Peb txhua tus paub tias nws nyuaj thiab nyuaj npaum li cas los tawm tsam mob qog noj ntshav. Tab sis nrog rau kev nce qib ntawm kev kho mob txhua hnub, cov kev kho mob tshiab thiab tshiab tau pom. Hnub no, peb yuav tham txog ib txoj kev tshiab uas ntau tus neeg muaj kev cia siab rau, siv peb cov hlwb hauv lub cev los kho mob qog noj ntshav. Qhov no hu ua TIL Therapy.
Hais yooj yim xwb, TIL Therapy yog dab tsi?
Zoo, cia peb ua kom yooj yim xwb. Tej zaum koj twb tau hnov txog kev kho mob tiv thaiv kab mob lawm. Nws yog hais txog kev txhawb peb lub cev tiv thaiv kab mob, peb cov tub rog uas tawm tsam kab mob, los pab rhuav tshem cov hlwb qog noj ntshav. Kev kho mob TIL yog ib qho kev kho mob tiv thaiv kab mob zoo li no.
Qhov no siv ib hom cell tiv thaiv kab mob tshwj xeeb heev thiab muaj zog heev hauv peb lub cev. Cov cell no hu ua tumor-infiltrating lymphocytes , lossis luv luv TILs .
Xav txog nws, peb lub cev muaj ntau hom tub rog (cov hlwb tiv thaiv kab mob) uas saib xyuas txoj kev nrhiav kab mob. Tab sis cov tub rog no hu ua TILs tshwj xeeb dua. Lawv mus rau hauv cov qog nqaij hlav, uas yog, nkag mus rau hauv lawv, thiab kawm paub meej tias cov qhov tsis muaj zog ntawm cov hlwb qog nqaij hlav ntawd yog dab tsi thiab txoj hauv kev zoo tshaj plaws los rhuav tshem lawv yog dab tsi. Lawv zoo li pab tub rog tshwj xeeb uas nkag mus rau hauv lub yeej thiab cov neeg soj ntsuam ntawm cov yeeb ncuab.
Yog li ntawd, qhov teeb meem yog dab tsi? Qhov teeb meem yog, peb lub cev tiv thaiv kab mob tsis tuaj yeem tsim cov tub rog ntse no, lossis TILs txaus. Nws nyuaj rau ob peb tug neeg uas yuav tsum tawm tsam tus kab mob qog noj ntshav no ib leeg thiab yeej.
Qhov ntawd yog qhov uas kev kho mob TIL los txog. Qhov kev kho mob no ua yog tshem tawm cov tub rog TIL ntse tshaj plaws hauv koj lub cev, nce lawv los ntawm ntau txhiab lab, tsim ib pab tub rog muaj zog, thiab tom qab ntawd muab lawv rov qab rau hauv koj lub cev. Tom qab ntawd pab tub rog loj no mus thiab rhuav tshem cov hlwb qog noj ntshav.
Cov kev kho mob no siv tau rau hom mob qog noj ntshav twg?
Txij li xyoo 2024, Lub Chaw Saib Xyuas Khoom Noj thiab Tshuaj ntawm Teb Chaws Asmeskas (FDA) tau pom zoo rau kev kho mob TIL hu ua lifileucel (Amtagvi®) . Nws yog tsim los kho ib hom mob qog nqaij hlav hu ua melanoma . Txawm li cas los xij, nws tsis haum rau txhua hom melanoma. Kev kho mob no haum rau:
- Nws kho tsis tau los ntawm kev phais ib leeg xwb,
- Mob qog nqaij hlav uas tau kis mus rau lwm qhov ntawm lub cev (mob qog nqaij hlav metastatic),
- Thiab rau cov neeg uas tsis teb rau cov kev kho mob ib txwm muaj uas cov kws kho mob oncologist feem ntau muab ua ntej.
Yog koj muaj ib yam mob zoo li no, tej zaum koj yuav yog ib tus neeg zoo rau kev kho mob no. Koj yuav tsum nrog koj tus kws kho mob tham txog qhov no.
Ntxiv rau, cov kws kho mob thiab cov kws tshawb fawb tab tom kawm txog kev vam meej ntawm kev kho mob TIL rau ntau hom mob qog noj ntshav, suav nrog:
- Mob qog noj ntshav hauv lub mis
- Mob qog nqaij hlav ntawm lub tsev menyuam
- Mob qog nqaij hlav plab
- Mob qog noj ntshav hauv taub hau thiab caj dab
- Mob qog nqaij hlav ntsws uas tsis yog mob me
Kev kho mob no ua haujlwm li cas? Cia peb kawm ib kauj ruam zuj zus.
