Ukwelashwa kwe-Tumor-infiltrating lymphocyte (TIL).
Indlela yokuguqula ekwelapheni umdlavuza.
Ingabe ufuna ukubhalisa kule mpumelelo yokwelashwa komdlavuza?
Ukwelashwa kwe-tumor-infiltrating lymphocyte (TIL) kuyindlela ethembisayo ekwelapheni umdlavuza. Kuhilela ukukhipha amangqamuzana okuzivikela komzimba, ikakhulukazi ama-T cell, esicutshini sesimila sesiguli. Lama-T cell abe esekhuliswa futhi aphindaphindeke elabhorethri ngaphambi kokuba aphinde abuyiselwe emzimbeni wesiguli. Umgomo uwukuthuthukisa amandla amasosha omzimba okubona nokuhlasela amangqamuzana omdlavuza ngempumelelo. Ukwelashwa kwe-TIL kuthathwa njengohlobo lokudluliswa kwamaseli okutholwa, okusebenzisa impendulo yesiguli yamasosha omzimba ngokumelene nesimila. Le immunotherapy yomuntu siqu inamandla okwelapha imidlavuza ehlukahlukene futhi iyindawo esebenzayo yocwaningo nokuthuthukiswa komtholampilo ku-oncology.
Febhuwari 2024: I-novel cellular immunotherapy manje isinikezwa iziguli ezinemelanoma ethuthukisiwe. Kwaziwa ngokuthi Ukwelashwa kwe-TIL, okusho ukuthi i-tumor-infiltrating lymphocyte therapy. Umjovo wesikhathi esisodwa we-T-cell therapy usebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Kungokokuqala ukuthi ukwelashwa kweseli yezimila eziqinile kugunyazwe yi-FDA.
Idatha yocwaningo lomtholampilo iphakamisa ukuthi umuthi wesikhathi esisodwa ube nezinga lokuphendula elingama-36% kubantu abane-melanoma ye-metastatic, okuwumphumela omuhle uma kucatshangelwa ukuthi lokhu kwelashwa kwahlolwa ezigulini okugula kwazo okwaba kubi kakhulu ngemva kokuthola izinhlobo ezahlukene ze-immunotherapy. Iziguli nazo ziye zabhekana nezimpendulo zesikhathi eside, ezihlala ngaphezu kweminyaka emibili.
Ukwelashwa kwe-tumor-infiltrating lymphocyte (TIL) kuyindlela esezingeni eliphezulu ye-immunotherapy esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Lokhu kwelashwa kwenoveli kuhlukaniswa njengokudluliswa kwamaseli okutholwa (ACT), lapho amasosha omzimba esiguli akhishwa, asetshenziswe, noma akhuliswe elebhu ngaphambi kokuba aphinde afakwe esigulini ukuze aqondise futhi aqede amaseli omdlavuza.
Isebenza kanjani i-TIL therapy?
Ukwelashwa kwe-TIL kufaka phakathi ukuqoqa ama-T-lymphocyte (T-cell) esimila esikhishwe ngokuhlinzwa. Lawa maseli abe eseqiniswa elabhorethri ukuze athuthukise ikhono lawo lokulwa nomdlavuza ngokukhetha nokuphindaphinda ama-T-cell anamandla kakhulu. Lawa maseli aphinde afakwe esigulini ngokumuselwa kulandela ukwelashwa ngamakhemikhali okungeniswa. Ama-T-cell asanda kushajwa kakhulu ahamba emzimbeni wonke, ehlasela futhi ebulala amaseli wesimila.
Iyini inqubo yokwelashwa kwe-TIL?
Ukwelashwa kwe-tumor-infiltrating lymphocyte (TIL) kuwuhlobo oluguquguqukayo lwe-immunotherapy oluhlanganisa amasosha omzimba esiguli ukuze ahlasele ngempumelelo umdlavuza. Nasi isifinyezo esigcwele senqubo ehilelekile ekwelashweni kwe-TIL okusekelwe kudatha etholwe emithonjeni eminingi:
Ukukhishwa kwe-T-lymphocyte: Ukwelashwa kwe-TIL kuqala ngokuvunwa kwama-T cell esimila esikhishwe ngokuhlinzwa. Lawa ma-T-cell ayizingxenye ezibalulekile zamasosha omzimba, ahlonza futhi aqede amangqamuzana omdlavuza.
Ukuthuthukiswa Kwelabhorethri: Ama-T-cell atholiwe abe esethuthelwa elabhorethri, lapho alungiswa khona futhi akhuliswe ukuze athuthukise amandla awo okulwa nomdlavuza. Le nqubo ihlanganisa ukukhetha ama-T-cell anamandla kakhulu nokuwaphindaphinda ukuze akhe amasosha omzimba anamandla.
