Ukubaluleka Kweklinikhi Kweebhendi Zeeprotheyini ze-Oligoclonal Emva Konyango lwe-BCMA CAR-T Kwizigulane Ezininzi ZeMyeloma

Ukuqonda ii-Oligoclonal Protein Bands kwi-CAR-T Therapy
Ngaphakathi I-Multiple Myeloma (MM), ubukho beebhendi zeprotheyini ezingaqhelekanga (APB), ezaziwa ngokuba ziibhendi zeprotheyini ze-oligoclonal, bubonwe emva kokufakelwa kweeseli ze-hematopoietic stem. Nangona kunjalo, ukuphindaphindeka kwazo kunye nokubaluleka kwazo kwizigulane ezifumana unyango lweseli ye-CAR-T olujoliswe kwi-BCMA akukacaci. Ukujongana noku, abaphandi abavela kwiSibhedlele sesiBini esiManyeneyo kwiYunivesithi yaseXi'an Jiaotong benze uphando olujonga emva ukuze bahlalutye ukwenzeka kwe-APB, iintlobo ezahlukeneyo, kunye nokubaluleka kokuxela kwangaphambili kwizigulane ze-MM ezinyangwe nge-LCAR-B38M njengenxalenye yovavanyo lweSigaba soku-1 LEGEND-2. Iziphumo zipapashwe kutshanje kwiIHemaSphere, ekhokelwa ngooNjingalwazi uHe Aili, uWang Fangxia, kunye noBai Ju.

Iziphumo eziphambili

Olu phononongo luvavanye izigulane ezingama-47, apho ezingama-23 (48.9%) zakha i-APB emva konyango lwe-CAR-T. Uhlobo oluqhelekileyo yayiyi-IgG (91.3%). Ixesha eliphakathi lokuqalisa kwe-APB yayiziinyanga ezi-3.6 emva kokufakwa kwe-CAR-T, kwaye ixesha eliphakathi yayiziinyanga ezi-5.8. Okubalulekileyo kukuba, ukwenzeka kwe-APB kwakunxulunyaniswa neempendulo zonyango eziphuculweyo, ukusinda okude okungenankqubela phambili (PFS), kunye nokusinda okuphuculweyo ngokubanzi (OS).

Ezinye izinto eziqokelelweyo ziquka:

• Iziphumo zeKlinikhi eziphuculweyo: Izigulane ezine-APB zibonise amazinga angcono okusabela kunyango lwe-LCAR-B38M kwaye zafumana ukuphumla okunzulu ngakumbi.
• Ukuphucula Ukubuyiselwa Kwamajoni Omzimba: Izigulane ze-APB zibonise amazinga aphezulu okuchacha kwee-immunoglobulins kunye nee-lymphocytes kwiinyanga ezi-3 nezi-6 emva konyango, nto leyo ebonisa iimpendulo eziqinileyo zomzimba ezibangelwa yi-humoral kunye nokuhlaziywa kwakhona komzimba emva koko.
• Izalathisi zokuxela kwangaphambiliUhlalutyo lwe-Multivariate luchonge ukusebenza kakuhle konyango lwe-CAR-T, inani leeplatelet, ubukho be-APB, kunye namanqanaba e-β2-microglobulin njengezinto ezizimeleyo zokuxela kwangaphambili ze-PFS. Kwi-OS, ukusebenza kakuhle kwe-CAR-T kunye nenani leeplatelet yayizizinto ezizimeleyo.

Okubangel’ umdla kukuba, olu phononongo alufumananga mahluko abalulekileyo kwinani leeseli ze-T okanye ze-NK phakathi kwamaqela e-APB kunye namaqela angengawo e-APB, nto leyo ebonisa ukuba ixabiso lokuxela kwangaphambili le-APB lisenokuvela ngokuyintloko ekuphuculweni kokubuyiselwa kwe-humoral kunye ne-immune endaweni yeendlela zokuzikhusela zeseli.

Isiphelo kunye neziphumo

Olu phononongo lugxininisa ukuba ubukho be-APB emva konyango lwe-BCMA CAR-T buhambelana nokukhululwa okunzulu kunye neziphumo ezingcono zeklinikhi kwizigulane ze-MM eziphinde zabuyela kwi-refractory/refractory. Ukongeza, iziphumo zibonisa i-APB njengophawu olunokwenzeka lokubuyisela amasosha omzimba emva konyango olusebenzayo, oluvula iindlela zophando olongezelelekileyo malunga nokwenza ngcono unyango lwe-CAR-T kunye nokuqonda amandla okuvuselela amasosha omzimba.

Njengoko unyango lwe-CAR-T olujoliswe kwi-BCMA luqhubeka lukhula, ulwazi olunjalo lubaluleke kakhulu ekuphuculeni iindlela zonyango kunye nokuphucula iziphumo zezigulane ze-MM kwihlabathi liphela.