Chiyembekezo Chatsopano mu Chithandizo cha Khansa: Chithandizo cha TILs Chikuonekera Monga Malire Otsatira
Gawo la chithandizo cha maselo likupitirirabe kukula, ndipo chithandizo cha TIL tsopano chikuwoneka ngati kupita patsogolo kwakukulu mu Chithandizo cha KhansaNgakhale kuti pali chiyembekezo chachikulu pa chithandizo cha CAR-T, zotsatira zake pa zotupa zolimba, zomwe zimakhala ndi 90% ya khansa, sizinali zokwanira. Komabe, chithandizo cha TIL chili pafupi kusintha nkhaniyi.
Chithandizo cha TIL chapeza chidwi chachikulu posachedwapa pamene Lifileucel ya Iovance Biotherapeutics idalandira chilolezo cha FDA mwachangu pa 16 February kuti ichite chithandizo cha melanoma chomwe chapita patsogolo pambuyo pa chithandizo cha PD-1 antibody. Chivomerezo cha Lifileucel chikuyimira ichi ngati chithandizo choyamba cha TIL kufika pamsika, zomwe zikuwonetsa gawo latsopano mu chithandizo cha maselo chomwe chimayang'ana kwambiri pa zotupa zolimba.
Njira Yaitali Yopita Ku Chipambano
Ulendo wa chithandizo cha TIL umatenga zaka zoposa makumi anayi. Ma Lymphocyte Olowa M'mimba (TILs) ndi gulu losiyanasiyana la maselo oteteza chitetezo chamthupi omwe amapezeka mkati mwa chotupa, kuphatikiza maselo a T, maselo a B, ndi maselo ena. Nk Cells, macrophages, ndi maselo oletsa kutupa omwe amachokera ku myeloid. Maselo amenewa, omwe nthawi zambiri amakhala ochepa mu kuchuluka ndi ntchito mkati mwa zotupa, amatha kusonkhanitsidwa, kukulitsidwa mu labu, ndikubwezeretsedwanso kwa wodwalayo kuti ayang'ane ndikuwononga maselo a khansa.
Mosiyana ndi maselo a CAR-T, ma TIL amachokera mwachindunji ku chotupacho, zomwe zimawathandiza kuzindikira mitundu yosiyanasiyana ya ma antigen a chotupa ndikupereka njira zabwino zolowera komanso chitetezo. Njira imeneyi yawonetsa kuti ndi yothandiza, makamaka pochiza zotupa zolimba pomwe CAR-T yakhala ikuvutika kupita patsogolo.
Kuthana ndi Mavuto
Lifileucel yawonetsa zotsatira zabwino kwambiri zachipatala, zomwe zapereka chiyembekezo kwa odwala khansa ya m'magazi omwe ali ndi njira zochepa zochiritsira. Mu kafukufuku wa zachipatala wa C-144-01, chithandizochi chinapeza chiŵerengero choyankha bwino cha 31%, ndipo 42% ya odwala akupeza mayankho omwe amatenga zaka zoposa ziwiri. Ngakhale kuti izi zachitika bwino, njira yopezera chithandizo chofala ikukumana ndi zovuta zazikulu.
Mavuto a Mafakitale ndi Malonda
Chimodzi mwa mavuto akuluakulu ndi chikhalidwe cha munthu payekha Til Production, yomwe imafuna njira yayitali komanso yovuta yopangira. Ngakhale kuti Iovance yachepetsa nthawi yopangira kufika pa masiku pafupifupi 22, kupititsa patsogolo kwina kukufunika kuti tikwaniritse zosowa za odwala mwachangu. Kampaniyo ikufuna kufupikitsa nthawiyi kufika pa masiku 16 kudzera mu kusintha komwe kukuchitika.
Kugulitsa kumabweretsanso zopinga. Mtengo wokwera wa chithandizo chapadera—chomwe pakadali pano chili pamtengo wa $515,000 pa Lifileucel, komanso ndalama zina zowonjezera—zimalepheretsa kuvomerezedwa msanga pamsika wa US. Kuti makampani afikire padziko lonse lapansi komanso kuti chuma chawo chikhale bwino, ayenera kuchepetsa kupanga ndikuchepetsa ndalama.
Kuchepetsa njira yochizira kuti wodwala azitha kuchira ndi chinthu china chofunikira kwambiri. Chithandizo cha TIL chimaphatikizapo njira zingapo, kuphatikizapo kusonkhanitsa minofu ya chotupa, kukulitsa maselo, ndi kuchotsedwa kwa lymphocyte, zonse zomwe zimafuna zipatala zapadera ndi ogwira ntchito. Kupanga netiweki yayikulu komanso yothandiza yochizira ndikofunikira kuti malonda ambiri apambane.
Tsogolo la Lonjezo
Poganizira zamtsogolo, kufalikira kwa chithandizo cha TIL ku zotupa zina zolimba kukadali cholinga chachikulu. Ngakhale kafukufuku wapano akuyang'ana kwambiri pa melanoma, kuyesetsa kukuchitika kuti afufuze momwe imagwirira ntchito pa khansa zina monga khansa ya m'mapapo yopanda maselo ang'onoang'ono. Kumvetsetsa mfundo zazikulu za chithandizo cha TIL, kuphatikizapo kuzindikira maselo a T omwe ndi othandiza kwambiri ndikupanga mankhwala ophatikizana, kudzakhala kofunikira kwambiri.
Mankhwala ophatikizana, kuphatikiza ma TIL ndi mankhwala ochiritsira monga chemotherapy, radiation, immunotherapy, ndi katemera, akuwonetsa kuthekera kowonjezera zotsatira za chithandizo ndikuchepetsa zotsatirapo zake. Makampani monga Iovance akufufuza kale kuphatikiza ndi zoletsa za PD-1, cholinga chake ndikukweza mphamvu ya TIL komanso kuchuluka kwa mayankho a odwala.
Pamene Lifileucel ikukonza njira ya chithandizo cha TIL, gawo la chithandizo cha maselo lili pafupi ndi nthawi yosintha chithandizo cha khansa yolimba. Khama logwirizana ndi zatsopano kuchokera ku makampani opanga mankhwala zidzasankha amene akutsogolera malire atsopanowa. Chiyembekezo chomwe chikuyambitsidwa ndi chithandizo cha TIL chikulonjeza kukoka zinthu zambiri ndi chidwi, kutsogolera kupita patsogolo ndikupereka chiyembekezo chatsopano kwa odwala padziko lonse lapansi.