Antibody-Drug Conjugates (ADCs) - cancer cell zawng chhuaktu leh damdawi pe chhuaktu ‘magic bullet’ chungchang hi i zir dawn em ni?

"Cancer" kan tih hian kan rilruah thumal lo lang nghal pakhat chu "chemotherapy" tih hi a ni. Mi tam takin he damdawi hi an hlau hle a, a chhan chu sam a tlakchhiat avangin taksa tan pawh a harsat phah a ni. Mahse, damdawi lam thiamna a lo thang chho zel a, khawvelah hmanraw thar a lo chhuak ta a, chu chuan cancer cell chauh a target thei a, cell hriselte chhiatna nasa takin a tihtlem thei bawk. Vawiin hian cancer enkawlna khawvelah hmasawnna lian tak nei, ‘magic bullet’ ang maia hnathawk thei enkawlna kawng kan sawi dawn a ni. Chu chu Antibody-Drug Conjugates, a tawi zawnga kan sawi angin ADCs a ni.

A awlsam zawngin, he Antibody-Drug Conjugate (ADC) hi eng nge ni?

Mi tam tak awmna hmunah mi pakhat chauh hnenah parcel i thawn a ngai tih han ngaihtuah teh. Chu mi chu zawng chhuakin mi zawng zawng hnena sem chhuah ai chuan parcel chu thawn chhuah chu engtiang chiahin nge a awlsam zawk ang? Chu chu he ADC hian a ti a ni.

ADC hi hmun thum inzawmkhawm a ni. A dik tak chuan technology hmanga siam ‘smart bomb’ ang mai a ni.

1. Antibody: Hei hi kan ‘identification agent’ a ni. Cancer cell chung lamah chauh awm protein bik (hengte hi ``tumor antigens'' kan ti) a awm a. He antibody hi chu cancer cell-a protein awmte chu kal a, a inzawm tlat theih nan siam a ni. A corresponding lock-a in fit key ang mai a ni. Cell hriselte hian heng protein te hi an neih loh avangin he antibody hian a nghet lo. Hengte hi laboratory-a siam bik a nih avangin ``Monoclonal Antibody'' kan ti bawk.

2. Chemotherapy damdawi: Hei hi chu package chhunga awm chu a ni. Chemotherapy pangngaia pek thin aiin cancer dona damdawi chak zawk a hmang a ni. Cancer cell chhungah direct-a a luh avangin pawn lama cell hrisel te tichhe lovin damdawi chak tak a pe thei a ni.

3. Linker: Hei hi ‘gum’ a ni a, spy (Antibody) leh bomb (Chemo drug) te chu a vawn tlat a ni. He linker hnathawh chu antibody-in cancer cell a hmuh a, a luh hma loh chuan damdawi chu a chhuah loh nan a veng a ni. Cancer cell a luh hnuah chauh he linker hi a chhe a, damdawi chu a chhuak ta a ni.

He ‘biological missile’ hian engtin nge hna a thawh?

Hetiang kalphung hi a ngaihnawm hle. Step khat hnu step khatin eng nge thleng tih i lo en ang u.

• Step 1: ADC damdawi hi saline solution hmangin damlo vein-ah inject a ni.
• Step 2: He damdawi hian thisen kaltlangin taksa pum puiah a fang kual a. Mahse, a kal zel chuan antibody part hian GPS angin hna a thawk a, cancer cell awmna hmun a zawng chhuak thin.
• Step 3: Cancer cell hmuh a nih veleh antibody chu a kal a, chu cell chunglama protein (antigen) bik pakhat chu a ‘lock’ a.
• Step 4: Hetianga a lock chuan cancer cell hian hei hi a duh niin a ngai a, chuvang chuan he ADC package pumpui hi a chhungah a hruai lut vek a ni.
• Step 5: Cancer cell chhunga kan luh hnu chuan a chhunga enzyme te chuan chu ‘linker’ chu an tichhia a.
• Step 6: Linker a chhiat chuan a inzawm tlat chemotherapy damdawi chak tak chu cancer cell chhungah a chhuak ta a ni.
• Step 7: He damdawi chakna avang hian cancer cell chu a chhung atangin a chhe vek a.

ADC hmang hian eng cancer chi nge enkawl?

ADC hi cancer chi hrang hrang enkawlna a ni lo. Tunah hian doctor-te chuan he enkawlna hi cancer chi hrang hrang tan an ngaihtuah a, a bik takin enkawlna dang a hlawhchham (`(refractory cancer)`), cancer chu a lo let leh (`(recur)`), emaw taksa hmun dangah a darh (`(metastasize)`) a nih chuan.

Hei hi a hnuaia table-ah hian sawifiah belh leh ila.

Khawvela hman thin ADC damdawi eng emaw zat

United States-ah hian FDA ang agency-te pawmpui ADC damdawi sawmhnih chuang a awm tawh a ni. Entirna thenkhat chu:

• Brentuximab vedotin (Adcetris®): Thisen cancer, Hodgkin lymphoma ang chi tan hman a ni.
• Trastuzumab emtansine (Kadcyla®): HER2-positive hnute cancer taksa pum puia darh tawh tan hman a ni.
• Sacituzumab govitecan (Trodelvy®): Hnute cancer leh bladder cancer triple-negative tan hman a ni.

He enkawlna hian side effect a nei lo em ni?

"Cell hriselte tana chhiatna hi a tlem hle" tih sawi ni mah se, hei hian he enkawlna hian side effect a nei lo tihna a ni lo. Mahse, chemotherapy pangngai nena khaikhin chuan hengte hi enkawl theih a ni fo. Side effect lo awm dan hi damlo hrang hrangah a inang lo thei a, chu chu cancer chi hrang hrang, a stage leh damlo hriselna zawng zawng a zirin a ni.

I oncology team chuan i enkawlna chhung zawngin uluk takin an enkawl ang che. Side effect eng emaw a awm chuan enkawlna an pe nghal ang che.

Side effects awm tlangpui:

• Chau
• Nausea leh luak chhuak
• Thisen tlakchhamna (Anaemia).
• Leukopenia (thisen var zat tlahniam) .
• Thisen platelet a tlem (`(Thrombocytopenia)`) .
• Anorexia a awm
• Constipation emaw riltam emaw
• Lu na, khawsik
• Peripheral neuropathy - taksa peng hrang hranga natna leh tingling
• Vun a hring chhuak

Heng thil zawng zawng hi a tenau deuh pawh ni se, doctor hnenah hriattir nghal a pawimawh hle.

He enkawlna atan hian beiseina kan nei thei ang em?

Ni e, a dik tak zet. ADC hi cancer vei tam tak tan beiseina thar thlentu enkawlna a ni. Zirna hrang hrangah chuan ADC hmanga enkawl damlote chu standard chemotherapy chauh dawngtu damlote aiin an dam rei zawk tih hmuhchhuah a ni.

Tin, he field hi a thang chak hle bawk. Tunah hian khawvel hmun hrang hrangah clinical trial 100 chuang kalpui mek a ni. Scientist te chuan cancer chi hrang hrang tan ADCs tha zawk leh side effect tlem zawk nei siam chhuah an tum mek a ni. Chuvangin, nakin lawkah he ‘magic bullet’ enkawlna hi cancer chi hrang hrang tam tak tan pawh kan hmu thei ngei kan beisei.