Hom Kev Kho Mob Tiv Thaiv Kab Mob Cancer
Kev kho mob qog noj ntshav yog ib txoj kev kho mob qog noj ntshav uas siv lub cev tiv thaiv kab mob kom paub thiab tawm tsam cov hlwb qog noj ntshav. Tsis zoo li chemotherapy, uas tawm tsam cov hlwb uas faib sai sai, lossis radiotherapy, uas ua rau puas tsuaj rau DNA ntawm cov hlwb qog noj ntshav nrog kev siv hluav taws xob, kev kho mob immunotherapy ua haujlwm los ntawm "txhawb nqa," "qhia," lossis "tso tawm" ntawm kev teb ntawm lub cev tiv thaiv kab mob, ua rau lub cev ua haujlwm tau zoo dua ntawm kev rhuav tshem cov hlwb qog noj ntshav. Nyob rau xyoo tas los no, kev kho mob immunotherapy tau dhau los ua qhov kev hloov pauv tseem ceeb hauv kev kho mob qog noj ntshav vim tias nws tuaj yeem muab cov lus teb ruaj khov rau qee tus neeg mob, txawm tias hauv cov hlwb qog noj ntshav uas yav dhau los nyuaj kho.
Txawm li cas los xij, kev kho mob tiv thaiv kab mob tsis haum rau txhua hom mob qog noj ntshav lossis txhua tus neeg mob. Cov kev mob tshwm sim tuaj yeem txawv ntawm cov kev kho mob ib txwm muaj, feem ntau cuam tshuam nrog kev ua haujlwm ntau dhau ntawm lub cev tiv thaiv kab mob. Yog li ntawd, kev xaiv kev kho mob tiv thaiv kab mob feem ntau yog raws li hom mob qog noj ntshav, theem ntawm tus kab mob, tus neeg mob tus mob, thiab cov cim tshwj xeeb. Cov hauv qab no yog cov hom kev kho mob tiv thaiv kab mob feem ntau siv rau hauv kev kho mob qog noj ntshav.
1. Cov Tshuaj Tiv Thaiv Kab Mob (Cov Tshuaj Tiv Thaiv Kab Mob)
Ib qho ntawm cov tshuaj kho mob uas paub zoo tshaj plaws yog cov tshuaj tiv thaiv kab mob. Lub cev tiv thaiv kab mob muaj "checkpoints," cov txheej txheem ntuj uas tiv thaiv kev teb ntawm lub cev ntau dhau uas tuaj yeem ua rau lub cev cov nqaij puas tsuaj. Cov qog nqaij hlav feem ntau siv cov chaw kuaj xyuas no los "zais" ntawm kev tawm tsam los ntawm T cell (cov qog nqaij hlav tua kab mob).
Cov tshuaj Checkpoint inhibitors ua haujlwm los ntawm kev thaiv cov protein checkpoint tshwj xeeb, ua rau cov qe ntshav T rov ua haujlwm thiab tawm tsam cov qe ntshav qog. Ob lub hom phiaj feem ntau yog:
– PD-1/PD-L1 (Programmed Death-1 / Ligand-1): Cov hlwb qog nqaij hlav tuaj yeem qhia PD-L1 kom "tua" cov hlwb T. Cov tshuaj uas tiv thaiv PD-1 lossis PD-L1 tuaj yeem pab rov qhib cov haujlwm ntawm cov hlwb T.
– CTLA-4 (Cytotoxic T-Lymphocyte–Associated Protein 4): CTLA-4 yog ib qho kev nres rau kev ua haujlwm ntawm T cell, tshwj xeeb tshaj yog nyob rau theem pib ntawm kev teb ntawm lub cev tiv thaiv kab mob.
Cov tshuaj Checkpoint inhibitors siv los kho ntau yam mob qog noj ntshav, suav nrog melanoma, mob qog noj ntshav ntsws, mob qog noj ntshav raum, mob qog noj ntshav zais zis, thiab qee yam mob qog noj ntshav taub hau thiab caj dab. Qhov zoo ntawm kev kho mob no yog qhov muaj peev xwm ua tau ntev, tab sis muaj kev pheej hmoo suav nrog cov kev mob tshwm sim ntawm tus kab mob autoimmune xws li colitis, pneumonitis, mob qog thyroid, thiab txawm tias mob siab autoimmune.
