Gufata ingamba hakiri kare hifashishijwe CAR-T ubuvuzi bwa Lymphoma nini ya B-cell bigaragaza umusaruro mwiza
Ubushakashatsi buherutse gukorwa bwasohotse mu Gutera Umwobo w'Amagufwayasuzumye uburyo bwo kuvura hakiri kare ugereranije n’uburyo bwo gutinda hakoreshejwe uburyo bwa CAR-T ku barwayi bafite ikibazo kinini Lymphoma y'uturemangingo twa B (LBCL). Ubu bushakashatsi bwakorewe mu bigo bitatu muri Amerika na Isirayeli, bwakorewe ku barwayi 354 bavuwe hakoreshejwe uburyo bwa CD19-target therapy CAR-T hagati ya Mata 2016 na Werurwe 2024. Ubu bushakashatsi bwari bugamije gusuzuma ingaruka zo gutanga ubuvuzi bwa CAR-T nk'ubuvuzi bwo ku rwego rwa kabiri (ubuvuzi bwihuse) ugereranije n'ubwo ku rwego rwa gatatu cyangwa nyuma (ubuvuzi bwihuse) ku barwayi ba LBCL basubije cyangwa badafite uburyo bwo kuvura.
Ibisubizo byagaragaje ko gutanga ubuvuzi bwa CAR-T hakiri kare, mu gihe umutwaro w'ikibyimba cy'umurwayi wari muto kandi ubudahangarwa bw'umubiri bukaba bwiza kurushaho, byagize ingaruka nziza. Igipimo rusange cy'ubutabazi nyuma y'umwaka umwe cyari 87% ku bavuwe hakiri kare na 82% ku bavuwe hakiri kare, nubwo itandukaniro ritari rigaragara mu mibare (p=0.3). Ariko, igipimo rusange cy'abarokotse (OS) cyari kinini ku itsinda ryavuwe hakiri kare, aho 82% barokotse mu mwaka umwe ugereranije na 71% ku itsinda ryavuwe hakiri kare (p=0.048).
Igishimishije ni uko ubushakashatsi butagaragaje itandukaniro rinini hagati y’ayo matsinda abiri mu bijyanye no kubaho nta guhindagurika kw’indwara (PFS), igipimo cyo gusubira inyuma kw’indwara, cyangwa impfu zikomoka ku kuvurwa. Igipimo cyo gusubira inyuma kw’indwara mu mwaka umwe cyari 37% ku itsinda rya mbere na 43% ku itsinda rya nyuma, nta ngaruka nini zavuye ku gihe cyo gutanga CAR-T (p=0.2). Ubushakashatsi bwagaragaje kandi ko umubare w’abantu barwaye indwara ya cytokine release syndrome (CRS) yo mu cyiciro cya 2 cyangwa hejuru wari muto cyane mu itsinda rya mbere ry’ubuvuzi (26%) ugereranije n’itsinda rya nyuma ry’ubuvuzi (39%) (p=0.031), bigaragaza ko gufata ingamba mbere y’igihe bishobora kugabanya uburozi bumwe na bumwe bukomoka ku kuvurwa.
Ibi byavuye mu bushakashatsi bishyigikira ikoreshwa rya CAR-T therapy nk'uburyo bwa kabiri bwo kuvura LBCL, kuko ishobora gukumira ingorane zijyanye no kuvura nyuma, harimo no kugabanuka k'ubushobozi bwo kwihanganira indwara bitewe n'ubuzima bw'umurwayi muri rusange cyangwa umunaniro wa T-cells. Ubu bushakashatsi kandi bushimangira ko hakenewe ubushakashatsi bwimbitse kugira ngo hasobanuke uburyo bwo kurwanya CAR-T mu mubiri no gushakisha uburyo bwo kuvura buvanze kugira ngo harusheho kunozwa umusaruro mu byiciro byose by'ubuvuzi.
Nubwo ubushakashatsi bugamije gusuzuma ibyavuye mu bushakashatsi kandi bushobora kuba bufite aho bubogamiye no gukurikirana bike, ibisubizo bitanga ubumenyi bw'ingirakamaro ku gihe cyiza cyo kuvura CAR-T ku barwayi ba LBCL. Ibyavuye mu bushakashatsi bigaragaza ko gutera inkunga hakiri kare hakoreshejwe CAR-T therapy bishobora kunoza ubuzima no kugabanya uburozi, bigatanga intambwe ikomeye mu kunoza ingamba zo kuvura iyi kanseri igoye.