Engqungqutheleni Yomhlaba Ye-18 Yomdlavuza Wesisu, ucwaningo lomtholampilo lwesigaba I lwabonisa ukuthi i-anti-PD-L1 immunotherapy ehlanganiswe ne-MEK inhibitors ingawelapha ngempumelelo umdlavuza we-metastatic colorectal ozinzile we-microsatellite.
Umphenyi oholayo walolu cwaningo, uJohanna Bendell weSarah Cannon Cancer Institute, uveze ukuthi: Kuze kube manje, i-immunotherapy isebenze kuphela ezigulini ezinomdlavuza we-colorectal we-microsatellite ongazinzile kakhulu, kanti lolu hlobo lweziguli lubalelwa ku-5% kuphela wabantu.
Umdlavuza we-colorectal ongazinzile we-microsatellite ephezulu unenani elikhulu lokuguqulwa kwezakhi zofuzo ngakho-ke uphendula ku-anti-PD-1 / PD-L1 immunotherapy. Kodwa-ke, cishe i-95% yeziguli ezinomdlavuza we-metastatic colorectal zine-microsatellite foci ezinzile. Kuze kube manje, le ngxenye yeziguli ayikaphenduli neze ku-immunotherapy.
Ucwaningo olwenziwe ngaphambi kokuhlinzwa lubonisa ukuthi ama-MEK inhibitors angenza izicubu zizwele kakhulu ku-immunotherapy. Indlela ethile kungenzeka kube ukukhulisa inani lamaseli omzimba asebenzayo (njengamaseli we-CD8 amahle) kulesimila futhi andise ukubonakaliswa kwezici zokwenza kusebenze amasosha omzimba.
Imiphumela yocwaningo ikhombise ukuthi isifundo somtholampilo seSigaba I b sisebenzise i-MEK inhibitor Cobimetinib ekwelapheni iziguli ezingama-23 ezinomdlavuza welashwa opholile ngokwendlela ekhuphuka ngomthamo. (Q3W), iziguli eziningi zingakwazi ukubekezelela imithamo emikhulu futhi ziphathwe nge-800 mg ye-PD-L1 inhibitor Atezolizumab (umjovo we-intravenous, Q2W).
Ekwelashweni okulandelwayo, abacwaningi babone ukuthi iziguli ezi-4 (17%) zine-tumor shrinkage okungenani engama-30%, kanti iziguli ezi-5 (22%) zinezifo ezizinzile. Isikhathi sokuxolelwa esiqhubekayo singaphezu kwezinyanga ezi-4 ~ 15. Ngokuphathelene nedatha yamanje, iziguli ezimbili kwezine ezine-remission engaphelele zizuze ukuxolelwa okuqhubekayo. Phakathi kweziguli ezinokuxolelwa okuyingxenye, amacala ama-2 bekungazinzile kwe-microsatellite ezinzile noma ezingeni eliphansi le-microsatellite, kanti ikesi elingu-4 lalinesimo se-microsatellite esingaziwa. Phakathi kweziguli ezifakiwe ocwaningweni, abengekho amacala ama-microsatellites angaqiniseki kakhulu.
Ngaphezu kwalokho, izinga lokuqala le-PD-L1 alithinti ukuxolelwa kwezifo, umuthi wokuhlanganiswa ubekezeleleke kahle, futhi azikho izehlakalo ezimbi ezihlobene nokwelashwa.
UBendell uphethe ngokuthi: "Imiphumela yocwaningo iyahambisana nombono wokwelashwa okuhlanganisiwe, okuphinde kunikeze ezinye iziguli ezingama-95% zeziguli ezinomdlavuza onamathuba amaningi okuthola i-immunotherapy." Umphenyi usezokwethula isifundo somtholampilo sesigaba III, ukuhlela ukungena eqenjini kunzima Kumdlavuza wokwelapha we-metastatic colorectal, qhathanisa ukusebenza kahle kwale nhlanganisela yemithi nemithi ejwayelekile.
