Iterambere mu by'amasomo | Itsinda ry'abaganga rya Lu Daopei ryasohoye ubushakashatsi butangaje mu kinyamakuru cy'ubwongereza cy'ubuvuzi bw'amaraso

Mu gikorwa gikomeye cyakozwe n'ikipe y'ubuvuzi ya Lu Daopei, inyandiko y'ubushakashatsi bw'ubuvuzi yitwa “Inyigo y’umutekano n’ubushobozi bwo gutera uturemangingo tw’amaraso ya allogeneic hematopoietic ku barwayi ba T-cell leukaemia/lymphoblastic lymphoma bakize kandi basubiranyemo, bakize burundu nyuma yo kuvurwa na autologous CD7 chimeric antigen receptor T-cell” byasohotse mu gitabo kizwi cyane Ikinyamakuru cy'Ubwongereza cy'Ubumenyi bw'amaraso (IF=5.1). Ubu bushakashatsi, bwanditswe na Dr. Cao Xingyu, Prof. Lu Peihua akaba ari we mwanditsi ujyanye na bwo, bwibanze ku bushobozi bwiza bwo guhuza abarwayi ba R/R T-ALL na T-LBL bakize burundu nyuma yo kuvurwa na CD7 CAR-T.

Amasomo y'ubushakashatsi:

Indwara za kanseri zo mu turemangingo twa T, nka T-ALL na T-LBL, zizwiho kuba zikomeye kandi zirwanya cyane kuvurwa. Ku barwayi bafite T-ALL/LBL (R/R T-ALL/T-LBL) idakira cyangwa yongeye gusubira inyuma, ubuvuzi gakondo butanga umusaruro muke kandi butanga icyerekezo kibi. Ariko, ubuvuzi bwa CD7 CAR-T bwagaragaye nk'intambwe ishobora gutera imbere, bugaragaza icyizere gikomeye mu kuvura izi ndwara zigoye kuvurwa, nubwo zikiri mu ntangiriro z'igeragezwa ry'ubuvuzi. Iyo hakurikiyeho guhuza na allo-HSCT, abarwayi bakira CR bakoresheje CD7 CAR-T bahabwa amahirwe nyayo yo koroherwa igihe kirekire.

Uburyo bwo Kwiga:

Ubu bushakashatsi bwakorewe inyuma bwasesenguye abarwayi ba R/R T-ALL na T-LBL bahawe ubuvuzi bwa NS7 CAR-T, bukurikirwa no guhuza allo-HSCT hagati y'Ugushyingo 2020 na Mutarama 2023 mu bitaro bya Lu Daopei. Ubushakashatsi bwasuzumye ibintu bitandukanye, birimo imyaka y'umurwayi, nimero ya kopi y'uturemangingo twa CAR-T mbere yo guterwa, n'uburyo butandukanye bwo gufata CAR-T, kugira ngo harebwe ingaruka zabyo ku musaruro wo guterwa. Ibisubizo byagereranyijwe n'iby'abarwayi 124 bakiriye CR binyuze mu miti igabanya ubukana bwa chemotherapy hagakurikiraho allo-HSCT.

Ibyavumbuwe by'ingenzi:

Ubushakashatsi bwakorewe ku barwayi 34 ba R/R T-ALL/T-LBL bagezeho CR nyuma yo kuvurwa na NS7 CAR-T hanyuma bakaza guhabwa allo-HSCT. Igihe cyo hagati y’ubuvuzi bwa CAR-T no guterwa inshinge cyari iminsi 57.5. Ikigaragara ni uko 47.1% by’abarwayi bari bafite indwara yo kutagira icyo ikora, mu gihe 52.9% bari barasubiye kurwara. Nyuma yo guhabwa imiti ya cytokine release syndrome (CRS) yagaragaye ku barwayi 33, aho 94.1% bahuye na CRS yo mu cyiciro cya 1-2. Ku bw’amahirwe, nta barwayi barwaye indwara yo kuvura indwara iterwa n’imitsi iterwa n’umubiri (ICANS).

Nyuma y'iminsi 28 nyuma ya CAR-T, abarwayi 31 bagize CR idahuye na MRD, mu gihe abarwayi 3 bari bafite CR idahuye na MRD. Ubushakashatsi bwagaragaje kandi ko abarwayi bafite ≤20% by'ibisebe by'umusonga mbere yo guterwa inshinge bari bafite igipimo cyo gusubira inyuma cya 0% nyuma y'amezi 18 nyuma yo guterwa inshinge. Ugereranyije n'abarwayi ba CR bashingiye ku mikorere ya chimiotherapie, igipimo cy'imyaka 2 yo kubaho (OS) cyari gisa: 61.9% ku itsinda rya CD7 CAR-T ugereranije na 67.6% ku itsinda rya chimiotherapie. Byongeye kandi, igipimo cy'imyaka 2 yo kubaho nta leukemia (LFS) cyari hafi kimwe (62.3% ugereranyije na 62.0%).

By’umwihariko, abarwayi bafite imyaka ≤14 bahawe ubuvuzi bwa CD7 CAR-T bari bafite 87.5% by’indwara zo mu mutwe zifata ingirabuzima fatizo n’indwara zo mu mutwe zifata ingirabuzima fatizo mu gihe cy’imyaka 2. Ibisubizo bigaragaza ko ubuvuzi bwa CD7 CAR-T bukurikirwa na allo-HSCT bushobora gutanga ubundi buryo bwizewe kandi bufite akamaro ku barwayi ba R/R T-ALL/T-LBL batemerewe kuvurwa gakondo.

Umwanzuro:

Ubushakashatsi bwanzuye ko guhuza uburyo bwo kuvura CD7 CAR-T bukurikirwa na allo-HSCT bitanga uburyo bwiza kandi butanga umusaruro ku barwayi ba R/R T-ALL/T-LBL. Ibisubizo byabonetse byari bisa n'ibyabonetse hakoreshejwe imiti ya chimiotherapie na allo-HSCT, nta bwiyongere bw'impfu zitarasubira inyuma, bitanga uburyo bw'ingirakamaro bwo kuvura ku barwayi bafite uburyo buke bwo kuvura. Ibyavuye mu bushakashatsi bitanga icyizere cyo koroherwa no kubaho igihe kirekire, cyane cyane ku barwayi bafite ibyago byinshi byo kuvura bakorerwa isuzuma rya allo-HSCT ku gihe.

Ingaruka n'icyerekezo cy'ejo hazaza:

Gusohora ubu bushakashatsi bw'ingenzi muri Ikinyamakuru cy'Ubwongereza cy'Ubumenyi bw'amarasoni igihamya cy'ubwitange n'ubuhanga bw'itsinda ry'abaganga rya Lu Daopei. Iyi ntambwe igaragaza imbaraga ibitaro bikomeje gushyira mu bikorwa mu kuvura indwara z'amaraso n'uruhare rwabyo rukomeye mu muryango w'abaganga ku isi. Igaragaza ubushobozi bw'ubuvuzi bwa CD7 CAR-T nk'uburyo bufatika ku barwayi bafite R/R T-ALL/T-LBL kandi igaragaza ubwitange bw'itsinda mu kuzamura imipaka y'ubuvuzi bw'amaraso. Ubuvuzi bwa kanseri.