loo marayo dhibic. Tani waxay u baahan tahay dhowr saacadood.
Unugyada CAR-T waxay beegsadaan oo tirtiraan unugyada kansarka ee jirka oo dhan. Ka dib markaad hesho daawaynta CAR-T, si dhow ayaa laguula socon doonaa.
Noocee ah unugyada kansarka ayaa lagu daweyn karaa CAR-T Cell Therapy?
Only patients with adult B-cell non-lymphoma Hodgkin’s or pediatric Lymphoblastic lymphoblastic leukemia who have already tried two unsuccessful conventional therapies can currently use CAR T-cell therapy products that have received FDA approval. However, CAR T-cell therapy is now being tested in clinical studies as a first or second-line treatment for adult lymphoma and pediatric acute lymphoblastic leukemia. Recently, some of the studies have shown remarkable successes in cases of solid tumors too like glioblastoma, gliomas, liver cancer, lung cancer, GI cancer, pancreatic cancer and afka kansarrada.
Si loo soo gabagabeeyo
Tani waxay ka dhigan tahay horumar la taaban karo oo laga sameeyay maaraynta leukemia iyo lymphoma B-cell. Intaa waxa dheer, waxa ay rajo gelinaysaa kuwa hore loo saadaaliyay in noloshooda ay ku jirto lix bilood oo keliya. Hadda oo aanu aqoonsannay hababka wax-iska-caabbinta oo aanu abuurnay farsamooyin badan oo lagula dagaallamo, mustaqbalka waxa uu u muuqdaa mid aad u rajo badan.
Kala xidhiidh bixiyeyaashayada daryeelka caafimaadka ee khibradda sare leh halkan Faa'iidada Kansarka la tashi bilaash ah si loo sameeyo qorshe daryeel oo ku habboon baahiyahaaga daryeelka caafimaadka. Fadlan u soo dir warbixinnadaada caafimaad info@cancerfax.com ama WhatsApp + 1 213 789 56 55.
Waa maxay faa'iidooyinka CAR-T Cell Therapy?
Faa'iidada ugu weyni waa in daawaynta CAR T-cell ay u baahan tahay faleebo keliya oo badanaa waxay u baahan tahay laba toddobaad oo keliya daryeelka bukaan-jiifka. Bukaanka qaba qanjirada unugyada 'Hodgkin' iyo leukemia-ga carruurta ee hadda la helay, dhanka kale, caadi ahaan waxay u baahan yihiin kiimoterabi ugu yaraan lix bilood ama ka badan.
Faa'iidooyinka daaweynta CAR T-cell, oo runtii ah dawo nool, waxay sii jiri kartaa sanado badan. Haddi iyo marka ay soo noqodku dhacdo, unugyadu wali way awoodi doonaan inay aqoonsadaan oo ay beegsadaan unugyada kansarka sababtoo ah waxay ku noolaan karaan jidhka muddo dheer.
Inkasta oo macluumaadka uu weli soo korayo, 42% bukaannada lymphoma ee qaangaarka ah ee lagu sameeyay daawaynta CD19 CAR T-cell ayaa weli ku jira cafis 15 bilood ka dib. Lix bilood ka dib, saddex-meelood laba meel bukaannada qaba kansarka leukemia ee ba'an ee carruurta ayaa weli ku jiray cafis. Nasiib darro, bukaannadani waxay lahaayeen burooyin aad u daran kuwaas oo aan si guul leh loo daweyn iyadoo la adeegsanayo heerarka daryeelka dhaqameed.
Bukaanno noocee ah ayaa noqon lahaa kuwa si wanaagsan u qaata daawaynta unugyada CAR-T?