Qhov no tsis yog ib yam dab tsi uas yuav tshwm sim hauv ib hnub xwb. Qhov tseem ceeb tshaj plaws yog muab koj cov hlwb TIL rov qab rau koj tus kheej. Tab sis muaj ob peb kauj ruam ua ntej peb mus txog qhov ntawd. Cia peb saib cov kauj ruam ntawd raws li kev txiav txim.
| Cov kauj ruam | Muaj dab tsi tshwm sim? |
|---|---|
| 1. Tshem tawm ib feem ntawm lub qog (Tshem tawm) | Ua ntej, koj raug muab tshuaj loog, thiab tus kws phais yuav rho ib daim me me ntawm koj lub qog, uas loj li txiv kab ntxwv qaub. Qhov no raug xa mus rau chav kuaj mob. Koj yuav tsis hnov mob dab tsi li. |
| 2. TIL-kev sau qoob loo thiab kev nthuav dav | Hauv chav kuaj mob, cov hlwb TIL raug rho tawm ntawm cov qog nqaij hlav. Tom qab ntawd, siv cov txheej txheem tshwj xeeb, lawv raug muab ntau txhiab lab. Cov txheej txheem no siv sijhawm li tsib lub lis piam. Tom qab ntawd, cov pab tub rog ntawm cov hlwb no raug xa mus rau koj tus kws kho mob. |
| 3. Kev txhaj tshuaj chemotherapy | Koj yuav raug xa mus rau tsev kho mob thiab muab tshuaj chemotherapy rau tsib txog xya hnub. Qhov no yog los npaj koj lub cev rau cov tub rog tshiab ntawm TIL cell. |
| 4. Muab cov qe ntshav TIL rau hauv lub cev (TIL transfusion) | Tam sim no yog qhov tseem ceeb tshaj plaws. Koj cov qe ntshav TIL, uas tau tsim nyob rau hauv chav kuaj, raug txhaj rau hauv koj lub cev zoo li saline. Qhov no tsuas yog ua ib zaug xwb. Nws siv sijhawm li ob teev. |
| 5. Kev txhaj tshuaj Interleukin-2 | Tom qab muab cov qe ntshav TIL rau koj lawm, koj yuav tau txais tshuaj hu ua Interleukin-2 (IL-2) rau peb txog tsib hnub. Qhov no kuj yog kev kho mob tiv thaiv kab mob. Qhov no ua rau cov qe ntshav TIL uas tau txhaj rau hauv lub cev ua haujlwm thiab txhawb kom lawv tawm tsam tus kab mob qog noj ntshav. |
Tom qab kev kho mob tas, koj yuav tsum tau nyob hauv tsev kho mob ob peb hnub ntxiv. Thaum lub sijhawm ntawd, pab pawg kho mob yuav ua tib zoo saib xyuas seb koj lub cev teb li cas rau kev kho mob. Tom qab ntawd, koj yuav raug qhia kom nyob ze tsev kho mob tau ob peb lub lis piam. Qhov no yog kom koj thiaj li tau txais kev kho mob sai yog tias koj muaj kev phiv.
Kev kho mob tag nrho no yuav siv sijhawm ntev npaum li cas?
Kev kho mob TIL yog ib zaug xwb . Txawm li cas los xij, tag nrho cov txheej txheem txij li hnub uas mob qog noj ntshav raug tshem tawm, mus txog hnub uas cov hlwb raug tsim, mus txog lub sijhawm koj tau kho, mus txog lub sijhawm koj rov qab mus rau qhov qub tuaj yeem siv sijhawm li 10 lub lis piam . Koj yuav tsum nyob hauv tsev kho mob li ob lub lis piam.
Cov txiaj ntsig thiab kev pheej hmoo ntawm qhov no yog dab tsi?
Cov txiaj ntsig ntawm kev kho mob no
Qhov no yog ib qho kev kho mob muaj zog heev, uas yog kho raws li tus kheej xav tau.
- Kev tawm tsam uas tsom mus rau ib yam dab tsi: Kev kho mob no tsuas yog tsom mus rau cov hlwb qog nqaij hlav xwb. Yog li ntawd, muaj kev puas tsuaj me ntsis rau cov hlwb noj qab haus huv. Qhov no kuj txo qhov kev pheej hmoo ntawm cov kev mob tshwm sim.
- Kev tiv thaiv mus sij hawm ntev: Cov qe ntshav TIL uas raug txhaj rau hauv koj lub cev yuav nyob hauv koj lub cev tau ntau xyoo. Qhov no txhais tau tias txawm tias tom qab kev kho mob tas lawm, cov qe ntshav no tseem yuav tawm tsam mob qog noj ntshav.
- Kev Cia Siab Tshiab: Tej zaum qhov tseem ceeb tshaj plaws, qhov no coj kev cia siab zoo rau cov neeg uas muaj mob qog nqaij hlav melanoma uas yav dhau los xav tias tsis kho tau.
Ib txoj kev tshawb fawb xyoo 2023 qhia tau tias plaub xyoos tom qab tau txais kev kho mob TIL, 7 ntawm 10 tus neeg uas tau txais kev kho mob tsis muaj kab mob lossis kev nce qib. Hauv 3 ntawm 10, cov qog tau me me lossis ploj mus tag.
