Maganin CAR-T Ya Shawo Kan Mummunan Hasashe a Cikin Lymphoma Mai Matakin B

Wani bincike da aka buga kwanan nan a cikin Ci gaban Jiniya bayyana cewa maganin ƙwayoyin CAR-T yana ba da fa'idodi masu mahimmanci ga marasa lafiya masu babban matakin Lymphoma na B-Cell (HGBL), wani nau'in lymphoma mai tsanani musamman na babban ƙwayoyin B-cell (LBCL). Binciken DESCAR-T LYSA, wanda masu bincike na Faransa suka gudanar, ya mayar da hankali kan marasa lafiya da aka yi wa maganin CAR-T a matsayin magani na uku ko fiye da haka, gami da waɗanda ke da MYC da BCL2 da/ko BCL6 reorganizations—wanda aka sani da "double-hit" ko "triple-hit" lymphoma.

Binciken ya yi rijistar marasa lafiya 228 daga rajistar DESCAR-T ta Faransa, inda 73 daga cikinsu aka gano suna da HGBL, yayin da sauran 155 kuma suka sami LBCL mara HGBL. Binciken ya yi nufin kimanta aminci da ingancin maganin CAR-T a cikin waɗannan ƙungiyoyin, tare da matsakaicin lokacin bin diddigin sa na watanni 18.5.

Binciken ya nuna cewa jimillar ƙimar amsawar (ORR) da ƙimar cikakkiyar amsawar (CR) sun kasance daidai tsakanin marasa lafiya na HGBL da waɗanda ba su da HGBL, a kashi 68% da 60% ga HGBL, da kuma kashi 76% da 59% ga waɗanda ba su da HGBL, bi da bi (p=0.293 da p=0.923). Bugu da ƙari, matsakaicin rayuwa ba tare da ci gaba ba (PFS) ga marasa lafiya na HGBL shine watanni 3.2, idan aka kwatanta da watanni 4.5 ga marasa lafiya na HGBL, kodayake wannan bambancin ba shi da mahimmanci a kididdiga (p=0.103). Hakazalika, matsakaicin rayuwa gaba ɗaya (OS) shine watanni 15.4 ga marasa lafiya na HGBL idan aka kwatanta da watanni 18.3 ga marasa lafiya na HGBL (p=0.214).

Abin sha'awa, lokacin da aka ƙididdige tsarin aiki na OS daga ranar da marasa lafiya suka cancanci maganin CAR-T, matsakaicin tsarin aiki na marasa lafiya na HGBL ya ragu zuwa watanni 7.6, idan aka kwatanta da watanni 11.8 ga marasa lafiya waɗanda ba su da HGBL (p=0.062), wanda ke nuna cewa lokacin da aka ba CAR-T yana taka muhimmiyar rawa wajen inganta sakamako.

Daga cikin nau'ikan HGBL daban-daban, waɗanda ke da cutar lymphoma mai kama da MYC-BCL2 suna da mafi ƙarancin sakamako, tare da matsakaicin OS na watanni 6.6 kawai, ƙasa da sauran nau'ikan HGBL (HGBL-DH MYC-BCL6: watanni 13.6, HGBL-NOS: watanni 18.5) da marasa lafiya marasa HGBL (watanni 11.8). Duk da haka, babu wani bambanci mai mahimmanci a cikin OS ko PFS lokacin kwatanta lokacin da aka yi amfani da CAR-T.

Amincin maganin CAR-T ya kasance iri ɗaya a tsakanin ƙungiyoyin HGBL da waɗanda ba HGBL ba. Faruwar cutar cytokine release syndrome (CRS) da kuma cutar neurotoxicity da ke da alaƙa da ƙwayoyin rigakafi (ICANS) iri ɗaya ne tsakanin ƙungiyoyin biyu. Duk da haka, kashi 38% na marasa lafiya na HGBL suna buƙatar kulawar ICU don CRS, kodayake wannan ya yi daidai da buƙatun magani da aka gani a cikin marasa lafiya waɗanda ba su da HGBL.

Binciken DESCAR-T LYSA ya nuna yuwuwar maganin CAR-T wajen inganta hasashen marasa lafiya da ke fama da HGBL, har ma a cikin layukan magani na gaba. Duk da cewa CAR-T ba zai iya shawo kan mummunan hasashen da ke tattare da wasu nau'ikan cututtukan da ke da haɗari sosai ba, kamar HGBL mai bugun biyu, binciken yana ƙarfafa shiga tsakani da wuri tare da maganin CAR-T, wanda zai iya ba da sakamako mafi kyau na rayuwa. Bugu da ƙari, rage lokacin da ke tsakanin cutar leukapheresis da jiko na CAR-T na iya zama mahimmanci ga marasa lafiya da ke da cututtuka masu tsanani kamar HGBL.

Wannan binciken ya nuna muhimmancin maganin CAR-T a matsayin magani mai inganci ga babban nau'in lymphoma na B-cell kuma yana ba da fahimta mai mahimmanci game da inganta jadawalin magani don samun sakamako mafi kyau ga marasa lafiya. Ana buƙatar ƙarin bincike don bincika hanyoyin inganta ingancin maganin CAR-T, musamman a cikin ƙananan nau'ikan lymphoma masu ƙalubale.