Ukungenelela Kwangoko Nge-CAR-T Therapy Kwi-B-Cell Lymphoma Enkulu Kubonisa Iziphumo Ezithembisayo
Uphononongo lwakutshanje olupapashwe kwi Ukufakelwa kweBone Marrowbaphonononge ukusebenza konyango lweeseli ze-CAR-T kwangethuba xa kuthelekiswa nonyango olukhawulezileyo kwizigulana ezine-“scale” enkulu. I-B-Cell Lymphoma (LBCL). Lwenziwe kwiindawo ezintathu e-US nase-Israel, olu phononongo lubandakanye izigulana ezingama-354 ezinyangwe ngonyango lwe-CAR-T olujoliswe kwi-CD19 phakathi kuka-Epreli 2016 noMatshi 2024. Olu phononongo lujolise ekuvavanyeni impembelelo yokunika unyango lwe-CAR-T njengonyango lodidi lwesibini (unyango lwasekuqaleni) xa kuthelekiswa nonyango lodidi lwesithathu okanye lwamva (unyango olusemva kwexesha) kwi-LBCL ephinde yabuyela kwisimo sayo okanye engayichaziyo.
Iziphumo zibonise ukuba ukunikezelwa kwangoko konyango lwe-CAR-T, nangona umthwalo wesigulana wesi sifo wawuphantsi kwaye imeko yomzimba yokuzikhusela ingcono, kwaba nemiphumo ethembisayo. Izinga lokuphendula lilonke emva konyaka omnye yayiyi-87% kunyango lwangoko nangoko kunye ne-82% kunyango lwangoko nangoko, nangona umahluko wawungabalulekanga ngokwezibalo (p=0.3). Nangona kunjalo, izinga lokusinda lilonke (OS) laliphezulu kwiqela lonyango lwangoko nangoko, kunye ne-82% yokusinda kunyaka omnye xa kuthelekiswa ne-71% kwiqela lonyango lwangoko nangoko (p=0.048).
Okunomdla kukuba, olu phononongo alufumananga mahluko mkhulu phakathi kwala maqela mabini kwi-progress-free survival (PFS), amazinga okubuyela umva, okanye ukufa okunxulumene nonyango. Amazinga okubuyela umva konyaka omnye ayengama-37% kwiqela lokuqala kunye nama-43% kwiqela elingasekhoyo, kungekho mpembelelo ibalulekileyo kwixesha lokunikwa kwe-CAR-T (p=0.2). Olu phononongo lukwafumanise ukuba ukwanda kwe-cytokine release syndrome (CRS) yebanga lesi-2 okanye ngaphezulu kwakuphantsi kakhulu kwiqela lokuqala lonyango (26%) xa kuthelekiswa neqela lokugqibela lonyango (39%) (p=0.031), nto leyo ebonisa ukuba ukungenelela kwangaphambili kunokunciphisa ezinye izinto ezinobungozi ezinxulumene nonyango.
Ezi ziphumo zixhasa ukusetyenziswa konyango lwe-CAR-T njengonyango lwesibini lwe-LBCL, njengoko lunokuthintela iingxaki ezinxulumene nonyango olukwinqanaba lokugqibela, kubandakanya ukuncipha kokunyamezela ngenxa yempilo iyonke yesigulana okanye ukudinwa kweeseli ze-T. Olu phononongo lukwagxininisa isidingo sophando olongezelelweyo ukuqonda iindlela zebhayoloji zokuxhathisa i-CAR-T kunye nokuphonononga unyango oludibeneyo olunokubakho ukuphucula iziphumo kuzo zonke izigaba zonyango.
Nangona olu phononongo lujonga emva kwaye lunokukhethwa kwaye lunokulandelelana okulinganiselweyo, iziphumo zibonelela ngengqiqo ebalulekileyo malunga nexesha elifanelekileyo lonyango lwe-CAR-T kwizigulane ze-LBCL. Iziphumo zibonisa ukuba ukungenelela kwangoko ngonyango lwe-CAR-T kunokuphucula ukusinda nokunciphisa ubuthi, okubonelela ngenyathelo elibalulekileyo ekuphuculeni amaqhinga okunyanga lo mhlaza unzima.