Ukubuyisela Esigulini: Uma ama-TIL esekhuliswe ngempumelelo abe izigidigidi zamaseli, aphinde afakwe esigulini ngokufakwa. Lawa ma-T-cell ashajwe kakhulu ahlelelwe ukuhlonza futhi ahlasele amaseli omdlavuza kuyilapho evikela amaseli anempilo.
I-Induction Chemotherapy: Ngaphambi kokufakwa kwama-TIL, iziguli zivame ukuthola inkambo yesonto elilodwa yokwelapha ngamakhemikhali ukuze kuvunyelwe ama-T-cell asanda kwethulwa ukuthi ande ngempumelelo ngaphakathi komzimba. Lesi sigaba sibalulekile ekwandiseni amandla okwelapha okwelashwa kwe-TIL.
Ubude besikhathi sokwelashwa: Ngokungafani nezinye izindlela eziningi zokwelapha umdlavuza ezidinga ukunakekelwa okuqhubekayo, ukwelashwa kwe-TIL ngokuvamile kunikezwa kanye kuphela. Kodwa-ke, uma iziguli zike zazuza ekwelashweni kwe-TIL futhi zidinga ukwelashwa okwengeziwe, umzuliswano wesibili wokwelapha ungase ucatshangelwe.
Ukwelashwa kwe-TIL ngokuvamile kunemiphumela emibi engemihle, enezimpawu ezivamile ezihlanganisa imfiva, ukugodola, nokuphelelwa umoya. Le miphumela engemihle ivamise ukuchazwa kwezinye izingxenye zemithi yokwelapha kunamaseli e-TIL ngokwawo.
Ukwelashwa kwe-TIL kuyahluka ekwelapheni kwamaseli e-CAR-T ngoba ikhulisa ama-TIL ngokuqondile eqhumeni kunokuba iwaguqule ngokofuzo. Ngaphezu kwalokho, imikhiqizo ye-TIL iyi-polyclonal, kufaka phakathi ama-T-cell clones ambalwa akwazi ukukhomba inqwaba yama-antigens wesimila.
Ukufingqa, ukwelashwa kwe-TIL kuyindlela ethembisayo yokwelashwa komdlavuza njengoba kusebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Lo muthi wenoveli unamandla amakhulu okwelapha izifo eziningi ezibulalayo futhi unikeza ithemba elisha ezigulini ezingazange zisabele emithini yokwelapha yendabuko.
Ungahle uthande ukufunda: Ukwelashwa kwe-TIL eChina
Inqubekelaphambili kanye nokusetshenziswa kokwelashwa kwe-TIL
UDkt. Steven Rosenberg welapha ngempumelelo izifo zamagundane ngama-TIL azenzakalelayo ngasekupheleni kwawo-1980, lapho eqala ukwenza ukwelashwa kwe-TIL. Kusukela lapho, ukwelashwa kwe-TIL kuthuthuke kakhulu, okubonisa ukusebenza kahle okukhulu kumathumba athile aqinile, ikakhulukazi i-melanoma, umdlavuza womlomo wesibeletho, nomdlavuza we-colorectal.
I-Grit Biotechnology, enekomkhulu e-Shanghai, ithole amaRandi ayizigidi ezingu-60 ku-Series B yoxhaso ukuze kuthuthukiswe abantu abazongenela ukhetho lwe-TIL, ngokugcizelela kakhulu kumdlavuza we-melanoma, womlomo wesibeletho, nowamaphaphu. Le mizamo ihambisana namaphethini omhlaba wonke ekwelapheni kwe-TIL, okuvame ukuhlanganisa ukwelapha okuyinhlanganisela namanye ama-immunotherapies, njengemithi evimba amasosha omzimba.
Ucwaningo lwakamuva lugcizelele ukuthi ukwakheka nendawo yama-TIL ngaphakathi kwamathumba yizici ezibalulekile ezithinta ukubikezela kanye nemiphumela yokwelashwa. Ukuqonda ubudlelwano obuyinkimbinkimbi phakathi kwama-TIL kanye ne-tumor microenvironment kubalulekile ukuze kuthuthukiswe ukwelashwa kwe-TIL okuklanyelwe izinhlobo ezithile zesimila kanye nokucwengwa kwezigaba zesiguli.
Ihluke kanjani ukwelashwa kwe-TIL kune-immunotherapy?
