Ua ʻike mākou a pau i ka paʻakikī a me ka paʻakikī o ke kaua ʻana i ka maʻi kanesa. Akā me ka holomua o ka ʻepekema lapaʻau i kēlā me kēia lā, ke loaʻa nei nā lāʻau lapaʻau hou a me nā mea hou. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano hana hou a ka poʻe he nui e manaʻolana nui nei, me ka hoʻohana ʻana i ko mākou mau hunaola kino ponoʻī e mālama i ka maʻi kanesa. Ua kapa ʻia kēia ʻo TIL Therapy.
I ka ʻōlelo maʻalahi, he aha ka TIL Therapy?
ʻAe, e mālama kākou i kēia maʻalahi. Ua lohe paha ʻoe i ka immunotherapy . E pili ana i ka hoʻoulu ʻana i kā mākou ʻōnaehana pale ponoʻī, ko mākou pūʻali koa ponoʻī e hakakā nei i nā maʻi, e kōkua i ka luku ʻana i nā hunaola kanesa. ʻO ka TIL therapy kekahi o ia ʻano immunotherapy.
Hoʻohana kēia i kahi ʻano cell immune kūikawā a ikaika loa i loko o ko mākou kino. Ua kapa ʻia kēia mau cell he tumor-infiltrating lymphocytes , a i ʻole TILs no ka pōkole.
E noʻonoʻo e pili ana i ia mea, he ʻano koa like ʻole ko ko kākou kino (nā pūnaewele pale) e kiaʻi ana ma nā alanui e ʻimi ana i nā maʻi. Akā, ʻoi aku ka kūikawā o kēia mau koa i kapa ʻia ʻo TIL. Hele pololei lākou i loko o nā puʻupuʻu, ʻo ia hoʻi, e hoʻouka iā lākou, a aʻo pono i nā wahi nāwaliwali o kēlā mau pūnaewele kanesa a me ke ala maikaʻi loa e luku ai iā lākou. Ua like lākou me kahi hui pūʻali koa kūikawā e komo hewa ana i loko o kahi hoʻomoana a me nā mākaʻi.
No laila he aha ka pilikia? ʻO ka pilikia, ʻaʻole hiki i kā mākou ʻōnaehana pale ke hana i ka lawa o kēia mau koa akamai, a i ʻole TIL. He mea paʻakikī no ka poʻe liʻiliʻi e pono e hakakā i kēia maʻi kanesa hoʻokahi a lanakila.
ʻO ia kahi e komo mai ai ka lāʻau lapaʻau TIL. ʻO ka hana a kēia lāʻau lapaʻau, ʻo ia ke lawe aku i kēlā mau koa TIL akamai loa i loko o kou kino, hoʻonui iā lākou i nā piliona, hana i kahi pūʻali koa ikaika, a laila hoʻihoʻi iā lākou i loko o kou kino. A laila hele kēia pūʻali koa nui a luku i nā hunaola kanesa.
He aha nā ʻano maʻi kanesa e hiki ai ke hoʻohana ʻia kēia lāʻau lapaʻau?
Ma ka makahiki 2024, ua ʻāpono ka U.S. Food and Drug Administration (FDA) i kahi lāʻau lapaʻau TIL i kapa ʻia ʻo lifileucel (Amtagvi®) . Ua hoʻolālā kūikawā ʻia ia e mālama i kahi ʻano maʻi ʻili i kapa ʻia ʻo melanoma . Eia naʻe, ʻaʻole kūpono ia no nā ʻano melanoma āpau. Kūpono kēia lāʻau lapaʻau no:
- ʻAʻole hiki ke ho'ōla ʻia e ke ʻoki kino wale nō,
- ʻO ke kanesa i pālahalaha i nā ʻāpana ʻē aʻe o ke kino (cancer metastatic),
- A no ka poʻe i pane ʻole i nā lāʻau lapaʻau maʻamau a nā kauka oncology e hāʻawi mua ai.
