Ukwelashwa kwe-CAR-T Kubonisa Ukuphepha Nokusebenza Kahle Ezigulini Zomdlavuza Ezinezifo Ezizimele Noma Ezivuvukalayo
Ocwaningweni olusanda kushicilelwa ku- I-Lancet Rheumatology, abacwaningi abavela eDana-Farber Cancer Institute bahlole ukuphepha nokusebenza kahle kokwelashwa kwamaseli e-CAR-T ezigulini ezinomdlavuza ezinomlando wezifo zokuzivikela komzimba noma izifo ezivuvukalayo. Ucwaningo, olubukeze idatha kusukela ngo-2017 kuya ku-2023, luhlanganise iziguli ezingu-604 ezine-lymphoma kanye I-Multiple Myeloma, abangu-53 kubo babenezimo zokuzivikela komzimba noma ukuvuvukala. Lezi zimo zazihlanganisa izifo ze-rheumatoid, kanti i-psoriasis iyona evame kakhulu.
Ukwelashwa kwamaseli e-CAR-T, okugxile kakhulu ku-CD19 kanye ne-BCMA, kubonise impumelelo emangalisayo ekwelapheni ukuphinda kusebenze kanye nokungaguquki kwesifo. I-B-Cell Lymphoma, i-leukemia, kanye ne-multiple myeloma. Kodwa-ke, kuye kwavela ukukhathazeka mayelana nokuphepha nokusebenza kwayo ezigulini ezinezifo zokuzivikela komzimba noma ukuvuvukala ezikhona kakade, njengoba lezi ziguli zisengozini enkulu yokusabela okubi njenge-cytokine release syndrome (CRS) kanye ne-immune effector cell-associated neurotoxicity syndrome (ICANS).
Ucwaningo luthole ukuthi ukwanda kwe-CRS kanye ne-ICANS ezigulini ezinezifo zokuzivikela komzimba noma ukuvuvukala kwakufana nokweziguli ezingenazo lezi zimo. Ngokukhethekile, amazinga e-CRS enzima ayemancane, kungekho mehluko omkhulu phakathi kwamaqembu amabili. Ukuvela kwe-ICANS nakho kwakufana, okuphakamisa ukuthi ukwelashwa kwe-CAR-T kuphephile kulezi ziguli.
Ngokuphathelene nokusebenza kahle, bekungekho mehluko omkhulu ekusindeni okungenazo iziyaluyalu (PFS) kanye nasekusindeni okuphelele (OS) phakathi kwamaqembu amabili, okuqinisekisa ukuthi ukuba khona kwezifo ezizimele noma ezivuvukalayo akuthinti kabi i- Ukwelashwa Komdlavuza imiphumela. Ngokuthakazelisayo, lolu cwaningo luphinde lwabona ukuthuthuka emsebenzini wesifo sokuzivikela komzimba ngemva kokwelashwa. Kubonakale ukwehla okukhulu kwesidingo semithi yokucindezela amasosha omzimba, futhi ukuqubuka kwesifo kwakungavamile eqenjini lokwelashwa.
Lolu cwaningo lunikeza ubufakazi obuqinile obusekela ukusetshenziswa kokwelashwa kwe-CAR-T ezigulini ezinezifo zokuzivikela komzimba noma ukuvuvukala ngasikhathi sinye, okubonisa ukuthi kuyindlela efanelekile yeziguli eziningi ezinomdlavuza. Okutholakele kukhuthaza izifundo ezengeziwe ezizokwenzeka ukuthi zihlole izinzuzo ezingaba khona zokwelashwa kwe-CAR-T kuleli qembu leziguli elihlukile.
Njengoba ukwelashwa kwe-CAR-T kuqhubeka nokukhula, le miphumela inikeza ithemba lokuthuthukisa izinketho zokwelapha kanye nemiphumela yeziguli ezinemilando yezokwelapha eyinkimbinkimbi.