2. Kev Kho Mob CAR T-Cell (CAR T-Cell Therapy)
Kev kho mob CAR T-cell yog kev kho mob tiv thaiv kab mob uas haum rau tus neeg mob. Hauv kev kho mob no, cov qe ntshav T ntawm tus neeg mob raug coj los ntawm cov ntshav thiab tom qab ntawd hloov kho hauv chav kuaj mob kom muaj ib lub receptor tshwj xeeb hu ua Chimeric Antigen Receptor (CAR). Lub receptor no yog tsim los lees paub cov antigens tshwj xeeb ntawm qhov chaw ntawm cov qe ntshav qog nqaij hlav. Thaum hloov kho thiab sib kis, cov qe ntshav T raug xa rov qab mus rau tus neeg mob lub cev kom nrhiav thiab rhuav tshem cov qe ntshav qog nqaij hlav.
Kev kho mob CAR T-cell tau pom tias muaj kev vam meej zoo tshwj xeeb tshaj yog rau qee yam mob qog ntshav, xws li:
- mob leukemia lymphoblastic mob hnyav (ALL) hauv qee kis,
- qee cov kab mob lymphomas uas tsis yog Hodgkin,
- ntau yam mob myeloma hauv qee cov cim qhia.
Txawm li cas los xij, txoj kev kho mob no kuj tseem tuaj yeem ua rau muaj kev phiv loj heev, xws li Cytokine Release Syndrome (CRS), uas ua rau kub taub hau thiab ntshav qis, nrog rau qee yam kev mob hlwb. Ntxiv mus, tus nqi thiab kev muaj chaw kho mob yog qhov nyuaj vim yog cov txheej txheem nyuaj.
3. Cov Tshuaj Monoclonal Antibodies
Cov tshuaj monoclonal antibodies yog cov protein tsim los txuas rau cov hom phiaj tshwj xeeb ntawm cov hlwb qog noj ntshav. Los ntawm "tagging" cov hlwb qog noj ntshav, cov tshuaj antibodies pab lub cev tiv thaiv kab mob paub txog cov qog noj ntshav lossis cuam tshuam cov cim qhia kev loj hlob ntawm cov qog noj ntshav.
Muaj ntau txoj hauv kev uas cov tshuaj monoclonal antibodies ua haujlwm hauv mob qog noj ntshav:
1. Cov tshuaj tiv thaiv kab mob uas tsom mus rau tus neeg txais: tiv thaiv cov cim qhia kev loj hlob hauv cov hlwb qog noj ntshav.
2. Cov tshuaj tiv thaiv kab mob uas ua rau lub cev tiv thaiv kab mob puas tsuaj: nyiam cov hlwb tiv thaiv kab mob kom tawm tsam cov hlwb uas raug cim.
3. Cov tshuaj tiv thaiv kab mob (ADC): cov tshuaj tiv thaiv kab mob nqa cov "payload" ntawm cov tshuaj chemotherapy mus rau cov hlwb qog noj ntshav kom lawv raug tsom mus rau ntau dua.
4. Kev kho mob los ntawm kev siv hluav taws xob: cov tshuaj tiv thaiv kab mob nqa cov tshuaj radioactive mus rau qhov mob qog.
Cov tshuaj monoclonal antibodies siv dav dav los kho ntau hom mob qog noj ntshav, suav nrog mob qog noj ntshav mis , lymphoma, mob qog noj ntshav colorectal, thiab lwm yam. Cov kev mob tshwm sim sib txawv, xws li kev tsis haum tshuaj thiab pob khaus ntawm daim tawv nqaij mus rau kev puas tsuaj rau lub cev, nyob ntawm lub hom phiaj uas lawv tsom.