Bukaanada da'doodu u dhaxayso 3 Sano ilaa 70 Sano ayaa lagu tijaabiyay daawaynta CAR T-cell ee noocyada kala duwan ee kansarka dhiiga waxaana la ogaaday in ay aad waxtar u leedahay. Xarumo badan ayaa sheegtey heerarka guusha ee in ka badan 80%. Musharaxa ugu wanagsan ee daawaynta unugyada CAR T-cell wakhtigan waa ilmo yar oo qaba lymfoblastic leukemia ba'an ama qof weyn oo qaba lymphoma B-cell oo daran kaas oo horey u lahaa laba xariiq oo daaweyn aan waxtar lahayn.
Ka hor dhamaadka 2017, ma jirin heer la aqbalay daryeelka bukaanka kuwaas oo horay u soo maray laba xariiq oo daawaynta ah iyada oo aan la kulmin cafis. Daawaynta kaliya ee FDA-ansixisay ee ilaa hadda la caddeeyey inay faa'iido weyn u leedahay bukaankan waa daawaynta CAR T-cell.
Sidee waxtar u leeyahay daawaynta unug ee CAR-T?
Daawaynta CAR T-cell ayaa aad waxtar u leh daaweynta noocyada kansarka dhiigga qaarkood, sida lymphoblastic leukemia ba'an (ALL) iyo lymphoma non-Hodgkin. Tijaabooyinka kiliinikada, heerka jawaab celinta ayaa aad u wanaagsanaa, bukaanno badan ayaa galay cafis buuxa. Xaaladaha qaarkood, dadka isku dayay dawo kasta waxay heleen cafis waara ama xataa daawooyin suurtagal ah.
Mid ka mid ah waxyaabaha ugu wanaagsan ee ku saabsan daaweynta CAR T-cell waa inay beegsato unugyada saxda ah. Qabayaasha CAR ee lagu daray unugyada T waxay heli karaan calaamado gaar ah unugyada kansarka. Tani waxay suurtogal ka dhigaysaa in la bixiyo daawaynta la beegsaday. Habkan la beegsanayo waxa ay wax u dhimaysaa unugyada caafimaadka qaba sida ugu yar ee suurtogalka ah waxana ay hoos u dhigtaa halista waxyeelooyinka ka yimaada daawaynta dhaqameed sida kiimoterabiga.
Laakiin waxaa muhiim ah in maskaxda lagu hayo in daawaynta CAR T-cell ay wali tahay aag cusub oo wali isbedelaysa. Cilmi-baarayaasha iyo takhaatiirta ayaa si adag u shaqeynaya si ay u xalliyaan dhibaatooyinka sida kharashka badan, suurtagalnimada waxyeellooyin halis ah, iyo xaqiiqda ah in ay u shaqeyso oo kaliya noocyada kansarka qaarkood.
Dhammaadkii, daawaynta CAR T-cell waxay muujisay inay tahay hab aad loogu guulaysto in lagu daweeyo noocyada kansarka dhiigga qaarkood. Inkasta oo ay tahay hab rajo leh oo awood leh, daraasado badan iyo tijaabooyin caafimaad ayaa loo baahan yahay si loo hagaajiyo loona helo habab cusub oo loo isticmaalo. Daaweynta CAR T-cell waxay bedeli kartaa sida loo daweeyo kansarka oo wax u roonaan kara dadka adduunka oo dhan haddii ay sii fiicnaanayso.
Ka mid noqoshada & shuruudaha ka saarida
Shuruudaha ka mid noqoshada daaweynta CAR T-cell:
1. Bukaanada qaba CD19+ B-cell Lymphoma (Ugu yaraan 2 nidaamyadii hore ee kiimoteraabiga ee la isku daray)
2. Inaad gaarto 3 ilaa 75 sano
3. Dhibcaha ECOG ≤2
4. Haweenka awoodda dhalmada leh waa in laga qaado shaybaadh uur kaadi ah oo la caddeeyey in aan lahayn daawaynta ka hor. Dhammaan bukaannadu waxay ku heshiiyaan inay isticmaalaan habab la isku halayn karo oo ka hortagga uurka inta lagu jiro muddada tijaabada iyo ilaa la socodka wakhtiga ugu dambeeya.