Umehluko Phakathi kwe-TIL Therapy kanye nezinye Izinhlobo ze-Immunotherapy
Ukwelashwa kwe-tumor-infiltrating lymphocyte (TIL) kugqama kwamanye amasu e-immunotherapy ngenxa yezakhiwo nezindlela zawo ezihlukile. Nawu umehluko omkhulu phakathi kokwelashwa kwe-TIL nezinye izinhlobo ze-immunotherapy, ngokusekelwe olwazini olutholwe emithonjeni ethembekile:
1. Umthombo Weseli Nokulungiswa: - Ukwelashwa kwe-TIL kuyinqubo yokuqoqa ama-T-cell ngokuqondile esimila esikhishwe ngesikhathi sokuhlinzwa. Lawa maseli abe esetshalwa elabhorethri ngaphandle kokuguqulwa kofuzo, okuthuthukisa amandla awo emvelo okukhomba amangqamuzana omdlavuza.
I-CAR-T Cell Therapy: Ngokuphambene, i-CAR-T cell therapy ihlela kabusha ama-T-cell esiguli elebhu ukuze abone amaprotheni athile kumaseli omdlavuza. Lawa maseli ashintshwe izakhi zofuzo abe esebuyiselwa esigulini ukuze alwe namangqamuzana omdlavuza.
2. Izinhlobo Zomdlavuza Okuhlosiwe: Ukwelashwa kwe-TIL kube nenzuzo ekwelapheni izimila eziqinile njengekhanda nentamo i-squamous cell carcinoma, i-melanoma, umdlavuza wamaphaphu, kanye nezifo zabesifazane. Isebenza kahle kakhulu ezenzweni ezimbi ezisabalele kwezinye izifunda zomzimba.
I-CAR-T Cell Therapy: I-CAR-T cell therapy ngokuvamile isetshenziselwa ukwelapha izifo zegazi ezifana ne-leukemia ne-lymphoma ngokukhomba izimpawu ezithile kumaseli omdlavuza. Ukwelashwa kwe-TIL, ngakolunye uhlangothi, kungase kusebenze kangcono ngokumelene nezimila eziqinile ngoba kungathola i-spectrum ebanzi yezimpawu zesimila.
3. Indlela Yesenzo: Ama-TIL angamangqamuzana okuzivikela omzimba avela ngokwemvelo angena kumathumba futhi anwetshwa elebhu ngaphambi kokuba abuyiselwe emzimbeni wesiguli. Lawa maseli aqondise inqwaba yama-antigen e-tumor abonakala kumathumba aqinile.
I-CAR-T Cell Therapy: Amaseli e-CAR-T aklanyelwe ukuveza ama-chimeric antigen receptors athola ngokuqondile ama-antigen kumaseli omdlavuza. Lokhu kwelashwa kucace kakhulu kuma-antigen aziwayo atholakala kumaseli omdlavuza wegazi.
4. Ubude besikhathi sokwelashwa kanye nemiphumela engemihle: Ukwelashwa kwe-TIL kuvame ukuphathwa kanye, iziguli zithola i-induction chemotherapy ngaphambi kokumnika kwe-TIL. Ngokuvamile, imiphumela emibi yokwelashwa kwe-TIL ayinaki futhi ivamise ukuvela kwezinye izici zohlelo lokwelapha kunamaseli e-TIL ngokwawo.
I-CAR-T Cell Therapy: Ukwelashwa kwamaseli e-CAR-T kungase kudinge ukucwiliswa okuningana futhi kungabangela imiphumela emibi kakhulu njenge-cytokine release syndrome kanye ne-neurotoxicity ngenxa yokuvuselela okusheshayo kwezimpendulo zokuzivikela komzimba.
Kafushane, ukwelashwa kwe-TIL kanye nokwelashwa kwamaseli e-CAR-T kokubili kuyi-adoptive cell transfer immunotherapies, nokho, kuhluke kakhulu ngokomthombo wamangqamuzana omzimba omzimba, izinhlobo zomdlavuza oqondiwe, indlela yokusebenza, kanye nemiphumela emibi ehlobene nayo. Ukwelashwa kwe-TIL kuyindlela engaba khona yokwelashwa komdlavuza ngenxa yokusetshenziswa kwayo okubanzi ngokumelene nezimila eziqinile nokuthembela ezimpendulweni ezikhona ngokwemvelo zokuzivikela komzimba.
Ungahle uthande ukufunda: Ukwelashwa kwe-CAR T-Cell eChina
Izifo ziphathwa ngempumelelo ngemithi ye-TIL
- Inhloko nentamo squamous cell carcinoma
- I-Melanoma
- Umdlavuza we-Lung
- Umdlavuza weGenitourinary
- Ezinye izigameko ezimbi
Uma utholakale une-melanoma, noma ngabe i-melanoma yakho ine-metastatic noma isakazekile, likhona ithemba. Ukwelashwa okusha okuthuthukile kwenza ukuthi i-melanoma esezingeni eliphezulu isinde. Olunye lwezindlela zokwelapha eziphumelela kakhulu yi-tumor infiltrating lymphocyte (TIL) immunotherapy.