4. Tshuaj Tiv Thaiv Kab Mob Cancer
Cov tshuaj tiv thaiv kab mob qog noj ntshav lub hom phiaj yog ua kom lub cev tiv thaiv kab mob paub txog cov tshuaj tiv thaiv kab mob qog noj ntshav. Tsis zoo li cov tshuaj tiv thaiv kab mob sib kis , cov tshuaj tiv thaiv kab mob qog noj ntshav muaj ob pawg loj:
– Cov tshuaj tiv thaiv kab mob: tiv thaiv kab mob qog noj ntshav uas tshwm sim los ntawm qee cov kab mob. Piv txwv li, cov tshuaj tiv thaiv kab mob HPV uas txo qhov kev pheej hmoo mob qog nqaij hlav ntawm lub tsev menyuam thiab qee yam mob qog noj ntshav hauv taub hau thiab caj dab, nrog rau tshuaj tiv thaiv kab mob siab B kom txo qhov kev pheej hmoo ntawm mob qog noj ntshav hauv siab.
- Cov tshuaj tiv thaiv kab mob: muab rau cov neeg mob uas twb muaj mob qog noj ntshav los pab lub cev tiv thaiv kab mob tawm tsam cov qog noj ntshav.
Cov tshuaj tiv thaiv kab mob feem ntau tsom mus rau cov antigens tshwj xeeb rau tus neeg mob lub qog lossis cov antigens uas feem ntau muaj rau qee hom mob qog noj ntshav. Cov lus teb tuaj yeem sib txawv, thiab kev tshawb fawb txuas ntxiv txhim kho kev ua haujlwm, suav nrog kev siv cov tshuaj sib xyaw ua ke uas tiv thaiv kev kuaj xyuas.
5. Kev Kho Mob Cytokine
Cov cytokines yog cov tshuaj uas cov hlwb tiv thaiv kab mob siv los sib txuas lus thiab tswj cov lus teb ntawm lub cev tiv thaiv kab mob. Hauv kev kho mob qog noj ntshav, qee cov cytokines tuaj yeem siv los txhim kho kev ua haujlwm ntawm lub cev tiv thaiv kab mob.
Piv txwv ntawm cov cytokines uas tau siv dav dav suav nrog:
– Interleukin-2 (IL-2): tuaj yeem ua rau cov T cell thiab NK (natural killer cell) loj hlob sai. Nws tau siv rau qee yam mob qog noj ntshav hauv lub raum thiab melanomas.
- Interferon alpha: tuaj yeem ua kom lub cev tiv thaiv kab mob zoo dua thiab muaj cov teebmeem tiv thaiv kev loj hlob ntawm qee yam mob qog noj ntshav.
Kev kho mob Cytokine tuaj yeem ua tau zoo rau qee tus neeg mob, tab sis feem ntau muaj cov kev mob tshwm sim hauv lub cev xws li kub taub hau, qaug zog heev, ntshav siab qis, thiab kev ua haujlwm tsis zoo ntawm lub cev, yog li nws siv tam sim no xaiv ntau dua thiab feem ntau hloov los ntawm kev kho mob tiv thaiv kab mob tshwj xeeb dua.
6. Kev Kho Mob Kab Mob Oncolytic
Kev kho mob Oncolytic virus siv cov kab mob hloov kho los kis thiab rhuav tshem cov hlwb qog noj ntshav, tib lub sijhawm "tsim" lub cev tiv thaiv kab mob kom paub txog cov qog noj ntshav. Thaum cov kab mob lyses (rhuav tshem) cov hlwb qog noj ntshav, cov antigens ntawm cov qog noj ntshav raug tso tawm, ua rau muaj kev teb tiv thaiv kab mob dav dua.
Txoj kev kho mob no zoo heev vim nws ua haujlwm los ntawm ob txoj hauv kev: kev rhuav tshem cov hlwb qog nqaij hlav ncaj qha thiab kev ua kom lub cev tiv thaiv kab mob qog nqaij hlav ua haujlwm. Feem ntau nws yog muab los ntawm kev txhaj tshuaj ncaj qha rau hauv cov qog nqaij hlav. Kev tshawb fawb tseem tab tom ua kom nthuav dav nws txoj kev siv thoob plaws ntau hom qog nqaij hlav thiab los sib xyaw nrog cov tshuaj tiv thaiv kev kuaj xyuas kom muaj zog dua.
