Imiphumela Ethembisayo Yokwelashwa Kwe-CD7 CAR-T Ekwelapheni I-Relapsed/Refractory Peripheral T-Cell Lymphoma e-ASH 2024
Emhlanganweni Waminyaka Yonke Wama-66 we-American Society of Hematology (ASH) 2024, owawubanjwe kusukela mhla ziyi-7 kuya ku-10 kuZibandlela eSan Diego, uSolwazi Lu Peihua waseLu Daopei Hospital wethule isivivinyo sezokwelapha seSigaba I sokwelashwa kwe-Chimeric Antigen Receptor T-cell (CAR-T) okuqondiswe ku-CD7 ekwelapheni i-peripheral ephinde yabuya/engaphenduli kahle. I-T-Cell Lymphoma (R/R PTCL). Lokhu kuyintuthuko ebalulekile ekwelapheni umdlavuza we-T-cell, lapho izinketho zokwelapha ezitholakalayo ziye zancipha futhi ngokuvamile zingasebenzi kahle.
I-R/R PTCL yaziwa ngokubikezela kwayo okubi, ikakhulukazi ezigulini eziye zathola ukwelashwa okuhlukahlukene, okuhlanganisa nokufakelwa kwe-allogeneic hematopoietic stem cell (allo-HSCT). Naphezu kwalokhu, ukwelashwa kwe-CD7 CAR-T, ikakhulukazi ukwelashwa kweseli le-NS7CAR-T okwakhiwe yithimba likaProf. Lu, kubonise imiphumela ekhuthazayo ekwelapheni iziguli ezine-CD7-positive R/R PTCL. Kulolu vivinyo, iziguli ezinhlanu, ezineminyaka engu-39 kuya kwengu-60, ezinezigaba ezithuthukile ze-R/R PTCL zabhaliswa phakathi kuka-Ephreli 2021 noNovemba 2023. Lezi ziguli ziye zathola ukwelashwa okulinganiselwe kwemigqa eyisithupha yangaphambilini, okuhlanganisa necala elilodwa elinomlando wokufakelwa kweseli le-autologous stem.
Imiphumela yayithembisa: phakathi nesikhathi sokulandelela esimaphakathi sezinsuku ezingu-234, ama-60% eziguli athole ukuxolelwa okuphelele (CR), kanti isiguli esisodwa sithole ukuxolelwa okungaphelele (PR). Okubaluleke kakhulu, ukwelashwa kubonise izinga eliphezulu lokwanda kwamaseli e-CAR-T kanye nokuphikelela ezigulini, kanti izinga eliphakeme elimaphakathi lamaseli e-CAR-T lifinyelela ukusebenza kahle okungu-93.5%. Okuphawulekayo ukuthi, bekungekho miphumela emibi ebalulekile njengobuthi be-neurotoxicity, kanti i-cytokine release syndrome (CRS) yayincane, kanti isiguli esisodwa kuphela sithole i-CRS yebanga lesi-2. Iphrofayili yokuphepha yayilawuleka, kungekho buthi obukhulu obubonwe.
Ucwaningo lukaProf. Lu luqokomisa amandla okwelashwa kwe-CD7 CAR-T njengokushintsha umdlalo ekwelapheni umdlavuza we-T-cell, ikakhulukazi ezigulini ezinezinketho ezimbalwa zokwelapha noma ezingenazo nhlobo. Ngaphezu kwemiphumela emihle ku-PTCL, ithimba likaProf. Lu selithole ukusebenza kahle okuvelele ekwelapheni i-T-cell acute lymphoblastic leukemia (T-ALL) kanye ne-T-cell lymphoblastic lymphoma (T-LBL), ngesilinganiso sokukhululwa okuphelele esicishe sibe ngu-95% eqenjini leziguli ezingu-60. Njengoba kunikezwe le miphumela, ithimba manje selisandisa ucwaningo lwalo kwezinye izifo zomdlavuza we-hematological ezifana ne-acute myeloid leukemia (AML), kanye nedatha yokuqala ebonisa izinga lokukhululwa okuphelele elithembisayo elingu-70% ezigulini ezine-CD7-positive AML.
Naphezu kwale miphumela emihle, uSolwazi Lu ugcizelela ukubaluleka kokuhlanganisa ukwelashwa kwe-CD7 CAR-T ne-allo-HSCT ukuze kuthuthukiswe imiphumela yesikhathi eside. Ukungafani komdlavuza we-T-cell kudinga isu lokwelapha eliphelele ukuze kwandiswe amathuba okuphulukiswa okuhlala isikhathi eside kanye nokwelashwa okungenzeka. Ithimba liyaqhubeka nokuthuthukisa indlela yalo futhi landise izinkomba zokwelapha ukwelashwa kwe-CD7 CAR-T.
Umsebenzi kaProf. Lu, osevele welaphe iziguli ezingaphezu kuka-300 ngokwelashwa nge-CD7 CAR-T, umele isinyathelo esikhulu ekwelashweni komdlavuza we-T-cell. Siqhubekela phambili, ithimba lizibophezele ekuhlolweni okuqhubekayo kwemitholampilo nasekuthuthukiseni amasu okwelapha nge-CAR-T cell, ukuqinisekisa ukuthi iziguli eziningi zizozuza kule ndlela entsha.
Lolu vivinyo oluthembisayo lweSigaba I e-ASH 2024 lugcizelela amandla okwelashwa kwe-CD7 CAR-T njengomngcele omusha ku-hematological oncology, lunikeza ithemba ezigulini ezinezimo ezingelapheki ngaphambilini.