Ka wikitoria te rongoā CAR-T i te matapae kino i roto i te Lymphoma pūtau-B taumata teitei
He rangahau hou i whakaputaina i roto i Ngā Whakatairanga Totoe whakaatu ana he nui ngā painga haumanu o te rongoā pūtau CAR-T mō ngā tūroro he nui te kounga o te rongoā Lymphoma Pūtau-B (HGBL), he momo lymphoma pūtau-B nui tino kaha (LBCL). Ko te rangahau DESCAR-T LYSA, i whakahaerehia e ngā kairangahau Wīwī, i arotahi ki ngā tūroro i whiwhi i te rongoā CAR-T hei maimoatanga tuatoru, i tua atu rānei, tae atu ki te hunga he whakarerekētanga MYC me BCL2 me/ranei BCL6—e mōhiotia ana ko te lymphoma "double-hit" "triple-hit" rānei.
I whakaurua e te rangahau he 228 ngā tūroro mai i te rēhita DESCAR-T Wīwī, ā, 73 o rātou i kitea he HGBL, ko te toenga 155 he LBCL kore-HGBL. Ko te whāinga o te rangahau he aromatawai i te haumaru me te whai huatanga o te rongoā CAR-T i roto i ēnei rōpū, me te wā aroturuki toharite o te 18.5 marama.
I whakaatuhia e ngā kitenga he rite tonu ngā reiti urupare whānui (ORR) me ngā reiti urupare katoa (CR) i waenga i ngā tūroro HGBL me ngā tūroro ehara i te HGBL, i te 68% me te 60% mō te HGBL, me te 76% me te 59% mō te hunga ehara i te HGBL, ia (p=0.293 me te p=0.923). I tua atu, ko te roanga oranga kore-haere whakamua (PFS) mō ngā tūroro HGBL he 3.2 marama, ki te whakaritea ki te 4.5 marama mō ngā tūroro ehara i te HGBL, ahakoa kāore tēnei rerekētanga i te tino hira i te tatauranga (p=0.103). Waihoki, ko te roanga oranga whānui (OS) he 15.4 marama mō ngā tūroro HGBL ki te 18.3 marama mō ngā tūroro ehara i te HGBL (p=0.214).
He mea whakamere, i te tataunga o te OS mai i te rā i whai wāhi ai ngā tūroro ki te rongoā CAR-T, i heke te OS toharite mō ngā tūroro HGBL ki te 7.6 marama, ki te whakaritea ki te 11.8 marama mō ngā tūroro ehara i te HGBL (p=0.062), e whakaatu ana ko te wā o te whakahaerenga CAR-T he mea nui ki te whakapai ake i ngā putanga.
I roto i ngā momo rerekē o te HGBL, ko te hunga whai lymphoma MYC-BCL2 double-hit i whiwhi i ngā putanga tino kino, me te OS toharite o te 6.6 marama anake, he iti iho i ētahi atu momo HGBL (HGBL-DH MYC-BCL6: 13.6 marama, HGBL-NOS: 18.5 marama) me ngā tūroro ehara i te HGBL (11.8 marama). Ahakoa tēnei, kāore i kitea he rerekētanga nui i roto i te OS, i te PFS rānei i te whakataurite i te wā i werohia ai te CAR-T.
He rite tonu te haumaru o te rongoā CAR-T puta noa i ngā rōpū HGBL me ngā rōpū kāore i te HGBL. He rite tonu te putanga mai o te cytokine release syndrome (CRS) me te immune effector cell-associated neurotoxicity syndrome (ICANS) i waenga i ngā rōpū e rua. Heoi, 38% o ngā tūroro HGBL i hiahia ki te tiaki ICU mō te CRS, ahakoa he rite tonu tēnei ki ngā whakaritenga maimoatanga i kitea i roto i ngā tūroro kāore i te HGBL.
E whakaatu ana te rangahau DESCAR-T LYSA i te kaha o te rongoā CAR-T ki te whakapai ake i te matapae o ngā tūroro e pāngia ana e te HGBL, ahakoa i ngā momo rongoā o muri mai. Ahakoa kāore pea a CAR-T e tino wikitoria i te matapae kino e pā ana ki ētahi momo morearea nui, pērā i te HGBL takirua, e akiaki ana te rangahau i te wawaotanga wawe ki te rongoā CAR-T, e pai ake ai pea ngā hua oranga. Heoi anō, ko te whakaiti i te wā i waenga i te leukapheresis me te werohanga CAR-T he mea nui pea mō ngā tūroro e pāngia ana e te mate kino pērā i te HGBL.
E whakaatu ana tēnei rangahau i te hiranga o te rongoā CAR-T hei rongoā whai hua mō te lymphoma pūtau-B kounga teitei, ā, e whakarato ana i ngā māramatanga whai hua ki te arotau i ngā wā maimoatanga kia pai ake ai ngā putanga o te tūroro. Me whai atu anō ngā rangahau hei tūhura i ngā huarahi hei whakarei ake i te whai huatanga o te rongoā CAR-T, inā koa i roto i ngā momo lymphoma wero.