Immunotherapy dina pengobatan kanker
Terapi CAR-NK Kanker ngagaduhan tingkat efektif 73%, sareng direkrut dina uji klinis domestik.
Immunotherapy geus revolutionized cara kanker dirawat. Imunoterapi kanker dibagi jadi dua kategori: hiji nyaéta inhibitor pamariksaan imun, sareng PD-1, PD-L1 sareng CTLA-4 parantos disatujuan pikeun pengobatan rupa-rupa kanker. Sareng Hadiah Nobel 2018 dina Fisiologi atanapi Kedokteran dilélér kontribusi pangembangan sambetan checkpoint imun pikeun manusa.
Anu sanésna nyaéta immunotherapy sélular, dimana éta chimeric antigen receptor CAR-T therapy is the most rapidly progressing one. In 2017, the US Food and Drug Administration (FDA) approved two CAR-T cell therapies, Yescarta and Kymriah, which mainly target hematological tumors, leukemias and limfoma.
Terapi Mobil T Cell
CAR-T therapy has a long way to go to treat solid tumors, so scientists have begun to seek other cellular imunoterapi to treat cancer, and natural killer (NK) cell therapy is one of the most promising methods. The success of CAR-T cell therapy has stimulated enthusiasm for modifying NK cells with CAR genes to enhance their tumor-killing ability.
Recently, the results of a phase I / IIa trial of the MD Anderson Cancer Center in the United States announced that CD19-targeted umbilical cord blood chimeric antigen receptor natural killer cell therapy (CAR-NK) has achieved a clinical response. No major toxicities were observed in patients with refractory or refractory lymphoma non-Hodgkin urang (NHL) and chronic lymphocytic leukemia (CLL).
Data panalungtikan terapi sél CAR-NK
Hasil sidang dikaluarkeun kamari dina New England Journal of Medicine. Tina 11 pasién anu ilubiung dina panilitian, 8 (73%) ngaréspon pangobatan, sareng 7 diantarana ngaréspon lengkep, hartosna yén aranjeunna henteu acan nunjukkeun tanda kanker dina median nurutan 13.8 bulan, sareng henteu pasién ngalaman sél Sindrom pelepasan faktor atanapi neurotoksisitas.
Réspon kana terapi sél CD19 CAR-NK penting dina 1 bulan saatos infus, sareng kegigihan sél ieu masih kauninga dina 1 taun saatos infus.
Panulis anu pakait Katy Rezvani, profésor cangkok sél sirung sareng Terapi Sél, nyarios: "Kami didorong ku hasil sidang klinis, anu bakal ngalaksanakeun studi klinis salajengna pikeun diajar poténsial sél allogeneik tina sél CAR-NK turunan getih salaku pasién anu peryogi Pilihan Perlakuan. "
Di Pusat Kanker MD Anderson, sél NK diisolasi tina getih tali pusar sareng direkayasa sacara genétis pikeun nganyatakeun CAR anu diperyogikeun, anu tiasa ngaidentipikasi udagan khusus kanker. Sél CAR-NK ogé kedah "dilengkepan" ku IL-15, hiji molekul sinyal imun anu dirancang pikeun ningkatkeun proliferasi sél sareng salamet.
Dina panilitian ieu, sél CAR-NK mangrupikeun allogeneic, anu hartosna yén sél ieu dicandak tina donatur anu séhat anu henteu aya hubunganana sareng pasién, sanés sanésna sanés. Kusabab kitu, sél CAR-NK gaduh kamungkinan pikeun didamel sareng disimpen sateuacanna kanggo dianggo langsung. Kontrasna, sél CAR-T anu aya sacara komersil ayeuna kedah nganggo prosés panyebaran budaya multi-minggu pikeun ngahasilkeun sél T anu direkayasa sacara genetik dumasar kana gén pasién sorangan.
Sél CAR-NK gaduh sababaraha kaunggulan tibatan sél CAR-T
First, unlike CAR-T cells, CAR-NK cells retain the inherent ability to recognize and target tumor cells through their natural receptors, so that when CAR-NK targeted therapy is used, tumor cells are less likely to escape killing.
Second, CAR-NK cells do not undergo immune rejection for days to weeks. As a result, they have not shown the same safety issues in many CAR-T clinical trials, such as the absence of sindrom sékrési sitokin.
Tungtungna, sél NK henteu meryogikeun cocog HLA anu ketat sareng teu ngagaduhan kamungkinan janten panyawat graft-versus-host, anu mangrupikeun résiko anu penting pikeun imunoterapi sél CAR-T.