Shuruudaha ka saarida ee daaweynta CAR T-cell:
1. Dhiig-kar gudaha ah ama miyir-beel
2. Neefsashada oo xumaata
3. Xinjirowga xididdada dhiigga ku faafa
4. Hematosepsis ama Infekshan firfircoon oo aan la xakamayn
5. Xakamayn la'aan sonkorow
CAR T-Cell daawaynta ay ansixisay USFDA
Unugyada B-unugyada leukemia ba'an oo soo noqnoqda ama soo noqnoqda
Heerka jawaabta oo dhammaystiran (CR): >90%
Beegsiga: CD19
Price: $ 475,000
Waqtiga ansixinta: Agoosto 30, 2017
Soo noqoshada ama dib-u-soo-celinta waxay kala firdhisaa lymphoma unugga B-weyn, soo noqoshada ama dib-u-kicinta unugyada follicular
Heerka jawaab celinta dhamaystiran ee lymphoma non-Hodgkin (CR): 51%
Beegsiga: CD19
Price: $ 373,000
Waqtiga ansixinta: 2017 Oktoobar 18
Soo noqoshada ama dib-u-celinta waxay faafisaa lymphoma weyn ee unugyada B
lymphoma unugga mantle Heerka jawaabta oo dhammaystiran (CR): 67%
Beegsiga: CD19
Price: $ 373,000
Waqtiga la ansixiyay: Oktoobar 18, 2017
Soo noqoshada ama dib-u-celinta waxay faafisaa lymphoma weyn ee unugyada B
Heerka jawaabta oo dhammaystiran (CR): 54%
Beegsiga: CD19
Price: $ 410,300
Waqtiga la ansixiyay: Oktoobar 18, 2017
Dib-u-soo-kabashada ama dib-u-soo-celinta Multiple Myeloma
Heerka jawaabta oo dhammaystiran: 28%
Beegsiga: CD19
Price: $ 419,500
Waxaa la ansixiyay: Oktoobar 18, 2017
Waa maxay waxyeelada daawaynta unug ee CAR-T?
Hoos waxaa ku xusan qaar ka mid ah waxyeelada daawaynta CAR T-cell.
- Cytokine release syndrome (CRS): The most prevalent and possibly significant side effect of CAR T-cell treatment is cytokine release syndrome (CRS). The flu-like symptoms, including fever, exhaustion, headaches, and muscle pain, are brought on by the modified T cells’ production of cytokines. In extreme circumstances, CRS may result in a high temperature, hypotension, organ failure, and even potentially fatal consequences.
- Sunta Neerfaha: Bukaanjiifka qaarkood waxaa laga yaabaa inay yeeshaan saameynaha neerfaha, kuwaas oo u dhexeeya darnaan laga bilaabo calaamado aan halis ahayn sida jahawareer khafiif ah iyo jahawareer ilaa kuwa ka sii daran sida suuxdin, delirium, iyo encephalopathy. Ka dib faleebada CAR T-cell, sunta neerfaha waxay badanaa dhacdaa usbuuca ugu horreeya.
- Cytopenia: Daawaynta CAR T-unuggu waxay keeni kartaa inay hoos u dhigto tirooyinka unugyada dhiigga, sida dhiig-yarida (tirada unugyada dhiigga cas ee hooseeya), neutropenia (tirada unugyada dhiigga cad oo hooseeya), iyo thrombocytopenia (tirada platelet oo hooseeya). Caabuqyada, dhiig-baxa, iyo daalku waxay ka mid yihiin khataraha ay uga sii dari karto cytopenia.
- Caabuqyada: CAR T-cell therapy's xakamaynta unugyada difaaca jirka ee caafimaadka qaba waxay kordhisaa halista caabuqyada bakteeriyada, fayraska, iyo fungal. Si looga hortago infekshannada, bukaanku waxay u baahan karaan in si dhow loola socdo oo la siiyo daawo ka hortag ah.
