Julayi 2021: Ukwelashwa kwe-CAR T-Cell kumathumba aqinile kuvunyiwe e-China ngezinkomba ezithile nomaka. Muva nje, Ukwelashwa kwe-CAR T-Cell ihlolelwe umdlavuza oqinile njenge:
- Umdlavuza wesibeletho
- Umdlavuza wamaphaphu ongewona wamaseli amancane
- Umdlavuza wesibindi
- I-Cholangiocarcinoma
- umdlavuza obomvu
- umdlavuza wesisu
- Umdlavuza wesibeletho
- umdlavuza we-esophageal
- umdlavuza wepancreatic
- I-Oophoroma
- Umdlavuza we-gallbladder
- Umdlavuza wesibeletho
ISIMOTO SEMOTO kuyo yonke le midlavuza iyasebenza ezigulini ezibuye zabuyela emuva ngemva kwemigudu ethile yokwelashwa njengokuhlinzwa, ichemotherapy kanye neradiotherapy.
Eyokuqala ISIMOTO SEMOTO Icala emhlabeni jikelele lapho intombazane eneminyaka engu-5 ubudala okuthiwa u-Emily ene-Leukemia yelashwa ngo-2012.
UJimmy Carter, 90, owayengumongameli waseMelika, umemezele lokho melanoma amangqamuzana ayesakazekele esibindini nasebuchosheni.
Ngomhla zi-6 kuZibandlela wezi-2015, nge-antibody ye-PD-1 kanye ne-radiotherapy, amangqamuzana omdlavuza ku-vivo anyamalala.
NgoMashi 6, 2016, wayengasadingi ukwelashwa nge-melanoma.
NgoDisemba 2, 2018, wabonakala nasemngcwabeni kaMongameli wangaphambilini uBush.
Ekupheleni kuka-2013, i-immunocytotherapy yalinganiswa njengenye yempumelelo ephezulu eyishumi yezobuchwepheshe yonyaka ngumagazini we-Science.
Ngo-2014, izingqungquthela ezimbili zomdlavuza ezigunyaziwe, i-AACR ne-ASCO, zabanjwa e-United States. I-Immunotherapy isiphenduke ukugxila kobuchwepheshe obusezingeni eliphezulu. Ngo-2014, i-FDA igunyaze ukufakwa kuhlu kwe-nivolumab ne-pembrolizumab.
Ukwelashwa kwe-CAR T Cell kumdlavuza we-thyroid
Ngo-2015, umqondisi we-Movie u-Chen Xunqi kwatholakala ukuthi akahlukanisiwe umdlavuza we-thyroid, wahlinzwa nokwelashwa ngamakhemikhali amaningi eBeijing, futhi wayeka ukwelashwa ngamakhemikhali;
Ngo-2016, amaphuzu e-PS angu-3 lapho esesibhedlela, enciphile, futhi wanquma ukuzama ukwelashwa kwe-CAR T ngemva kwezifundo ezimbili ukuze enze isisu zinyamalale;
Ku-2017, ihlolwe futhi yahlolwa kabusha, ejwayelekile; ngo-2018, kwahlolwa kwahlolwa kabusha, kwajwayelekile;
Kuyini ukwelashwa kwe-CAR T Cell?
Amaseli e-T angena ezicutshini zesimila, akhiphe amasosha omzimba (PD-1, CTLA-4 kanye namanye amasosha omzimba), futhi kancane kancane aguqule imvelo yasendaweni ye-tumor immunosuppression.
I-CAR-T kuma-T cell abulala izimila eziqondiwe futhi ikhipha ama-cytokines ukuze ulawule isisho se-MHC futhi uveze ama-antigen e-tumor. Ngaleso sikhathi, amasosha omzimba anciphisa ukuvinjelwa kwe-tumor yendawo ye-T cell (TIL), futhi ama-T cell angenile aqala Ukuqala, ukwenza kusebenze futhi ande.
I-CAR-T & TIL ikhiqiza umphumela weqoqo, iguqule izicubu enkundleni yempi yokuzivikela, ibulale zonke izinhlobo zamangqamuzana wesimila ndawonye futhi ziwaphendulele amathumba ashisayo, zibhubhise ngokuphelele izicubu futhi zenze amangqamuzana ezinkumbulo ze-effector, anciphise amathuba okuvela kwesimila.
Imiphumela emibi yokwelashwa kwe-CAR T-Cell ezimeni zomdlavuza oqinile
Ezigulini ezingama-25 ezazinomdlavuza oqinile, ezingama-25 ziye ezivivinyweni ze-CAR T-Cell:
- umkhuhlane ophezulu watholakala ezigulini eziyisi-6
- Izimpawu ze-dyspnea kanye ne-pneumonia ezigulini ezi-2
- Isiguli esingu-1 sasinesikhumba esomile nenkwethu
- azikho ezinye iziguli ezibonise ukungavamile okuphawulekayo.
Icala A: Isiguli somdlavuza wamaphaphu sithola ukwelashwa kwe-CAR T-Cell
NgoNovemba ka-2009, isiguli sathola isisindo sephaphu lesokunxele futhi sadlula kwesokunxele umdlavuza wamaphaphu ukuhlinzwa okukhulu. I-pathology: i-adenocarcinoma yamaphaphu;
Kusukela ngo-Jan 2013 kuya ku-January 2017, ama-metastases amathathu obuchopho enzeka, futhi ukuhlinzwa nokwelashwa ngemisebe kwanikezwa ngokulandelana ngokulawulwa okungalungile;
Kusukela ngoMashi 2017 kuya kuSepthemba 2017, kuma-metastases ebuchosheni, amaseli e-mesoCAR-αPD1 aveza i-PD-1 antibody anikezwe izifundo eziyisithupha zokwelapha. Ngemva kokwelashwa, i-PR yahlolwa futhi izimila zancipha kakhulu ngenani elincane kuphela lezinsalela.
Icala B: Isiguli somdlavuza wamasende esilashwa nge-CAR T-cell
Ngo-Agasti ka-2016, isiguli sathola inqwaba ku-scrotum esifanele futhi sathola ukwelashwa kokuhlinzwa. I-pathology: i-embryonic rhabdomyosarcoma;
Ngo-March ka-2017, ukubuyekezwa kwe-PET-CT, kwathola ukuthi i-peritoneum, i-omentum, namathumbu ayengacacile, kucatshangelwa ama-metastases amaningi emgodini wesisu;
Kusukela ngoJuni kuya kuSepthemba 2017, amaseli e-mesoCAR-αPD1 aveze i-antibody ye-PD-1 anikezwe izikhathi ezi-4. Umphumela waba CR; wonke ama-metastases esiswini ahamba.
Icala C: Isiguli se-Lung adenosquamous carcinoma sithola ukwelashwa kwe-CAR T-Cell
NgoNovemba 2017, kwatholakala i-adenosquamous carcinoma engaphezulu kwesokunxele (6.4 “2.9cm) ehambisana nokumetastasis kwe-clavicle yesokunxele kanye nama-lymph nodes omlomo wesibeletho. Ungeniswe esibhedlela ukuze athole ukwelashwa, futhi Ⅲ kanye no-V ukucindezeleka kwamathambo nobuchopho kwenzeke ngemva kokwelashwa ngamakhemikhali oku-3 , Imiphumela engemihle inamandla. Khetha ukuzama immunotherapy kuhlanganiswe ne-chemotherapy.
NgoJanuwari 2 noFebruwari 6, 2018, ukufakwa kwamangqamuzana omzimba amabili omzimba kwenziwa, futhi umzimba waba ngcono kakhulu, futhi imiphumela emibi yokwelashwa ngamakhemikhali yancipha kancane kancane. Ukuhlolwa kabusha akuzange kubonise ukumetastasis kabusha kwesimila noma ukwanda.
Ukuhlolwa kokuphela kukaFebhuwari 2018 kukhombisile ukuthi izilonda emaphashini zehle kakhulu futhi isimo somdlavuza besivele silawulwa.
Icala D: Isiguli somdlavuza wesibindi senziwe i-CAR T-cell therapy
Ngomhla ka-Juni 1, 2017, kwatholwa isimila esingu-66mm x 46mm engxenyeni engenhla yephaphu lelobe yesokunxele. NgoJuni 15, wangeniswa e-Oriental Hepatobiliary Surgery Hospital ukuze athole ukwelashwa. Ngokusekelwe emiphumeleni ye-CT-guided puncture biopsy yamaphaphu, uhlelo lokwelapha oluthathu kokukodwa oluhlanganisa i-CAR-T cell immunotherapy, ukwelapha okuqondiswe kuye + ukwelashwa ngamakhemikhali kwasungulwa. Ngomhla zingama-29 kuNtulikazi, 2017, ukwelashwa kokuqala kwe-immune cell infusion kwenziwa. Ngemva kokumnika, umzimba wasabela ngokuqinile. Ngemva kokuba isimo sakhe sizinzile, isimo sakhe saba ngcono ekuqaleni. Ngemva kwezinyanga ezingaphezu kweziyisithupha ze-immunotherapy ehlanganiswe nokwelashwa okuhlosiwe, izimila emzimbeni zibe zincane kakhulu.