Yimiphi imiphumela emibi yokwelashwa kwe-TIL?
Nakuba ukwelashwa kwe-tumor-infiltrating lymphocyte (TIL) kuwukwelashwa okuthembisayo komdlavuza, kungaba nemiphumela eminingi engemihle.
Nansi incazelo ephelele yemiphumela engemihle engenzeka exhunywe nokwelashwa kwe-TIL ngokusekelwe olwazini oluvela emithonjeni ethembekile:
1. Imiphumela Engalungile Esheshayo:
-Imfiva nokugodola. Iziguli zingase zibe nokushisa okukhulu nokugodola lapho kufakwa i-TIL.
- Isicanucanu kanye Nokulahlekelwa Isifiso Sokudla: Abanye abantu bangase babe nesicanucanu kanye nokuncipha kwesifiso sokudla ngemva kokwelashwa kwe-TIL.
- Izimpawu Zezinzwa: Ikhanda elibuhlungu, isiyezi, nezinye izinkinga zesistimu yezinzwa zingase zenzeke.
– Ukukhathala: Iziguli zingase zibe nokukhathala okukhulu nokuba buthakathaka ngenxa yokwelashwa.
- Ukugcinwa Kwe-Fluid: Umzimba ungaqongelela uketshezi, okubangela ukuvuvukala.
2. I-Chemotherapy Ehlobene Nemiphumela Emibi:
-Izibalo Zegazi Eziphansi: I-Chemotherapy ngaphambi kokumnika i-TIL ingase ibangele ukubala kwegazi eliphansi, okudinga ukumpontshelwa igazi.
Ukutheleleka: Amasosha omzimba abuthakathaka ngesikhathi sokwelashwa ngamakhemikhali akhulisa ukungenwa yizifo.
-Ukuqothuka kwezinwele: Abanye abantu bangase babe nokulahlekelwa izinwele ngenxa ye-conditioning chemotherapy.
– Izilonda emlonyeni: Ikhemotherapy ingabangela izilonda emlonyeni.
3. Ukuqapha Kwesikhathi Eside:
- Ithimba lezinhlaka eziningi lodokotela be-oncologists, abahlengikazi, nabanye odokotela baqapha ngokucophelela iziguli ezelashwa nge-TIL ngezinkinga ezingaba khona.
- Ukuqokwa kokulandelela kufaka phakathi ukuqapha izibalo zegazi, ukuhlola izinkinga, nokwenza izithwebuli zezithombe ukuze kutholakale impendulo yesimila.
4. Amasu Okuphatha:
Imiphumela emibi yokwelashwa kwe-TIL iyancipha ngokuqapha okuvamile nokunakekelwa kwangemva kokwelashwa.
- Izazi ze-oncologists zezokwelapha zinikeza iseluleko esiphelele mayelana nendlela yokulawula imiphumela emibi kanye nezinkinga.
5. Ukwelashwa kwe-TIL kuyahluka ekwelapheni kwamaseli e-CAR-T ngoba kusebenzisa amaseli e-T enzeka ngokwemvelo athathwe kumathumba, kunokuwashintsha ngofuzo elebhu. Imiphumela engemihle yokwelashwa kwe-TIL ivamise ukubangelwa ezinye izingxenye zemithi yokwelapha kunamaseli e-TIL ngokwawo.
Sengiphetha, ngenkathi ukwelashwa kwe-TIL kunesithembiso esikhulu sokwelashwa komdlavuza, iziguli kufanele zikhumbule imiphumela engemihle engaba khona yaleli su lenoveli le-immunotherapy. Ukuqapha ngokucophelela ochwepheshe bezempilo kanye nokunaka imihlahlandlela yokunakekelwa kwangemva kokwelashwa kubalulekile ekulawuleni ngempumelelo le miphumela emibi.
Ziyini izindleko zokwelashwa kwe-TIL?
Izindleko zokwelashwa kwe-Tumor-Infiltrating Lymphocyte (TIL). kuyehluka kuye ngenani lemibandela. Nasi isifinyezo sezindleko ezihlongozwayo ezihlobene nokwelashwa kwe-TIL ngokusekelwe olwazini olutholwe emithonjeni ethembekile:
1. Ukwehlukaniswa Kwezindleko:
Ukuhlola: Ukuskenwa ngokomzimba, ukuhlolwa kwegazi, nokuthintana ngokuvamile kubiza cishe $ 3000.
