Zotsatira Zabwino Kwambiri za Chithandizo cha CD7 CAR-T Pochiza Matenda a T-Cell Lymphoma Obwereranso/Osasinthika ku ASH 2024
Pa Msonkhano Wapachaka wa 66 wa American Society of Hematology (ASH) 2024, womwe unachitikira kuyambira pa 7 mpaka 10 Disembala ku San Diego, Pulofesa Lu Peihua wa ku Lu Daopei Hospital adapereka mayeso azachipatala a Gawo Loyamba a chithandizo cha CD7-target Chimeric Antigen Receptor T-cell (CAR-T) therapy pochiza matenda obwereranso/osakhazikika. T-Cell Lymphoma (R/R PTCL). Ichi ndi chitukuko chachikulu pakuchiza khansa ya T-cell, komwe njira zochiritsira zomwe zilipo zakhala zochepa ndipo nthawi zambiri sizigwira ntchito bwino.
R/R PTCL imadziwika ndi matenda ake osachiritsika, makamaka kwa odwala omwe adalandira chithandizo cha mitundu yosiyanasiyana, kuphatikizapo allogeneic hematopoietic hematopoietic stem cell transplantation (allo-HSCT). Ngakhale zili choncho, chithandizo cha CD7 CAR-T, makamaka chithandizo cha maselo a NS7CAR-T chomwe chidapangidwa ndi gulu la Pulofesa Lu, chawonetsa zotsatira zabwino pochiza odwala omwe ali ndi CD7-positive R/R PTCL. Mu kafukufukuyu, odwala asanu, azaka zapakati pa 39 ndi 60, omwe ali ndi magawo apamwamba a R/R PTCL adalembetsedwa pakati pa Epulo 2021 ndi Novembala 2023. Odwala awa adalandira chithandizo cha mitundu isanu ndi umodzi m'mbuyomu, kuphatikiza wodwala m'modzi yemwe adalandirapo chithandizo cha autologous stem cell transplantation.
Zotsatira zake zinali zabwino: mkati mwa nthawi yotsatila yapakati ya masiku 234, 60% ya odwala adapeza chikhululukiro chonse (CR), ndipo wodwala m'modzi adapeza chikhululukiro chaching'ono (PR). Chofunika kwambiri, chithandizochi chinawonetsa kuchuluka kwa maselo a CAR-T komanso kupirira kwa odwala, pomwe kuchuluka kwapakati kwa maselo a CAR-T kufika pa 93.5%. Chodziwika bwino ndichakuti, panalibe zotsatirapo zoyipa monga kuopsa kwa mitsempha, ndipo cytokine release syndrome (CRS) inali yofatsa, ndipo wodwala m'modzi yekha anali ndi CRS ya giredi II. Mbiri yachitetezo inali yotheka, popanda poizoni woopsa womwe unawonedwa.
Kafukufuku wa Pulofesa Lu akuwonetsa kuthekera kwa chithandizo cha CD7 CAR-T ngati njira yosinthira masewera pochiza khansa ya T-cell, makamaka kwa odwala omwe ali ndi njira zochepa zochiritsira kapena osapeza chithandizo. Kuwonjezera pa zotsatira zabwino za PTCL, gulu la Pulofesa Lu lakhala likugwira ntchito bwino kwambiri pochiza khansa ya T-cell acute lymphoblastic leukemia (T-ALL) ndi khansa ya T-cell lymphoblastic lymphoma (T-LBL), ndi pafupifupi 95% ya kuchira kwathunthu kwa odwala 60. Potengera zotsatirazi, gululi tsopano likuwonjezera kafukufuku wawo pa khansa zina zamagazi monga khansa ya m'magazi ya acute myeloid leukemia (AML), ndi deta yoyambirira ikuwonetsa kuti 70% ya kuchira kwathunthu kwa odwala a CD7-positive AML.
Ngakhale zotsatira zabwinozi, Pulofesa Lu akugogomezera kufunika kophatikiza chithandizo cha CD7 CAR-T ndi allo-HSCT kuti ziwongolere zotsatira za nthawi yayitali. Kusiyana kwa khansa ya T-cell kumafuna njira yokwanira yothandizira kuti pakhale mwayi wochira kwanthawi yayitali komanso kuchira. Gululi likupitilizabe kukonza njira yawo ndikukulitsa zizindikiro zochiritsira za chithandizo cha CD7 CAR-T.
Ntchito yoyambirira ya Pulofesa Lu, yomwe yathandiza kale odwala oposa 300 ndi chithandizo cha CD7 CAR-T, ikuyimira patsogolo kwambiri pa chithandizo cha khansa ya T-cell. Popita patsogolo, gululi ladzipereka kupititsa patsogolo mayeso azachipatala ndikuwongolera njira zothandizira maselo a CAR-T, kuonetsetsa kuti odwala ambiri apindula ndi njira yatsopanoyi.
Kuyesa kotsimikizika kwa Gawo Loyamba kumeneku ku ASH 2024 kukugogomezera kuthekera kwa chithandizo cha CD7 CAR-T ngati malire atsopano mu khansa ya m'magazi, kupereka chiyembekezo kwa odwala omwe anali ndi matenda osachiritsika kale.