Ithemba elitsha kuNyango loMhlaza: Unyango lwe-TILs luyavela njenge Frontier elandelayo
Intsimi yonyango lweeseli iyaqhubeka nokuvela, kunye nonyango lwe-TIL ngoku luvela njengenkqubela phambili ebalulekileyo kunyango lomhlaza. Ngaphandle kwamathemba aphezulu afakwe kunyango lwe-CAR-T, impembelelo yayo kwiithumba eziqinileyo, ezibandakanya i-90% ye-cancer, inqunyelwe. Nangona kunjalo, unyango lwe-TIL lulungele ukutshintsha loo ngxelo.
Unyango lwe-TIL kutshanje luye lwafumana ingqwalasela enkulu xa i-Iovance Biotherapeutics 'Lifileucel ifumana imvume ekhawulezileyo ye-FDA ngoFebruwari 16 kunyango lwe-melanoma oluye lwaqhubela phambili emva konyango lwe-antibody lwe-PD-1. Ukuvunywa kweLifileucel kuyiphawula njengonyango lokuqala lwe-TIL ukufikelela kwintengiso, ebonisa isigaba esitsha kunyango lweeseli ezijolise kumathumba aqinileyo.
Indlela ende eya empumelelweni
Uhambo lonyango lwe-TIL luthatha iminyaka engaphezu kwamashumi amane. I-Tumor-Infiltrating Lymphocytes (TILs) liqela elihlukeneyo leeseli zomzimba ezifumaneka ngaphakathi kwe-tumor microenvironment, kuquka iiseli ze-T, iiseli ze-B, iiseli ze-NK, i-macrophages, kunye neeseli ze-myeloid-derived suppressor. Ezi seli, zihlala zilinganiselwe ngenani kunye nomsebenzi ngaphakathi kwamathumba, zinokuvunwa, zandiswe elebhu, kwaye ziphinde zingeniswe kwisigulana ukujolisa kunye nokutshabalalisa iiseli zomhlaza.
Ngokungafaniyo neeseli ze-CAR-T, ii-TILs zithathwa ngokuthe ngqo kwithumba, zivumela ukuba zibone uluhlu olubanzi lwee-antigens zethumba kwaye zinikezela ngokungenwa ngcono kunye neeprofayili zokhuseleko. Le ndlela ibonakalisile isithembiso, ngakumbi ekunyangeni amathumba aqinileyo apho i-CAR-T iye yasokola ukwenza inkqubela.
Ukophula Imingeni
I-Lifileucel ibonise iziphumo zeklinikhi ezinomdla, enika ithemba kwizigulane ze-melanoma ezinokhetho oluncinci zonyango. Kulingo lwezonyango lwe-C-144-01, unyango lufezekise izinga lempendulo yenjongo ye-31%, kunye ne-42% yezigulane ezifumana iimpendulo ezithatha iminyaka emibini. Ngaphandle kwezi mpumelelo, indlela yokwamkelwa ngokubanzi ijongene nemiqobo emikhulu.
Imingeni yoShishino neyoRhwebo
Omnye wemingeni ephambili yindalo yomntu ngamnye yemveliso ye-TIL, efuna inkqubo yokuvelisa ixesha elide nelinzima. Ngelixa i-Iovance icuthe ixesha lemveliso ukuya malunga neentsuku ezingama-22, ukukhawuleza okungaphezulu kuyafuneka ukuhlangabezana neemfuno zesigulane ngokukhawuleza. Inkampani ijolise ekunciphiseni eli xesha ukuya kwiintsuku ezili-16 ngokuqhubela phambili okuqhubekayo.
Urhwebo lukwanika imiqobo. Iindleko eziphezulu zonyango lomntu siqu-okwangoku ixabiso le-$ 515,000 ye-Lifileucel, kunye neendleko zonyango ezongezelelweyo-inciphisa ukwamkelwa kwangaphambili kwimarike yase-US. Ukufezekisa ukufikelela kwihlabathi kunye nokusebenza kwezoqoqosho, iinkampani kufuneka zilungelelanise imveliso kwaye zinciphise iindleko.
Ukwenza lula inkqubo yonyango ukomeleza amava esigulane yenye into ebalulekileyo. Unyango lwe-TIL lubandakanya amanyathelo amaninzi, kubandakanywa ukuqokelelwa kwezicubu ze-tumor, ukwanda kweeseli, kunye ne-lymphodepletion, zonke zifuna izibonelelo zonyango ezikhethekileyo kunye nabasebenzi. Ukwakha uthungelwano lonyango olunabileyo nolusebenzayo kubalulekile kwimpumelelo yorhwebo olubanzi.
Ikamva Lesithembiso
Ukujonga phambili, ukwandiswa konyango lwe-TIL kwamanye amathumba aqinileyo kuhlala kuyinjongo ephambili. Ngelixa uphando lwangoku lujolise ikakhulu kwi-melanoma, iinzame ziyaqhubeka ukuphonononga ukusebenza kwayo kwezinye ii-cancer ezinjengomhlaza wemiphunga weseli ongeyonxalenye encinci. Ukuqonda iinuances zonyango lwe-TIL, kubandakanya ukuchonga ukuba zeziphi iiseli ze-T ezisebenza kakhulu kunye nokuphuhlisa unyango oludibeneyo, kuya kubaluleka.
Unyango oludityanisiweyo, ukudibanisa i-TILs kunye nonyango oluqhelekileyo olufana ne-chemotherapy, i-radiation, i-immunotherapies, kunye nezitofu zokugonya, zibonisa amandla okuphucula iziphumo zonyango kunye nokunciphisa imiphumo emibi. Iinkampani ezifana ne-Iovance sele ziphanda indibaniselwano kunye ne-PD-1 inhibitors, ejolise ekuphuculeni ukusebenza kwe-TIL kunye namazinga okuphendula kwesigulane.
Njengoko i-Lifileucel ivula indlela yonyango lwe-TIL, intsimi yonyango lweeseli limi ekupheleni kwexesha lokuguqula unyango oluqinileyo lwe-tumor. Iinzame ezidibeneyo kunye nezinto ezintsha ezivela kwiinkampani zamachiza ziya kugqiba ukuba ngubani okhokelayo kulo mda mtsha. Ithemba elitshiswe lunyango lwe-TIL lithembisa ukutsala izixhobo ezingaphezulu kunye nengqalelo, ukuqhuba inkqubela phambili kunye nokubonelela ngethemba elitsha kwizigulana kwihlabathi liphela.