Chithandizo cha Tumor-Infiltrating Lymphocyte (TIL) Therapy: Njira Yodalirika Yothandizira Melanoma

Khansa ya Melanoma ndi mtundu wa khansa ya pakhungu yomwe imachokera ku ma melanocyte, maselo omwe amayambitsa kupanga melanin, utoto womwe umapatsa khungu mtundu wake. Imaonedwa kuti ndi imodzi mwa mitundu yoopsa kwambiri ya khansa chifukwa cha kuthekera kwake kufalikira ku ziwalo zina za thupi mwachangu. Ngakhale melanoma yoyambirira nthawi zambiri imatha kuchiritsidwa bwino pochotsa opaleshoni, melanoma yapamwamba kapena yofalikira imabweretsa zovuta zazikulu zamankhwala. M'zaka zaposachedwa, njira zatsopano zochiritsira matenda a immunotherapy zawonekera ngati njira zabwino zochiritsira matenda opitilira. Chimodzi mwa zinthu zopambanazi ndi chithandizo cha Tumor-Infiltrating Lymphocyte (TIL), chomwe chimagwiritsa ntchito chitetezo cha mthupi kuti chiwongolere ndikuwononga maselo a khansa, kupereka chiyembekezo chatsopano kwa odwala omwe ali ndi melanoma yomaliza.

Chithandizo cha khansa cholowa m'thupi (TIL) ndi njira yatsopano yochizira matenda yomwe imagwiritsa ntchito maselo a chitetezo chamthupi kuti awononge ndikuwononga maselo a khansa. Yakhala njira yabwino kwambiri yothandizira khansa ya khansa yomwe yafalikira m'thupi, makamaka kwa odwala omwe salabadira bwino njira zochiritsira monga zoletsa chitetezo chamthupi kapena njira zochiritsira zomwe zakonzedwa.

Njira Yothandizira TIL

Chithandizo cha TIL chimaphatikizapo kuchotsa maselo a T kuchokera ku chotupa cha wodwalayo, kuwakulitsa kunja kwa thupi, kenako nkuwabwezeretsanso kwa wodwalayo atatha kulandira mankhwala a chemotherapy. Maselo a T awa amakonzedwa mwachibadwa kuti azindikire ndikuukira maselo a chotupa, kupereka chithandizo chofunikira kwambiri. Akabwezeretsedwanso m'thupi, amafunafuna ndikuwononga maselo a melanoma, mothandizidwa ndi kuperekedwa kwa interleukin-2 (IL-2), yomwe imathandiza maselo a T kukhala ndi moyo ndikuchulukana.

Kafukufuku Wofunika ndi Zomwe Zapezeka

Van den Berg ndi ena (2020)adachita kafukufuku wa gawo loyamba/lachiwiri ku Netherlands Cancer Institute ndipo adapeza kuti chithandizo cha TIL chinapangitsa kuti odwala omwe ali ndi khansa ya m'magazi alandire chithandizo champhamvu komanso chokhazikika. 50 peresenti ya odwalawo adawonetsa kuti ali ndi chithandizo chabwino, ndipo awiri adachira kwathunthu komwe kumatenga zaka zoposa zisanu ndi ziwiri. Kafukufukuyu adawonetsa kuti ma TIL owonjezera mphamvu ya neoantigen adapitilirabe m'magazi kwa zaka zambiri atalandira chithandizo, zomwe zidathandizira kuwongolera khansa kwa nthawi yayitali.

Gastman ndi ena (2021)adachita kafukufuku wa DELTA-1, womwe unayesa ITIL-168, mtundu wa chithandizo cha TIL chodziyimira pawokha, mwa odwala omwe ali ndi melanoma yapamwamba omwe adabwereranso kapena omwe sanalandire chithandizo cha checkpoint inhibitor. Kafukufukuyu adapeza kuti ITIL-168 ikhoza kupereka njira yothandiza yochizira odwala omwe ali ndi zosankha zina zochepa. Kafukufuku wamkuluyu wapadziko lonse lapansi wa gawo lachiwiri adawonetsa zotsatira zabwino, ndipo kafukufuku wopitilira umayang'ana kwambiri kuwunika zabwino za nthawi yayitali.

Rohan ndi anzake (2018)adapereka ndemanga yozama ya chithandizo cha TIL, ndikugogomezera kuthekera kwake ngati chithandizo chofunikira cha melanoma. Ngakhale pakadali pano cha mankhwala ofunikira komanso zoletsa chitetezo chamthupi, chithandizo cha TIL chikadali chofunikira komanso chothandiza, chikuwonetsa zotsatira zabwino m'mayesero azachipatala. Ndemangayi idawonetsa kufunika kwa njira zochotsera ma lymphodepleting ndi kufalikira kosankha kwa anthu a TIL kuti awonjezere kugwira ntchito kwa chithandizochi.

Ubwino ndi Malangizo a Mtsogolo

Chithandizo cha TIL chili ndi ubwino wofunika kwambiri kuposa ma immunotherapy ena:

• Mayankho Okhazikika: Monga momwe zasonyezedwera mu maphunziro a nthawi yayitali, chithandizo cha TIL chingapereke mpumulo wokhalitsa, makamaka kwa odwala omwe ali ndi melanoma yapamwamba omwe ali ndi njira zochepa zochiritsira.
• Chitetezo Chokhazikika: Ma TIL ndi oyenera kwambiri kuukira maselo a chotupa chifukwa amachokera ku chotupa cha wodwalayo, zomwe zimapangitsa kuti azichita zinthu mwapadera.
• Kuthekera Kophatikizana: Chithandizo cha TIL chili ndi kuthekera kophatikizidwa ndi ma immunotherapy ena kapena njira zina zochiritsira, kukweza kuchuluka kwa mayankho ndikuwonjezera moyo wonse.

Chithandizo cha TIL chikuyimira kupita patsogolo kwakukulu pa chithandizo cha khansa yofalikira m'thupi, makamaka kwa odwala omwe sayankha ku mankhwala ena. Ndi kuchuluka kwa mayankho okhazikika komanso okhazikika, chithandizochi chili ndi lonjezo lokhala chithandizo chokhazikika posachedwa. Kafukufuku wopitilira akufunika kuti njira zokulitsa TIL ziwongolere bwino ndikuzindikira odwala abwino kwambiri pa chithandizochi.