Kev Pheej Hmoo ntawm kev kho mob
Ib yam li kev kho mob twg los xij, muaj qee qhov kev pheej hmoo. Cov kev mob tshwm sim no feem ntau yog los ntawm kev siv tshuaj kho mob thiab kev kho mob interleukin-2 (IL-2) . Cov kev mob tshwm sim los ntawm kev siv TIL cell tsis tshua muaj. Cov kev mob tshwm sim feem ntau yog:
- Mob raws plab
- Kev qaug zog
- Kub taub hau thiab mob khaub thuas
- Lub plawv dhia tsis xwm yeem (arrhythmia)
- Ntshav siab qis
- Xeev siab thiab ntuav
- Mob pob khaus ntawm daim tawv nqaij
Tsis tshua muaj, kev kho mob IL-2 tuaj yeem ua rau muaj teeb meem loj heev hu ua capillary leak syndrome . Tab sis tsis txhob txhawj, koj tus kws kho mob yuav piav qhia txog txhua yam kev pheej hmoo no rau koj ua ntej koj pib kho mob.
Yuav siv sijhawm ntev npaum li cas rau kuv kom rov zoo?
Tej zaum yuav siv sijhawm ob lub lis piam lossis ntau dua ua ntej koj pib zoo dua tom qab koj noj IL-2 zaum kawg. Qhov no yog vim tias lub cev xav tau sijhawm los rov zoo los ntawm kev ntxhov siab ntawm tag nrho cov txheej txheem kho mob (phais mob, tshuaj kho mob qog noj ntshav, IL-2).
Puas muaj dab tsi uas kuv ua tau los ua kom kev kho mob yooj yim dua?
Qhov no tsis yog ib qho yooj yim. Yog vim li ntawd koj pab neeg kho mob yuav saib xyuas koj ze heev thoob plaws koj nyob hauv tsev kho mob. Lawv yuav kuaj koj tas li, kuaj ntshav, thiab xyuas kom koj lub cev npaj txhij rau kev kho mob. Lawv yuav muab cov tshuaj tsim nyog rau koj kom txo cov kev phiv, thiab lawv yuav saib xyuas koj tas li rau txhua yam teeb meem. Txhua yam koj yuav tsum ua yog ua raws li cov lus qhia uas pab neeg kho mob muab thiab qhia rau lawv txog txhua yam kev tsis xis nyob uas koj xav.
Kuv yuav tsum hu rau kws kho mob thaum twg?
Yog tias koj mus tsev tom qab kho mob thiab muaj cov cim qhia tias muaj kev kis kab mob (kub taub hau, mob lub cev), lossis muaj tej yam tshwm sim tsis tau xav txog lossis hnyav, hu rau koj tus kws kho mob tam sim ntawd.
Tsis txhob xav ob zaug. Yog tias koj hnov qhov kev hloov pauv me me, qee yam uas zoo li 'qhov no tsis yog,' qhia rau koj tus kws kho mob paub tam sim ntawd.
Yog tias koj muaj melanoma uas tsis tau teb rau lwm yam kev kho mob, kev kho mob TIL yuav yog qhov kev xaiv zoo rau koj. Yog tias koj tus kws kho mob pom zoo kom kho qhov no, nco ntsoov mloog zoo rau tag nrho cov txheej txheem, lub sijhawm nws yuav siv sijhawm, thiab cov teebmeem uas nws yuav muaj rau koj tus mob. Koj tus kws kho mob tuaj yeem piav qhia zoo tshaj plaws txog cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob no rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev kho mob TIL yog ib txoj kev kho mob tshiab thiab muaj zog uas siv koj cov hlwb tiv thaiv kab mob (TILs) los kho mob qog noj ntshav.
- Tam sim no nws tau txais kev pom zoo rau melanoma, ib hom mob qog nqaij hlav uas tsis teb rau lwm yam kev kho mob.
- Cov txheej txheem kho mob no suav nrog kev phais tshem tawm ib feem ntawm cov qog nqaij hlav, kev loj hlob ntawm cov hlwb hauv chav kuaj mob, kev siv tshuaj kho mob qog noj ntshav, thiab lwm yam kev kho mob, thiab tag nrho cov txheej txheem tuaj yeem siv sijhawm li 10 lub lis piam.
- Qhov no tsom mus rau thiab rhuav tshem cov hlwb qog noj ntshav, nrog rau kev puas tsuaj me me rau cov hlwb ib txwm. Txawm li cas los xij, muaj qee qhov kev phiv thiab kev pheej hmoo.
- Yog tias koj muaj lus nug txog koj txoj kev kho mob lossis muaj kev tsis xis nyob tom qab kev kho mob, nws yog ib qho tseem ceeb heev uas yuav tsum tham nrog koj tus kws kho mob txog qhov ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus