Ua lanakila ka CAR-T Therapy i ka Prognosis maikaʻi ʻole ma ka Lymphoma B-Cell kiʻekiʻe

Ua paʻi ʻia kahi noiʻi hou i loko o Nā Holomua Kokohōʻike ʻia e hāʻawi ana ka lāʻau lapaʻau cell CAR-T i nā pono lapaʻau koʻikoʻi no nā poʻe maʻi me ke kiʻekiʻe kiʻekiʻe Lymphoma Pūnaewele B (HGBL), kahi ʻano koʻikoʻi loa o ka lymphoma B-cell nui (LBCL). ʻO ke aʻo ʻana a DESCAR-T LYSA, i mālama ʻia e nā kānaka noiʻi Farani, ua kālele ʻia i nā poʻe maʻi i loaʻa iā lākou ka lāʻau lapaʻau CAR-T ma ke ʻano he lāʻau lapaʻau laina ʻekolu a i ʻole ma waho, me ka poʻe me MYC a me BCL2 a/a i ʻole BCL6 rearrangements—i ʻike ʻia ʻo "double-hit" a i ʻole "triple-hit" lymphoma.

Ua kākau inoa ke aʻo ʻana i 228 mau maʻi mai ka papa inoa Farani DESCAR-T, kahi i ʻike ʻia ai he 73 me HGBL, aʻo ke koena 155 he LBCL ʻaʻole HGBL. ʻO ka pahuhopu o ke aʻo ʻana e loiloi i ka palekana a me ka pono o ka lāʻau lapaʻau CAR-T i loko o kēia mau hui, me ka awelika o ka manawa hahai ʻana he 18.5 mau mahina.

Ua hōʻike nā ʻike i ka hoʻohālikelike ʻana o nā helu pane holoʻokoʻa (ORR) a me nā helu pane piha (CR) ma waena o nā poʻe maʻi HGBL a me nā poʻe maʻi ʻole HGBL, ma 68% a me 60% no HGBL, a me 76% a me 59% no nā poʻe maʻi ʻole HGBL, kēlā me kēia (p=0.293 a me p=0.923). Eia kekahi, ʻo ka awelika o ke ola ʻole o ka holomua (PFS) no nā poʻe maʻi HGBL he 3.2 mau mahina, i hoʻohālikelike ʻia me 4.5 mau mahina no nā poʻe maʻi ʻole HGBL, ʻoiai ʻaʻole koʻikoʻi kēia ʻokoʻa (p=0.103). Pēlā nō, ʻo ka awelika o ke ola holoʻokoʻa (OS) he 15.4 mau mahina no nā poʻe maʻi HGBL e hoʻohālikelike ʻia me 18.3 mau mahina no nā poʻe maʻi ʻole HGBL (p=0.214).

ʻO ka mea hoihoi, i ka wā i helu ʻia ai ka OS mai ka lā i kūpono ai nā maʻi no ka lāʻau CAR-T, ua hāʻule ka OS waena no nā maʻi HGBL i 7.6 mau mahina, i hoʻohālikelike ʻia me 11.8 mau mahina no nā maʻi ʻaʻole HGBL (p=0.062), e hōʻike ana he kuleana koʻikoʻi ka manawa o ka hoʻokele CAR-T i ka hoʻomaikaʻi ʻana i nā hopena.

Ma waena o nā ʻano like ʻole o HGBL, ʻo ka poʻe me MYC-BCL2 double-hit lymphoma ka mea i loaʻa nā hopena ʻilihune loa, me ka OS waena o 6.6 mau mahina wale nō, ʻoi aku ka haʻahaʻa ma mua o nā ʻano HGBL ʻē aʻe (HGBL-DH MYC-BCL6: 13.6 mau mahina, HGBL-NOS: 18.5 mau mahina) a me nā poʻe maʻi ʻaʻole HGBL (11.8 mau mahina). ʻOiai kēia, ʻaʻohe ʻokoʻa koʻikoʻi i loaʻa i ka OS a i ʻole PFS i ka hoʻohālikelike ʻana i ka manawa o ka hoʻokomo ʻana o CAR-T.

Ua kūlike ka palekana o ka lāʻau lapaʻau CAR-T ma waena o nā hui HGBL a me nā hui ʻole HGBL. Ua like ka hanana o ka cytokine release syndrome (CRS) a me ka immune effector cell-associated neurotoxicity syndrome (ICANS) ma waena o nā hui ʻelua. Eia nō naʻe, 38% o nā maʻi HGBL i koi i ka mālama ICU no CRS, ʻoiai ua like kēia me nā koi lapaʻau i ʻike ʻia i nā maʻi ʻole HGBL.

Hōʻike ka haʻawina DESCAR-T LYSA i ka hiki o ka lāʻau lapaʻau CAR-T i ka hoʻomaikaʻi ʻana i ka prognosis o nā maʻi me HGBL, ʻoiai ma nā laina lapaʻau ma hope. ʻOiai ʻaʻole paha e lanakila loa ʻo CAR-T i ka prognosis maikaʻi ʻole e pili ana me kekahi mau ʻano kiʻekiʻe-pilikia, e like me ka double-hit HGBL, paipai ka haʻawina i ke komo mua ʻana me ka lāʻau lapaʻau CAR-T, kahi e hāʻawi ai i nā hopena ola maikaʻi aʻe. Eia kekahi, ʻo ka hoʻemi ʻana i ka manawa ma waena o leukapheresis a me ka hoʻokomo ʻana o CAR-T he mea koʻikoʻi paha no nā maʻi me nā maʻi ʻino e like me HGBL.

Hōʻike kēia noiʻi i ke koʻikoʻi o ka lāʻau CAR-T ma ke ʻano he lāʻau lapaʻau kūpono no ka lymphoma B-cell kiʻekiʻe a hāʻawi i nā ʻike waiwai i ka hoʻonui ʻana i nā manawa lapaʻau no nā hopena maikaʻi aʻe o ka mea maʻi. Pono nā haʻawina hou aʻe e ʻimi i nā ala e hoʻonui ai i ka pono o ka lāʻau CAR-T, ʻoi aku hoʻi i nā ʻano lymphoma paʻakikī.