He Hua Pai te Wawaotanga Moata me te Whakaora CAR-T mō te Lymphoma Pūtau-B Nui
I whakaputaina tētahi rangahau whakamuri tata nei i roto i Te Whakatō Huango Wheuai tūhuratia te whai huatanga o te wawaotanga wawe me te wawaotanga tōmuri me te rongoā pūtau CAR-T i roto i ngā tūroro he nui te mate Lymphoma Pūtau-B (LBCL). I whakahaerehia puta noa i ngā pokapū e toru i te US me Iharaira, i uru atu ki te rangahau ngā tūroro e 354 i rongoatia ki te rongoā CAR-T e arohia ana ki te CD19 i waenga i a Paenga-whāwhā 2016 me Poutū-te-rangi 2024. Ko te whāinga o te rangahau he aromatawai i te pānga o te whakahaere i te rongoā CAR-T hei rongoā raina tuarua (maimoatanga wawe) me te raina tuatoru, muri iho rānei (maimoatanga tōmuri) mō te LBCL kua hoki mai, kua uaua rānei te mate.
I whakaatuhia e ngā hua he pai ngā hua o te whakahaere wawe i te rongoā CAR-T, i te wā e iti ake ana te taumahatanga o te pukupuku o te tūroro, ā, he pai ake te taiao ārai mate. Ko te reiti urupare katoa i muri i te tau kotahi he 87% mō te maimoatanga wawe me te 82% mō te maimoatanga tōmuri, ahakoa kāore i tino nui te rerekētanga (p=0.3). Heoi, he teitei ake te reiti oranga whānui (OS) mō te rōpū maimoatanga tōmua, me te 82% te oranga i te tau kotahi ki te 71% mō te rōpū maimoatanga tōmuri (p=0.048).
He mea whakamīharo, kāore i kitea e te rangahau he rerekētanga nui i waenga i ngā rōpū e rua i roto i te oranga kore-whakamua (PFS), ngā reiti hokinga mai, me te mate e pā ana ki te maimoatanga. Ko ngā reiti hokinga mai i roto i te tau 1 he 37% mō te rōpū tōmua me te 43% mō te rōpū tōmuri, kāore he pānga nui mai i te wā o te whakahaerenga CAR-T (p=0.2). I kitea anō hoki e te rangahau he iti ake te auau o te mate tuku cytokine (CRS) taumata 2, teitei ake rānei i roto i te rōpū maimoatanga tōmua (26%) ki te whakaritea ki te rōpū maimoatanga tōmuri (39%) (p=0.031), e kī ana ko te wawaotanga wawe ka whakaiti i ētahi paitini e pā ana ki te maimoatanga.
E tautoko ana ēnei kitenga i te whakamahinga o te rongoā CAR-T hei rongoā tuarua mō te LBCL, nā te mea ka taea e ia te ārai i ngā raruraru e pā ana ki te maimoatanga o muri mai, tae atu ki te whakaiti i te manawanui nā te hauora whānui o te tūroro, te ngenge rānei o ngā pūtau-T. E whakanui ana hoki te rangahau i te hiahia mō ētahi atu rangahau hei mārama ki ngā tikanga koiora o te ātete CAR-T me te tūhura i ngā rongoā whakakotahi pea hei whakapai ake i ngā putanga puta noa i ngā wāhanga katoa o te maimoatanga.
Ahakoa he tirohanga whakamuri tēnei rangahau, ā, tera pea ka pāngia e ngā whakaaro pākiki me te iti o te aroturukitanga, he māramatanga nui kei roto i ngā hua mō te wā tino pai mō te rongoā CAR-T i roto i ngā tūroro LBCL. E kī ana ngā kitenga mā te wawaotanga wawe ki te rongoā CAR-T ka taea te whakapai ake i te oranga me te whakaiti i te paitini, ka whakarato i tētahi taahiraa nui ki mua i te arotau i ngā rautaki rongoā mō tēnei mate pukupuku uaua.