Ukuhlukaniswa kwama-TIL: Lesi sigaba sidinga ukuhlinzwa, izinsuku zokulaliswa esibhedlela, nokubonisana, futhi kubiza isilinganiso se $ 4000 USD.
Ukukhiqizwa kwe-TIL: Izindleko zokukhiqiza ziyahlukahluka phakathi kwama- $ 40,000 kanye nama- $ 60,000, kuya ngenani lemikhiqizo ngonyaka (iziguli eziyi-10 noma ezi-5).
2. Ingqikithi Yezindleko: Isilinganiso sokuqala sokwelapha isiguli esisodwa ngokwelashwa kwe-TIL sesiseduze $ 65,000.
Emazweni afana ne-United States, izindleko ezilinganiselwe zokwelashwa kwe-TIL zisuka ku-$97,600 ziye ku-$168,440 isiguli ngasinye.
E-Canada nase-United Kingdom, izilinganiso zezindleko zingu-C$89,072-C$116,295 kanye no-£32,945-£60,608, ngokulandelana.
Njengokuhlangenwe nakho kwamanje kwesiguli kanye nedatha, Ukwelashwa kwe-TIL kuzobiza cishe u-$125,000 USD kwa-Israel nanoma yini ephakathi kuka-$60-125,000 USD e-China. Izindleko zokwelashwa kwe-TIL zihluka kakhulu ngohlobo nesigaba somdlavuza. Njengoba lokhu kwelashwa kusesesigabeni sokuhlolwa komtholampilo, isilinganiso esinqunyiwe sezindleko cishe singenakwenzeka.
3. Izinto Ezithinta Izindleko: - Izindleko zokwelapha ze-TIL zithintwa ukukhiqizwa nokuphatha.
- Ukwakhiwa kwezindawo zokukhiqiza kanye nekhono ekwelapheni kwamaseli kungaba nomthelela kumanani entengo.
4. Ukusebenza Kwezindleko: - Ukwelashwa kwe-TIL kuyabiza kakhulu uma kuqhathaniswa nezinye izindlela zokwelapha ezifana ne-ipilimumab.
5. Ukutholakala Nezithiyo Zokulawula: - Ukwelashwa kwe-TIL kunikezwa kuphela ezikhungweni ezikhethekile emhlabeni wonke ngokusebenzisa izivivinyo zomtholampilo noma izinhlelo zokufinyelela kusenesikhathi ngenxa yezithiyo zokulawula nezokukhiqiza.
6. Ukuphathwa Kwemiphumela Engathandeki: - Imiphumela emibi evamile yokwelashwa kwe-TIL ihlanganisa imfiva, ukugodola, isicanucanu, ukuhlanza, isifo sohudo, nokukhathala. Le miphumela emibi ihlolwa njalo ngochwepheshe bezempilo ngesikhathi sokwelashwa.
Sengiphetha, ngenkathi ukwelashwa kwe-Tumor-Infiltrating Lymphocyte (TIL) kubonisa amandla ekwelapheni umdlavuza, kunezindleko eziphezulu ezihluka kuye ngendawo nezinqubo zokwelashwa. Ukuqapha ngokucophelela imiphumela engemihle kanye nokuphathwa okufanele kuyizici ezibalulekile zalo lonke uhlelo lokwelapha.
Ucwaningo oluqhubekayo kanye nombono wesikhathi esizayo
Nakuba ukwelashwa kwe-TIL okwamanje kuthathwa njengokuhlola, abacwaningi baphenya ukuthi luwusizo yini ezinhlotsheni ezihlukahlukene zomdlavuza. Izinga lempumelelo yokwelashwa, ikakhulukazi ezimeni ze-melanoma, likhuthaze ucwaningo olwengeziwe mayelana nokusetshenziswa kwalo okungaba khona uhla olubanzi lwezifo ezibulalayo. Abacwaningi baphinde baphenya ngethemba lokugcina amaseli e-TIL ukuze asetshenziswe kamuva njengokwelashwa “okungaphezulu” uma umdlavuza ubuya.
Ukufingqa, ukwelashwa kwe-TIL kuyintuthuko enkulu ekwelashweni komdlavuza, okuhlinzeka ngethemba elisha ezigulini ezingazange zisabele kuma-immunotherapies endabuko. Lokhu kwelashwa kunamandla amakhulu ekusasa le-oncology ngenxa yamandla ayo okukhomba ngempumelelo nokuqeda amangqamuzana omdlavuza kusetshenziswa amasosha omzimba.