- Tumor Lysis Syndrome (TLS)Ka dib daaweynta CAR T-cell, waxaa suurtagal ah xaaladaha qaarkood in xaddi la taaban karo oo ka kooban unugyada lagu sii daayo dhiigga sababtoo ah dilka degdega ah ee unugyada burooyinka. Tani waxay keeni kartaa cillado dheef-shiid kiimikaad ah, sida potassium-ka xad-dhaafka ah, uric acid, iyo heerarka fosfateet, kuwaas oo dhaawici kara kelyaha oo sababi kara dhibaatooyin kale.
- Hypogammaglobulinemia: Daawaynta CAR T-cell waxay leedahay awood ay ku yarayso isku-darka unugyada difaaca jirka, taas oo keeni karta hypogammaglobulinemia. Tani waxay ka dhigi kartaa infekshannada soo noqnoqda inay u badan tahay waxayna wacdaa in la sii wado daawada beddelka unugyada.
- Sunta Xubinta: Daaweynta CAR T-cell waxay leedahay awood ay ku waxyeeleyso tiro xubno ah, oo ay ku jiraan wadnaha, sambabada, beerka, iyo kelyaha. Tani waxay u horseedi kartaa baaritaanada shaqada kelyaha ee aan caadiga ahayn, arrimaha neefsashada, arrimaha wadnaha, iyo baaritaanka shaqada beerka ee aan caadiga ahayn.
- Hemophagocytic lymphohistiocytosis (HLH): Cudur naadir ah laakiin suurtagal ah oo dilaa ah oo loo yaqaan hemophagocytic lymphohistiocytosis (HLH) ayaa ku soo bixi kara natiijada daawaynta CAR T-cell. Waxay ku lug leedahay firfircoonida xad-dhaafka ah ee unugyada difaaca jirka, taas oo keenta dhaawac halis ah xubnaha iyo bararka.
- Hypotension iyo Haysashada Dheecaannada: Natiijadu waxay tahay cytokines ay unugyada CAR T sii daayaan, bukaannada qaarkood waxaa laga yaabaa inay yeeshaan cadaadis dhiig oo hooseeya (hypotension) iyo xajinta dareeraha. Si wax looga qabto calaamadahan, tillaabooyin taageero ah oo ay ku jiraan dheecaannada xididka iyo dawooyinka ayaa loo baahan karaa.
- Xannaanada Labaad: Warbixinnada malignancies-ka labaad ee soo baxaya ka dib daaweynta CAR T-cell ayaa jira, inkastoo ay naadir yihiin. Cilmi baaris ayaa hadda lagu sameynayaa suurtagalnimada malignant-ka labaad iyo khataraha mustaqbalka fog.
Waxaa muhiim ah in la xasuusnaado in bukaan kastaa aanu yeelanayn dhibaatooyinkan soo raaca, iyo in qof walba heerka dareenkiisu uu kala duwanaan doono. Si loo yareeyo loona yareeyo saamaynta xun ee iman karta, kooxda caafimaadku waxay si dhow u baadhaan bukaanka ka hor, inta lagu jiro, iyo ka dib daawaynta CAR T-cell.
Waqtiga waqtiga
Hoos ka hubi wadarta wakhtiga loo baahan yahay si loo dhamaystiro habka daawaynta CAR T-cell. In kasta oo wakhtiga xaddidan uu aad ugu xidhan yahay fogaanta shaybaadhka ee cusbitaalka diyaariyey CAR-da.
- Imtixaan & imtixaan: hal usbuuc
- Daawaynta kahor & Ururinta T-Cell: hal usbuuc
- Diyaarinta iyo soo celinta T-Cell: laba-saddex toddobaad
- Falanqaynta waxtarka 1aad: saddex toddobaad
- 2nd Waxtarka falanqaynta: saddex toddobaad.
Wadarta wakhtiga: 10-12 toddobaad