He lāʻau lapaʻau hou e hakakā ana i ka maʻi kanesa me kou mau pūnaewele ponoʻī (TIL therapy)

Ua manaʻo paha ʻoe e hiki i ko kākou kino ke hakakā i ka maʻi kanesa ma kāna iho? ʻOiaʻiʻo, he pūʻali koa pale kupaianaha ko ko kākou kino i kapa ʻia ʻo ka ʻōnaehana pale. Akā i kekahi manawa, no ka mea, ua ʻoi aku ka ikaika o ka ʻenemi i kapa ʻia ʻo ka maʻi kanesa, ua lilo ia i mea paʻakikī no ko kākou pūʻali koa ke lanakila wale i ke kaua. I ia mau manawa, e kamaʻilio mākou e pili ana i kahi lāʻau lapaʻau e hāʻawi ana i kā kākou pūʻali koa i ka hoʻomaʻamaʻa kūikawā, hoʻonui i kona mana, a hoʻouna hou iā ia i ke kaua.

He aha kēia lāʻau lapaʻau TIL?

I ka ʻōlelo maʻalahi, ʻo ka TIL therapy kahi ʻano immunotherapy hou no ka maʻi kanesa. Hana ia ma ke kōkua ʻana i ka ʻōnaehana pale ponoʻī o kou kino e ʻike a luku i nā hunaola kanesa.

ʻO ke kanaka koa o kēia lāʻau lapaʻau he ʻano cell kūikawā i kapa ʻia ʻo Tumor-Infiltrating Lymphocytes , a mākou e kapa nei he TILs no ka pōkole.

E noʻonoʻo e like me nā koa (nā pūnaewele pale) e kiaʻi ana i ko mākou kino. Akā, ʻoi aku ka kūikawā o kēia mau koa, i kapa ʻia ʻo TIL. Hoʻokomo lākou i loko o ka puʻupuʻu ponoʻī, aʻo i kona nāwaliwali, a aʻo pehea e luku maikaʻi ai. I nā huaʻōlelo ʻē aʻe, ua like lākou me nā pūʻali koa kūikawā e komo hohonu ana i loko o kahi hoʻomoana o ka ʻenemi a kiu iā ia.

ʻO ia kahi e komo mai ai ka lāʻau lapaʻau TIL. Pili ia i ka hoʻonui ʻana i kāu helu cell TIL i nā piliona. Wehe ke kauka lapaʻau i kahi ʻāpana liʻiliʻi o kāu puʻupuʻu. A laila hoʻouna lākou i kahi lab, hoʻokaʻawale i nā koa TIL, a hoʻonui iā lākou a hiki i ko lākou helu ʻana i nā piliona. ʻO ka hope loa, ua hoʻokomo hou ʻia kēia pūʻali koa nui, i hana ʻia mai kāu mau cell ponoʻī, i loko o kou kino.

He aha nā ʻano maʻi kanesa e mālama ʻia e kēia lāʻau?

Ma ka makahiki 2024, ua ʻāpono ka US Food and Drug Administration (FDA) i kahi lāʻau lapaʻau TIL i kapa ʻia ʻo lifileucel (Amtagvi®) . He mea kūikawā ia no ka melanoma, kahi ʻano maʻi ʻili. ʻO ia hoʻi, ka melanoma i hiki ʻole ke ho'ōla ʻia me ke ʻoki wale nō, a i ʻole ua pālahalaha i nā ʻāpana ʻē aʻe o ke kino (maʻi kanesa metastatic). He kūpono paha kēia lāʻau lapaʻau no kekahi mea i pane ʻole i nā lāʻau lapaʻau i hāʻawi pinepine ʻia e nā oncologists.

Eia kekahi, ke noiʻi nei nā kauka i ka pono o kēia lāʻau TIL no kekahi mau ʻano maʻi ʻē aʻe, me:

• Ka maʻi ʻaʻai umauma
• Ka maʻi ʻaʻai o ka ʻōpū
• Ka maʻi ʻaʻai kolona
• Ka maʻi ʻaʻai poʻo a me ka ʻāʻī
• Ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi

Pehea e hana ai ke kaʻina hana lapaʻau?

ʻAʻole kēia he mea e hana ʻia i ka manawa hoʻokahi. ʻOiai ʻo ka mea nui ka hoʻokomo ʻana i nā pūnaewele TIL, aia kekahi mau ʻanuʻu e pono e hana ʻia ma mua o kēlā. E nānā kākou i kēia kaʻina holoʻokoʻa i kēlā me kēia ʻanuʻu.

Pono ʻoe e noho i ka haukapila no kekahi mau lā ma hope o ka mālama ʻana. I loko o kēia manawa, e nānā pono ke kime lapaʻau i ka pane a kou kino i ka mālama ʻana. No nā pule e hiki mai ana, he mea nui e noho ma kahi kokoke i ka haukapila i hiki iā ʻoe ke loaʻa koke ka mālama ʻana inā loaʻa kekahi mau hopena ʻaoʻao.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

He aha nā pono?

He lāʻau lapaʻau pilikino a ikaika loa ka TIL therapy. Ma muli o ka hoʻohana ʻana i kāu mau cell ponoʻī, he liʻiliʻi ka pōʻino i nā cell olakino. No laila, haʻahaʻa nō hoʻi ka pilikia o nā hopena ʻaoʻao.

ʻOi aku ka mea nui, he lōʻihi ka hopena o kēia lāʻau . Noho nā pūnaewele TIL i hoʻokomo ʻia i loko o kou kino no nā makahiki, e hakakā ana i nā pūnaewele kanesa.

Nā pilikia a me nā hopena ʻaoʻao

E like me nā lāʻau lapaʻau a pau, aia nā pilikia ma kēlā me kēia pae o ke kaʻina hana. ʻO nā hopena ʻaoʻao ke kumu nui o ka chemotherapy a me ka lāʻau IL-2. He mea kākaʻikahi loa nā hopena ʻaoʻao mai ka hoʻokele ʻana o nā cell TIL.

Kākaʻikahi loa, ma muli o ka mālama ʻana iā IL-2Hiki ke loaʻa kahi pilikia koʻikoʻi, e like me ka capillary leak syndrome. Akā, mai hopohopo, e kūkākūkā pono kāu kauka i kēia mau pilikia āpau me ʻoe ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau.

ʻEhia ka lōʻihi e pono ai iaʻu e hoʻi i ka maʻamau?

E hoʻomaka ʻoe e ʻoluʻolu ma kahi o ʻelua pule ma hope o kāu mahele hope loa o IL-2. ʻOiai ʻo kēia kaʻina hana lapaʻau e pili ana i nā mea he nui, e like me ke ʻoki kino a me ka chemotherapy, pono kekahi manawa no ke kino e hoʻōla.

Āhea ʻoe e pono ai e ʻike i ke kauka?

Ma hope o ka lāʻau lapaʻau, inā loaʻa iā ʻoe nā hōʻailona o kahi maʻi (kuni, ʻeha kino), a inā loaʻa iā ʻoe kekahi mau hopena ʻino a koʻikoʻi paha, e kāhea koke aku i kāu kauka.

Inā loaʻa iā ʻoe ka melanoma i pane ʻole i nā lāʻau ʻē aʻe, he koho maikaʻi paha ʻo TIL nāu. Inā ʻōlelo kāu kauka i kēia lāʻau, e nīnau i kāu mau nīnau e pili ana i ia mea. E kamaʻilio me kāu kauka e pili ana i nā pono a me nā pilikia. ʻO kāu kauka kāu kumu ʻike maikaʻi loa.