Icala E: Isiguli somdlavuza wamaphaphu esine-metastasis yobuchopho selashwe nge-CAR T-cell
Ngomhla zingama-26 kuNovemba 2009, kwatholwa isimila esingu-3.03 “2.39cm engxenyeni engenhla yephaphu lesokunxele, futhi ingxenye engaphezulu kwesokunxele yakhishwa ngokuqondile nangokuphelele ekuqaleni. Ngomhla zingama-25 kuJanuwari, 2013, ukuba ndikindiki emkhawulweni ongezansi kwesokunxele akuphumelelanga ukuthola isimila se-metastatic yobuchopho Ukukhishwa kabusha kwezilonda ezijulile esikrinini + ukwelashwa okuhlosiwe nge-Iressa. 6 NgoJuni 2016, i-foci emise okweshidi, ethuthukiswe ngendlela engavamile yavela lapho kuhlangana khona i-frontal-parietal lobe yokukhishwa kwesimila ngaphakathi kwe-cranial. Ngo-2017, ebuchosheni Ukuwohloka, isimila esingaba ngu-3.3 “2.8 cm, savela engxenyeni efanele ye-parietal, futhi kwenziwa ama-metastases amaningi e-meningeal kanye ne-radiotherapy. 3 NgoMashi 2017, i-immunotherapy yaqalwa. Izikhathi ezine ngaphambi nangemva kokumnika, isimila ebuchosheni sithuthuke kakhulu.
Icala F: Isiguli somdlavuza wegilo esingahlukanisiwe sithola ukwelashwa kwe-CAR T-cell
Ngo-2016, watholakala enomdlavuza we-thyroid ongafani. I-Quine uhlobo olubi kakhulu lomdlavuza we-thyroid, futhi odokotela batshele ukuthi kusele izinyanga ezimbili kuphela zokuphila. Ngemuva kokwelashwa okuningana kwe-radiotherapy, wehla ngamakhilogremu angu-2, kodwa umzimba wakhe awuzange ube ngcono. Wabe esenqaba ukwelashwa ngamakhemikhali. Kamuva, ngaya kozama i-immunotherapy. Ngemuva kokungenwa ngamaseli ama-immune cell amabili, amangqamuzana omdlavuza asenyamalele ngokuphelele.
Icala G: Isiguli somdlavuza we-Hypopharyngeal sithola ukwelashwa kwe-CAR T-Cell
NgoJulayi 2014, kwatholakala ukuthi une-hypopharyngeal carcinoma, i-linary sacral carcinoma. Izifundo ezi-2 ze-chemotherapy kanye nokuhlinzwa komdlavuza we-hypopharyngeal kanye ne-neck neck dissection. Ngemva konyaka nesigamu, waphinde walulama, wabe eseqhubeka nokwelashwa nge-radiotherapy, okwabonakala imiphumela engemihle futhi isimo sakhe somzimba sasingesihle neze. NgoJanuwari 13, 2016, ama-immune cell infusions amane amukelwe ngokulandelana. Isimo saqala ukuzinza futhi isimo saba ngcono kakhulu. Kusukela ngoJulayi kuya kuDisemba 2016, ama-cell infusions amahlanu ayenziwa, futhi isimo somzimba sathuthuka kancane kancane, ngokulala okuvamile kanye nesifiso sokudla. Endabeni yokukhubazeka embhedeni izinyanga ezimbalwa, futhi imisipha kancane kancane i-atrophied, isisindo sakhe senyuka sisuka ku-80 kg saya ku-112 kg.
Icala H: Isiguli somdlavuza webele kwesokunxele esine-metastasis yobuchopho sithola ukwelashwa kwe-CAR T-Cell
NgoJanuwari 2014, kwatholakala ukuthi unebele elisakazekile umdlavuza wamaphaphu nesibindi ama-metastases. Kusukela ngoJanuwari kuya kuNovemba 2014, izikhathi eziyi-9 ze-chemotherapy zenziwe. Kusukela ngoJuni 2015, amangqamuzana omdlavuza angena ebuchosheni, futhi kwenziwa ukwelashwa kommese we-cranial gamma okungu-11, futhi amangqamuzana omdlavuza asakazeka ngokuphelele. 3NgoMashi 2017, e-Hong Kong, bathola ukwelashwa kwe-PD-1 futhi basahluleka. Kusukela ngo-Ephreli 2018, sazama i-CAR-T immunotherapy. Ngemva kwenkambo eyodwa yokwelashwa, umphumela wawumangalisa. Ukuvuvukala kobuchopho nesibindi kwanyamalala. Ukuvuvukala okwakusakazeke kuwo wonke amaphaphu kwahlakazeka kuphela. Yehliselwe ku-1.2.
