Disemba 2020: Abacwaningi base-University of Texas MD Anderson Cancer Centre bathole ukuthi i-axi-cel, i-autologous anti-CD19 chimeric antigen receptor (CAR) T cell therapy, iyindlela yokwelapha yomugqa wokuqala ephephile nesebenzayo yeziguli ezine-B-cell lymphoma esengozini enkulu. (LBCL), iqembu elidinga kakhulu izindlela zokwelapha ezintsha nezisebenzayo.
Lokhu okutholakele kwethulwe ku-American Society of Hematology's virtual 2020 Annual Meeting.
Traditionally, around half of patients with high-risk LBCL, a subgroup of the disease in which patients have double- or triple-hit i-lymphoma or additional clinical risk factors identified by the International Prognostic Index (IPI), have not achieved long-term disease remission with standard treatment approaches such as chemoimmunotherapy.
Lesi sivivinyo simele isinyathelo esiya ekwenziweni Ukwelashwa kwamaseli e-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. Ukwelashwa kwamaseli e-CAR T, uma iphumelele, ingase ikwenze ukufakwa kanye kuphela ngokwelashwa okuqedwe enyangeni eyodwa.
Ngokusekelwe ocwaningweni olubalulekile i-ZUMA-1, i-Axi-cel njengamanje inelayisensi yokwelapha abantu abane-LBCL ebuyele emuva noma ephikayo asebevele benemigqa emibili noma ngaphezulu yokwelapha okuhleliwe. Uhlolo lwe-ZUMA-12 luyiSigaba 2 esinelebula evulekile, ingalo eyodwa, uhlolo olugxile ezintweni eziningi olwakhelwa kulokho okutholwe ocwaningweni lwe-ZUMA-1 ukuze kuhlolwe ukusetshenziswa kwe-axi-cel njengokwelashwa komugqa wokuqala ezigulini ezine-LBCL esengozini enkulu. .
Ngokocwaningo lwesikhashana lwe-ZUMA-12, amaphesenti angama-85 eziguli ezelashwa nge-axi-cel abe nempendulo ephelele, kanti ama-74% abe nempendulo ephelele. Ngemuva kokulandelela okumaphakathi kwezinyanga ezingu-9.3, i-70% yeziguli eziqashiwe zibonise impendulo eqhubekayo ekunqanyulweni kwedatha.
Ukunciphisa inani lamaseli amhlophe egazi, i-encephalopathy, i-anemia, kanye i-cytokine release syndrome kwakuyimiphumela emibi kakhulu exhunywe nokwelashwa kwe-axi-cel. Ngesikhathi idatha ihlaziywa, zonke izehlakalo ezimbi zase zixazululiwe.
Ngaphezu kwalokho, uma kuqhathaniswa nalapho imikhiqizo ye-immunotherapy yenziwa ezigulini esezivele zithole imigqa eminingana ye-chemotherapy, izinga eliphakeme lamaseli e-CAR T akhona egazini, kanye nokunwetshwa kwamaseli e-CAR T amaphakathi, ayephezulu kulolu cwaningo. umugqa wokuqala Ukwelashwa kwamaseli e-CAR T.
"Lokhu kufaneleka kwe-T cell kungaxhunyaniswa nempumelelo enkulu yokwelapha, okuholela emiphumeleni engcono yesiguli," wanezela uNeelapu.
Kulandela imiphumela emihle yesikhashana ye-ZUMA-12, abacwaningi bahlela ukuqhubeka nokulandelela iziguli ukuze baqinisekise ukuthi ukusabela kwazo emithini kuhlala isikhathi eside.
“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 i-lymphoma.
