Chiyembekezo Chatsopano mu Chithandizo cha Khansa: TILs Therapy Emerges as the Next Frontier
Gawo la chithandizo cha ma cell likupitilirabe, ndipo chithandizo cha TIL tsopano chikutuluka ngati kupita patsogolo kwakukulu pamankhwala a khansa. Ngakhale pali ziyembekezo zazikulu zokhazikika pa chithandizo cha CAR-T, zotsatira zake pa zotupa zolimba, zomwe zimakhala ndi 90% ya khansa, zakhala zochepa. Komabe, chithandizo cha TIL chatsala pang'ono kusintha nkhaniyo.
Thandizo la TIL posachedwapa linakhudzidwa kwambiri pamene Iovance Biotherapeutics 'Lifileucel adalandira chivomerezo cha FDA chofulumira pa February 16th chithandizo cha melanoma chomwe chapita patsogolo kutsatira PD-1 antibody therapy. Chivomerezo cha Lifileucel chikuwonetsa ngati chithandizo choyamba cha TIL kufika pamsika, kuwonetsa gawo latsopano lama cell othandizira omwe amayang'ana kwambiri zotupa zolimba.
Njira Yaitali Yopita ku Chipambano
Ulendo wa chithandizo cha TIL umatenga zaka makumi anayi. Tumor-Infiltrating Lymphocytes (TILs) ndi magulu osiyanasiyana a chitetezo cha mthupi omwe amapezeka mkati mwa microenvironment ya chotupa, kuphatikizapo T maselo, B maselo, NK maselo, macrophages, ndi myeloid-derived suppressor cells. Maselo awa, omwe nthawi zambiri amakhala ochepa komanso amachitikira m'matumbo, amatha kukololedwa, kukulitsidwa mu labu, ndikubwezeretsedwanso mwa wodwala kuti ayang'ane ndikuwononga ma cell a khansa.
Mosiyana ndi ma cell a CAR-T, ma TIL amachokera ku chotupacho, kuwalola kuzindikira mitundu ingapo ya ma antigen a chotupa ndikupereka mbiri yabwino yolowera ndi chitetezo. Njirayi yawonetsa lonjezo, makamaka pochiza zotupa zolimba pomwe CAR-T idavutikira kuti ipite patsogolo.
Kuthetsa Mavuto
Lifileucel yawonetsa zotsatira zachipatala zochititsa chidwi, zopatsa chiyembekezo kwa odwala a melanoma omwe ali ndi njira zochepa zochizira. Mu mayeso azachipatala a C-144-01, chithandizocho chidakwaniritsa chiwopsezo cha 31%, ndi 42% ya odwala omwe adakumana ndi mayankho kwa zaka ziwiri. Ngakhale izi zikuyenda bwino, njira yopititsira kulera ana ambiri ikukumana ndi zopinga zazikulu.
Zovuta Zamakampani ndi Zamalonda
Chimodzi mwazovuta zazikulu ndizomwe zimachitika payekhapayekha kupanga TIL, komwe kumafunikira nthawi yayitali komanso yovuta kupanga. Ngakhale Iovance yachepetsa nthawi yopanga mpaka pafupifupi masiku 22, kuthamangitsa kwina kumafunika kuti mukwaniritse zosowa za odwala mwachangu. Kampaniyo ikufuna kufupikitsa nthawiyi kukhala masiku 16 kudzera mukupita patsogolo.
Kuchita malonda kumaperekanso zopinga. Mtengo wokwera wa chithandizo chamunthu payekha-pakali pano pamtengo wa $515,000 wa Lifileucel, ndi ndalama zowonjezera zachipatala-zimachepetsa kukhazikitsidwa koyambirira kumsika waku US. Kuti akwaniritse ntchito zapadziko lonse lapansi komanso zachuma, makampani amayenera kuwongolera zopanga ndikuchepetsa mtengo.
Kufewetsa njira ya chithandizo kuti muwonjezere chidziwitso cha odwala ndi chinthu china chofunikira. Thandizo la TIL limaphatikizapo masitepe angapo, kuphatikiza kusonkhanitsa minofu ya chotupa, kukula kwa maselo, ndi kuchepa kwa ma lymphode, zonse zomwe zimafunikira zipatala zapadera ndi ogwira ntchito. Kupanga maukonde ochiritsira ochulukirapo komanso ogwira mtima ndikofunikira kuti apambane pazamalonda.
Tsogolo la Lonjezo
Kuyang'ana m'tsogolo, kukulitsidwa kwa chithandizo cha TIL ku zotupa zina zolimba kumakhalabe cholinga chachikulu. Ngakhale kafukufuku waposachedwa amayang'ana kwambiri pa melanoma, kuyesetsa kuwunika momwe imagwirira ntchito pamakhansa ena monga khansa yosakhala yaying'ono ya m'mapapo. Kumvetsetsa zovuta za chithandizo cha TIL, kuphatikiza kuzindikira kuti ndi maselo ati a TIL omwe ali othandiza kwambiri ndikupanga chithandizo chophatikizana, ndikofunikira.
Thandizo lophatikizana, kuphatikiza ma TIL ndi mankhwala ochiritsira wamba monga chemotherapy, radiation, immunotherapies, ndi katemera, zikuwonetsa kuthekera kopititsa patsogolo zotsatira za chithandizo ndikuchepetsa zotsatira zoyipa. Makampani monga Iovance akufufuza kale zosakaniza ndi PD-1 inhibitors, pofuna kukonza bwino TIL ndi kuyankha kwa odwala.
Pamene Lifileucel akutsegulira njira ya chithandizo cha TIL, gawo la chithandizo cha ma cell likuyimira m'mphepete mwa nthawi yosinthika pakuchiza chotupa cholimba. Kuyesetsa pamodzi ndi zatsopano zochokera kumakampani opanga mankhwala zidzatsimikizira yemwe akutsogolera malire atsopanowa. Chiyembekezo chomwe chinayatsidwa ndi chithandizo cha TIL chimalonjeza kukopa zinthu zambiri ndi chidwi, kuyendetsa patsogolo ndikupereka chiyembekezo chatsopano kwa odwala padziko lonse lapansi.