Ithemba Elitsha Kunyango Lomhlaza: Unyango lwe-TILs Luvela Njengomda Olandelayo

Icandelo lonyango lweeseli liyaqhubeka nokukhula, kwaye unyango lwe-TIL ngoku luvela njengenkqubela phambili ebalulekileyo kwi Unyango lomhlazaNangona kukho amathemba amakhulu abekwe kunyango lwe-CAR-T, impembelelo yalo kwiithumba eziqinileyo, eziquka i-90% yomhlaza, incinci. Nangona kunjalo, unyango lwe-TIL lukulungele ukutshintsha loo ngxelo.

Unyango lwe-TIL lusandula ukufumana ingqalelo enkulu xa i-Lifileucel ka-Iovance Biotherapeutics ifumene imvume ekhawulezileyo ye-FDA ngomhla we-16 kuFebruwari yonyango lwe-melanoma oluye lwaqhubeka emva konyango lwe-PD-1 antibody. Imvume ye-Lifileucel iyiphawula njengonyango lokuqala lwe-TIL olufikelele kwimarike, nto leyo ebonisa isigaba esitsha kunyango lweseli olugxile kwiithumba eziqinileyo.

Indlela ende eya empumelelweni

Uhambo lonyango lwe-TIL luthatha iminyaka engaphezu kwamashumi amane. Ii-Tumor-Infiltrating Lymphocytes (ii-TIL) liqela elahlukeneyo leeseli zomzimba ezifumaneka ngaphakathi kwe-tumor microenvironment, kuquka ii-T cells, ii-B cells, Iseli yaseNkii-s, ii-macrophages, kunye neeseli ezithintela iiseli ezisuka kwi-myeloid. Ezi seli, ezihlala zilinganiselwe kwinani kunye nomsebenzi ngaphakathi kweethumba, zinokuvunwa, zandiswe kwilebhu, kwaye ziphinde zingeniswe kwisigulana ukuze zijolise kwaye zitshabalalise iiseli zomhlaza.

Ngokungafaniyo neeseli ze-CAR-T, ii-TIL zifunyanwa ngqo kwi-tumor, nto leyo ebavumela ukuba babone uluhlu olubanzi lwee-antigens ze-tumor kwaye banike iiprofayili zokungena okungcono kunye nokhuseleko. Le ndlela ibonakalise ithemba, ngakumbi ekunyangeni ii-tumor eziqinileyo apho i-CAR-T ibisokola khona ukwenza inkqubela phambili.

Ukuphumelela kwiingxaki

I-Lifileucel ibonakalise iziphumo ezimangalisayo zonyango, inika ithemba kwizigulana ze-melanoma ezineendlela ezimbalwa zonyango. Kwilingo leklinikhi le-C-144-01, unyango lufikelele kwizinga lokuphendula elichanekileyo le-31%, kunye nama-42% ezigulana ezifumana iimpendulo ezihlala iminyaka emibini. Nangona le mpumelelo, indlela eya ekuthathweni ngokubanzi kweyeza ijongene nemiqobo emikhulu.

Imingeni yezeShishini nezeRhwebo

Enye yeengxaki eziphambili yindlela umntu ngamnye ajongana ngayo Imveliso yeTili-ion, efuna inkqubo yokuvelisa ende neyinkimbinkimbi. Nangona i-Iovance inciphise ixesha lokuvelisa ukuya kuthi ga kwiintsuku ezingama-22, kufuneka ukukhawuleziswa okungakumbi ukuze kuhlangatyezwane neemfuno zezigulane ngokukhawuleza. Le nkampani ijonge ukufinyeza eli xesha ukuya kwiintsuku ezili-16 ngokuqhubela phambili okuqhubekayo.

Urhwebo lukwazisa imiqobo. Ixabiso eliphezulu lonyango olulungiselelwe umntu ngamnye—oluxabisa i-$515,000 kwiLifileucel, kunye neendleko zonyango ezongezelelweyo—lithintela ukwamkelwa kwangoko kwimarike yaseMelika. Ukuze kufikelelwe kufikeleleko lwehlabathi kunye nokuphila kakuhle kwezoqoqosho, iinkampani kufuneka zilungelelanise imveliso kwaye zinciphise iindleko.

Ukwenza lula inkqubo yonyango ukuze kuphuculwe amava esigulana yenye into ebalulekileyo. Unyango lwe-TIL lubandakanya amanyathelo amaninzi, kuquka ukuqokelelwa kwezicubu zethumba, ukwandiswa kweeseli, kunye nokususwa kweeseli emzimbeni, konke oku kufuna izibonelelo zonyango ezikhethekileyo kunye nabasebenzi. Ukwakha uthungelwano lonyango olubanzi nolusebenzayo kubalulekile kwimpumelelo ebanzi yorhwebo.

Ikamva Lesithembiso

Ukujonga phambili, ukwandiswa konyango lwe-TIL kwezinye iithumba eziqinileyo kuseyeyona njongo iphambili. Nangona uphando lwangoku lugxile kakhulu kwi-melanoma, kuyaqhubeka imizamo yokuhlola ukusebenza kwayo kwezinye iintlobo zomhlaza ezifana nomhlaza wemiphunga ongengoweeseli ezincinci. Ukuqonda iingongoma zonyango lwe-TIL, kuquka ukuchonga ukuba zeziphi iiseli ze-T ezisebenzayo kunye nokuphuhlisa unyango oludibeneyo, kuya kuba yimfuneko.

Unyango oludibeneyo, oludibanisa ii-TIL kunye nonyango oluqhelekileyo olufana ne-chemotherapy, i-radiation, i-immunotherapy, kunye nee-vaccines, lubonisa amandla okuphucula iziphumo zonyango kunye nokunciphisa iziphumo ebezingalindelekanga. Iinkampani ezifana ne-Iovance sele ziphonononga indibaniselwano kunye ne-PD-1 inhibitors, zijolise ekuphuculeni ukusebenza kakuhle kwe-TIL kunye namazinga okuphendula kwezigulane.

Njengoko iLifileucel ivula indlela yonyango lwe-TIL, icandelo lonyango lweeseli limi ecaleni kwexesha lotshintsho kunyango lwe-tumor eqinileyo. Imizamo edibeneyo kunye notshintsho oluvela kwiinkampani zamayeza luya kugqiba ukuba ngubani okhokela lo mda mtsha. Ithemba elivuselelwe lunyango lwe-TIL lithembisa ukutsala izixhobo kunye nengqwalaselo engaphezulu, ukuqhuba inkqubela phambili kunye nokubonelela ngethemba elitsha kwizigulana kwihlabathi liphela.