Maarso 2022: Cilmi-baarayaasha Xarunta Kansarka ee Jaamacadda Texas MD Anderson waxay ogaadeen in axi-cel, autologous anti-CD19 chimeric antigen reseptor (CAR T-cell therapy), ay tahay daawaynta safka koowaad ee badbaado leh oo wax ku ool ah bukaanada leh khatarta sare ee unugyada B-cell. lymphoma (LBCL), koox baahi weyn u qabta daaweyn cusub oo waxtar leh.
Natiijooyinkan waxaa lagu soo bandhigay Bulshada Maraykanka ee Hematology's shir sannadeedka 2020 ee casriga ah.
Dhaqan ahaan, qiyaastii kala badh bukaannada qaba LBCL-ka khatarta sare leh, koox-hoosaadyada cudurka kaas oo bukaannada ay qabaan laba-laab-ama saddex-laab ah lymphoma ama arrimo dheeraad ah oo khatar ah oo caafimaad oo lagu aqoonsaday Index-Index Prognostic International (IPI), ma aysan gaarin cudur muddo dheer ah. cafiska hababka daawaynta caadiga ah sida kiimoterabiga.
Tijaabadani waxa ay ka dhigan tahay tallaabo loo qaaday samaynta Daaweynta unugyada CAR T 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. Daaweynta unugyada CAR T, haddii lagu guuleysto, waxay ka dhigi kartaa faleebo hal mar ah oo daaweyn la dhammeeyey hal bil gudaheed.
Iyada oo ku saleysan cilmi-baarista muhiimka ah ee ZUMA-1, Axi-cel waxay hadda u haysataa shatiga daawaynta dadka soo noqnoqda ama LBCL dib u celinaya kuwaas oo horey u lahaa laba ama in ka badan oo daawaynta habaysan. Tijaabada ZUMA-12 waa wejiga 2-calaamad furan, hal-cudud, tijaabo xarun badan oo dhiseysa natiijooyinka tijaabada ZUMA-1 si loo qiimeeyo isticmaalka axi-cel oo ah daawaynta safka hore ee bukaanka leh LBCL khatarta sare leh. .
Marka loo eego daraasadda ku-meel-gaarka ah ee ZUMA-12, 85 boqolkiiba bukaannada lagu daweeyay axi-cel waxay heleen jawaab celin guud, iyo 74% waxay heleen jawaab dhammaystiran. Ka dib dabagal dhexdhexaad ah oo bilihii 9.3 ah, 70% bukaannada la shaqaaleysiiyay waxay muujiyeen jawaab celin joogta ah oo ku saabsan goynta xogta.
Dhimista tirada unugyada dhiiga cad, maskaxda, dhiig-yarida, iyo cytokine sii daayo syndrome waxay ahaayeen waxyeellooyinka ugu badan ee lala xiriiriyo daawaynta axi-cel. Waqtiga la baaray xogta, dhammaan dhacdooyinka xun waa la xalliyey.
Intaa waxaa dheer, marka la barbar dhigo marka alaabada difaaca jirka laga soo saaro bukaanada horey u helay dhowr xariiq oo kiimiko ah, heerka ugu sarreeya ee unugyada CAR T ee ku jira dhiigga, iyo sidoo kale dhexdhexaadinta unugyada CAR T, ayaa ka sarreeya tijaabadan safka hore Daaweynta unugyada CAR T.
"Taam ahaanshaha unugyada T-ga waxaa lagu xiri karaa waxtarka daaweynta weyn, taasoo keentay natiijooyin bukaan oo wanaagsan," Neelapu ayaa ku daray.
Iyadoo la raacayo natiijooyinka ku-meel-gaadhka ah ee wanaagsan ee ZUMA-12, cilmi-baarayaashu waxay qorsheynayaan inay sii wadaan la-socodka bukaannada si loo hubiyo in fal-celintooda daawadu ay tahay mid waara.
“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
