Ukubaluleka Kwezokwelapha Kwama-Oligoclonal Protein Bands Ngemva Kokwelashwa Kwe-BCMA CAR-T Ezigulini Eziningi Ze-Myeloma

Ukuqonda Amabhendi Amaprotheni e-Oligoclonal ku-CAR-T Therapy
Ku- I-Multiple Myeloma (MM), ukuba khona kwama-band amaprotheni angajwayelekile (i-APB), aziwa nangokuthi ama-band amaprotheni e-oligoclonal, kuye kwabonwa ngemuva kokufakelwa kweseli le-hematopoietic stem. Kodwa-ke, ukuvama kwawo kanye nokubaluleka kwawo emitholampilo ezigulini ezithola ukwelashwa kweseli le-CAR-T okuqondiswe ku-BCMA akukacaci. Ukuze kuxazululwe lokhu, abacwaningi base-Second Affiliated Hospital yase-Xi'an Jiaotong University benze ucwaningo lokuhlola emuva ukuze bahlaziye ukwenzeka kwe-APB, izinhlobo ezincane, kanye nokubaluleka kokubikezela ezigulini ze-MM ezelashwe nge-LCAR-B38M njengengxenye yokuhlolwa kwe-Phase 1 LEGEND-2. Okutholakele kusanda kushicilelwa ku-I-HemaSphere, eholwa oSolwazi uHe Aili, uWang Fangxia, noBai Ju.

Okutholakele Okubalulekile

Ucwaningo luhlole iziguli ezingu-47, kanti ezingu-23 (48.9%) zakha i-APB ngemva kokwelashwa nge-CAR-T. Uhlobo oluvame kakhulu kwakuyi-IgG (91.3%). Isikhathi esimaphakathi sokuqala kwe-APB sasiyizinyanga ezingu-3.6 ngemva kokufakwa kwe-CAR-T, kanti isikhathi esimaphakathi sasiyizinyanga ezingu-5.8. Okubaluleke kakhulu, ukwenzeka kwe-APB kwakuhlotshaniswa nezimpendulo zokwelashwa ezithuthukisiwe, ukusinda okude okungenalo inqubekela phambili (PFS), kanye nokusinda okuphelele okuthuthukisiwe (OS).

Ukuqonda okwengeziwe kufake phakathi:

• Imiphumela Yezokwelapha EthuthukisiweIziguli ezine-APB zibonise amazinga angcono okusabela ekwelashweni kwe-LCAR-B38M futhi zathola ukuphulukiswa okujulile.
• Ukuthuthukiswa Kokululama Kwamasosha Omzimba: Iziguli ze-APB zibonise amazinga aphezulu okululama kwama-immunoglobulins nama-lymphocyte ezinyangeni ezi-3 nezingu-6 ngemuva kokwelashwa, okubonisa izimpendulo eziqinile zokuzivikela komzimba kanye nokuvuselelwa kwamasosha omzimba okulandelayo.
• Izinkomba Zokubikezela: Ukuhlaziywa kwe-Multivariate kuthole ukusebenza kahle kokwelashwa kwe-CAR-T, inani lama-platelet, ukuba khona kwe-APB, kanye namazinga e-β2-microglobulin njengezinto ezizimele zokubikezela i-PFS. Ku-OS, ukusebenza kahle kwe-CAR-T kanye nenani lama-platelet kwakuyizinto ezizimele.

Ngokuthakazelisayo, ucwaningo alutholanga mehluko obalulekile kuma-subpopulation e-T-cell noma e-NK-cell phakathi kwamaqembu e-APB kanye namaqembu angewona ama-APB, okuphakamisa ukuthi inani lokubikezela le-APB lingase livele ngokuyinhloko ekuvuseleleni okuthuthukisiwe kwe-humoral kanye ne-immune systems kunezindlela zokuzivikela zamaseli.

Isiphetho kanye Nemiphumela

Ucwaningo lugcizelela ukuthi ukuba khona kwe-APB ngemuva kokwelashwa kwe-BCMA CAR-T kuhlobene nokuphumula okujulile kanye nemiphumela engcono yezokwelapha ezigulini ze-MM eziphinde zathola ukwelashwa kabusha/ezingalapheki. Ngaphezu kwalokho, okutholakele kugqamisa i-APB njengophawu olungase lube khona lokuvuselelwa kwamasosha omzimba ngemva kokwelashwa okuphumelelayo, okuvula izindlela zocwaningo olwengeziwe lokwenza ngcono ukwelashwa kwe-CAR-T kanye nokuqonda amandla okuvuselelwa kwamasosha omzimba.

Njengoba izindlela zokwelapha ze-CAR-T eziqondiswe ku-BCMA ziqhubeka nokukhula, ukuqonda okunjalo kubaluleke kakhulu ekuphuculeni izindlela zokwelapha kanye nokuthuthukisa imiphumela yeziguli ze-MM emhlabeni jikelele.