7. Kev Kho Mob TIL thiab Lwm Yam Kev Kho Mob Cell Txais Yuav
Ntxiv rau CAR T, muaj lwm txoj hauv kev hu ua kev kho mob hlwb adoptive cell, xws li kev kho mob qog nqaij hlav-infiltrating lymphocytes (TIL). Hauv kev kho mob TIL, cov kws kho mob coj cov hlwb tiv thaiv kab mob uas twb muaj nyob hauv cov nqaij hlav (lymphocytes uas "nkag mus rau hauv" qog nqaij hlav), nthuav lawv hauv chav kuaj mob, thiab tom qab ntawd xa rov qab rau tus neeg mob. Vim tias cov hlwb no "tau kawm" los paub txog qhov chaw ib puag ncig ntawm qog nqaij hlav, qhov kev kho mob no tuaj yeem ua tau zoo rau qee kis, tshwj xeeb tshaj yog nyob rau hauv cov ntsiab lus ntawm kev tshawb fawb thiab qee lub chaw kho mob qog nqaij hlav.
Kuj tseem muaj cov txoj hauv kev los tsim cov T cell nrog lwm cov receptors (piv txwv li, TCR-engineered T cells), uas tsom mus rau cov antigens ntawm qog nqaij hlav los ntawm kev lees paub txawv ntawm CARs.
Kev Kho Mob Tiv Thaiv Kab Mob Ua Ke thiab Cov Teeb Meem Yav Tom Ntej
Hauv kev kho mob , kev kho mob tiv thaiv kab mob feem ntau yog ua ke nrog kev kho mob chemotherapy, kev kho mob radiotherapy, kev kho mob targeted therapy, lossis kev sib xyaw ua ke ntawm kev kho mob tiv thaiv kab mob. Lub hom phiaj yog kom muaj feem ntau dua los teb, kov yeej kev tiv thaiv, thiab nthuav cov neeg mob uas yuav tau txais txiaj ntsig.
Txawm li cas los xij, tseem muaj cov teeb meem tseem ceeb, xws li:
- tsis yog txhua tus neeg mob teb,
– kev kwv yees cov lus teb yuav tsum muaj cov cim qhia tseeb (piv txwv li PD-L1 kev qhia tawm, kev hloov pauv ntawm qog nqaij hlav, MSI-siab hauv qee yam qog nqaij hlav),
- cov kev mob tshwm sim ntawm tus kab mob autoimmune yuav tsum tau saib xyuas zoo,
- kev nkag mus thiab tus nqi kho mob tseem yog teeb meem hauv ntau qhov chaw.
Kev kaw
Kev kho mob tiv thaiv kab mob tau hloov pauv qhov kev kho mob qog noj ntshav los ntawm kev muab txoj hauv kev tshiab los siv lub zog ntawm lub cev tiv thaiv kab mob . Cov kev qhia no suav nrog cov tshuaj tiv thaiv kab mob, kev kho mob CAR T-cell, monoclonal antibodies, tshuaj tiv thaiv kab mob qog noj ntshav, kev kho mob cytokine, cov kab mob oncolytic, thiab kev kho mob hlwb xws li TILs. Txhua txoj hauv kev muaj cov txiaj ntsig sib txawv, kev txwv, thiab cov cim qhia. Yog li ntawd, kev txiav txim siab txog kev kho mob tiv thaiv kab mob yuav tsum tau ua los ntawm kev sab laj nrog tus kws kho mob qog noj ntshav, xav txog hom qog noj ntshav, tus neeg mob tus mob, thiab cov cim qhia tseem ceeb. Nrog kev tshawb fawb txuas ntxiv mus, kev kho mob tiv thaiv kab mob yuav ua tau zoo dua, muaj kev nyab xeeb dua, thiab nkag tau yooj yim dua rau cov neeg mob qog noj ntshav.