Inā loaʻa iā ʻoe kahi maʻi like, he moho maikaʻi paha ʻoe no kēia lāʻau lapaʻau. Pono ʻoe e kamaʻilio me kāu kauka e pili ana i ia mea.
Eia kekahi, ke aʻo nei nā kauka a me nā mea noiʻi i ka holomua o ka lāʻau lapaʻau TIL no kekahi mau ʻano maʻi ʻē aʻe, e like me:
- Ka maʻi ʻaʻai umauma
- Ka maʻi ʻaʻai o ka ʻōpū
- Ka maʻi ʻaʻai kolona
- Nā maʻi ʻaʻai poʻo a me ka ʻāʻī
- Ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi
Pehea e hana ai kēia lāʻau lapaʻau? E aʻo kākou i kēlā me kēia ʻanuʻu.
ʻAʻole kēia he mea e hana ʻia i hoʻokahi lā. ʻO ka mea nui, ʻo ia ke hāʻawi hou aku i kāu mau pūnaewele TIL iā ʻoe iho. Akā, aia kekahi mau ʻanuʻu ma mua o ko kākou hiki ʻana i kēlā wahi. E nānā kākou i kēlā mau ʻanuʻu ma ke kaʻina.
| Nā ʻanuʻu | He aha ka mea e hana nei? |
|---|---|
| 1. Ka wehe ʻana i kahi ʻāpana o ka puʻupuʻu (Ka wehe ʻana) | ʻO ka mea mua, hoʻomaʻemaʻe ʻia ʻoe, a laila wehe ke kauka lapaʻau i kahi ʻāpana liʻiliʻi o kou puʻupuʻu, e like me ka nui o ka pomelo. Hoʻouna ʻia kēia i ka lab. ʻAʻole ʻoe e ʻeha. |
| 2. TIL-ʻohiʻohi a me ka hoʻonui ʻana | Ma ke keʻena hoʻokolohua, hoʻokaʻawale ʻia nā pūnaewele TIL mai ka puʻupuʻu. A laila, me ka hoʻohana ʻana i nā ʻano hana kūikawā, hoʻonui ʻia lākou e nā piliona. He ʻelima pule ka lōʻihi o kēia kaʻina hana. A laila, hoʻouna ʻia kēia pūʻali koa o nā pūnaewele i kāu kauka. |
| 3. Hoʻokomo ʻana i ka chemotherapy | E hoʻokomo ʻia ʻoe i ka haukapila a hāʻawi ʻia i ka chemotherapy no ʻelima a ʻehiku lā. ʻO kēia ke hoʻomākaukau i kou kino no ka pūʻali koa hou o nā pūnaewele TIL. |
| 4. Ke hāʻawi ʻana i nā pūnaewele TIL i ke kino (ka hoʻoili ʻana o TIL) | ʻO kēia ka ʻāpana koʻikoʻi loa. ʻO kāu mau pūnaewele TIL ponoʻī, i hana ʻia ma ka lab, ua hoʻokomo ʻia i loko o kou kino e like me ka saline. Hoʻokahi wale nō hana ʻia kēia. He ʻelua hola ka lōʻihi. |
| 5. Hoʻokomo ʻia ʻo Interleukin-2 | Ma hope o ka hāʻawi ʻia ʻana o nā pūnaewele TIL, e hāʻawi ʻia ʻoe i kahi lāʻau i kapa ʻia ʻo Interleukin-2 (IL-2) no ʻekolu a ʻelima mau lā. He immunotherapy nō hoʻi kēia. ʻO ka hana a kēia, ʻo ia ka hoʻoulu ʻana i nā pūnaewele TIL i hoʻokomo ʻia i loko o ke kino a paipai iā lākou e hoʻouka i ka maʻi kanesa. |
Ma hope o ka lāʻau lapaʻau, pono ʻoe e noho i ka haukapila no kekahi mau lā hou aʻe. I loko o ia manawa, e nānā pono ke kime lapaʻau i ke ʻano o ka pane ʻana o kou kino i ka lāʻau lapaʻau. Ma hope o kēlā, e aʻo ʻia ʻoe e noho ma kahi hiki ke hiki aku i ka haukapila no kekahi mau pule. ʻO kēia i hiki iā ʻoe ke loaʻa koke ka lāʻau lapaʻau inā loaʻa iā ʻoe kekahi mau hopena ʻaoʻao.
ʻEhia ka lōʻihi o kēia lapaʻau piha?
He lāʻau lapaʻau hoʻokahi wale nō ka TIL therapy. Eia nō naʻe, ʻo ke kaʻina holoʻokoʻa mai ka lā e wehe ʻia ai ke kanesa, a hiki i ka lā e hana ʻia ai nā ʻāpana, a hiki i ka manawa e mālama ʻia ai ʻoe, a hiki i ka manawa e hoʻi ai ʻoe i ka maʻamau hiki ke hala ma kahi o 10 mau pule . Pono ʻoe e noho ma ka haukapila no kahi o ʻelua pule.
He aha nā pōmaikaʻi a me nā pilikia o kēia?
Nā pono o kēia lāʻau lapaʻau
He lāʻau lapaʻau ikaika loa kēia a pilikino hoʻi.
- He hoʻouka kaua i kuhikuhi ʻia: Hoʻopili pololei kēia lāʻau i nā hunaola kanesa wale nō. No laila, he liʻiliʻi loa ka hōʻino ʻana i nā hunaola olakino. Hoʻemi pū kēia i ka pilikia o nā hopena ʻaoʻao.
- Palekana lōʻihi: ʻO nā pūnaewele TIL i hoʻokomo ʻia i loko o kou kino e noho mau i loko o kou kino no nā makahiki. ʻO ke ʻano kēia, ʻoiai ma hope o ka pau ʻana o ka lāʻau lapaʻau, hoʻomau kēia mau pūnaewele i ke kaua ʻana i ka maʻi kanesa.
- Manaʻolana Hou: ʻO ka mea nui loa paha, lawe mai kēia i ka manaʻolana nui i nā poʻe me nā maʻi ʻaʻai melanoma i manaʻo mua ʻia he hiki ʻole ke ho'ōla ʻia.
Ua hōʻike ʻia kahi noiʻi i ka makahiki 2023 i ʻehā mau makahiki ma hope o ka loaʻa ʻana o ka lāʻau lapaʻau TIL, 7 o 10 mau kānaka i loaʻa ka lāʻau lapaʻau ʻaʻohe maʻi a holomua paha. I loko o 3 o 10, ua emi a nalo loa paha nā puʻupuʻu.
Nā pilikia o ka mālama ʻana
E like me nā lāʻau lapaʻau a pau, aia kekahi mau pilikia. ʻO ka hapa nui o kēia mau hopena ʻaoʻao ke kumu o ka chemotherapy a me ka mālama ʻana o ka interleukin-2 (IL-2) . He mea kākaʻikahi loa nā hopena ʻaoʻao mai ka hoʻokele ʻana o nā cell TIL. ʻO nā hopena ʻaoʻao maʻamau:
- Ka maʻi pākī
- Luhi
- Kuni a me nā anu
- Puʻuwai puʻuwai kūpono ʻole (arrhythmia)
- Ke koko haʻahaʻa
- Ka luaʻi a me ka luaʻi
- ʻŌhū ʻili
I ka liʻiliʻi loa, hiki i ka mālama ʻana iā IL-2 ke hana i kahi pilikia koʻikoʻi i kapa ʻia ʻo ka capillary leak syndrome . Akā, mai hopohopo, e wehewehe kāu kauka i kēia mau pilikia āpau iā ʻoe ma mua o kou hoʻomaka ʻana i ka mālama ʻana.
Pehea ka lōʻihi o koʻu ola ʻana?
Hiki ke hala ʻelua pule a ʻoi aku paha ma mua o kou hoʻomaka ʻana e ʻoluʻolu ma hope o kāu mahele hope loa o IL-2. ʻO kēia no ka mea pono ke kino i ka manawa e hoʻōla ai mai ke kaumaha o ke kaʻina hana lapaʻau holoʻokoʻa (ʻoki kino, chemotherapy, IL-2).
Aia kekahi mea e hiki iaʻu ke hana e maʻalahi ai ka lāʻau lapaʻau?
ʻAʻole kēia he hana maʻalahi. ʻO ia ke kumu e nānā pono ai kāu hui lapaʻau iā ʻoe i kou noho ʻana ma ka haukapila. E nānā mau lākou iā ʻoe, e hana i nā hoʻāʻo koko, a e hōʻoia i ka mākaukau o kou kino no ka mālama ʻana. E hāʻawi lākou iā ʻoe i nā lāʻau lapaʻau e pono ai e hōʻemi i nā hopena ʻaoʻao, a e nānā mau lākou iā ʻoe no nā pilikia. ʻO kāu wale nō e hana ai, ʻo ia ke hahai i nā ʻōlelo aʻoaʻo i hāʻawi ʻia e ka hui lapaʻau a haʻi iā lākou e pili ana i kekahi ʻoluʻolu ʻole āu e manaʻo ai.
I ka manawa hea e pono ai iaʻu ke kāhea aku i ke kauka?
Inā hoʻi ʻoe i ka home ma hope o ka lāʻau lapaʻau a loaʻa i kekahi mau hōʻailona o ka maʻi (kuni, ʻeha kino), a i ʻole e loaʻa i kekahi mau hopena ʻaoʻao i manaʻo ʻole ʻia a koʻikoʻi paha, e kāhea koke aku i kāu kauka.
Mai noʻonoʻo hou. Inā ʻike ʻoe i kahi loli iki, kahi mea e like me 'ʻaʻole pololei kēia,' e haʻi koke aku i kāu kauka.
Inā loaʻa iā ʻoe ka melanoma i pane ʻole i nā lāʻau ʻē aʻe, he koho maikaʻi paha ka lāʻau TIL nou. Inā ʻōlelo kāu kauka i kēia lāʻau, e hoʻolohe pono i ke kaʻina hana piha, ka manawa e lawe ai, a me nā hopena e hiki ke loaʻa iā ʻoe ma kou kūlana. Hiki i kāu kauka ke wehewehe maikaʻi loa i nā pono a me nā pilikia o kēia lāʻau iā ʻoe.
Leka Lawe-Home
- He lāʻau hou a ikaika ka TIL therapy e hoʻohana ana i kāu mau pūnaewele pale ponoʻī (TILs) e mālama i ka maʻi kanesa.
- Ua ʻāpono ʻia i kēia manawa no ka melanoma, kahi ʻano maʻi ʻili i pane ʻole i nā lāʻau ʻē aʻe.
- ʻO kēia kaʻina hana lapaʻau e komo pū ana me ka wehe ʻana i kahi ʻāpana o ke kanesa, ka ulu ʻana o nā cell i loko o ka hale hana, ka chemotherapy, a me nā lāʻau lapaʻau ʻē aʻe, a hiki i ke kaʻina hana holoʻokoʻa ke hala ma kahi o 10 mau pule.
- Hoʻopaʻa kēia a luku i nā hunaola kanesa, me ka hōʻino iki ʻana i nā hunaola maʻamau. Eia nō naʻe, aia kekahi mau hopena ʻaoʻao a me nā pilikia.
- Inā he mau nīnau kāu e pili ana i kāu lāʻau lapaʻau a i ʻole ʻike ʻoe i kekahi ʻano ʻoluʻolu ʻole ma hope o ka lāʻau lapaʻau, he mea nui loa e kamaʻilio ākea me kāu kauka e pili ana i ia mea.
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