Immunotherapy ayaa si deg-deg ah u soo baxaysa sida qalab firfircoon oo loola dagaallamo cudurka, gaar ahaan cudurada ay adag tahay in la daweeyo. Daweynta difaaca jirka ee kansarka , habka difaaca jirka ayaa loo isticmaalaa si loola dagaallamo burooyinka hababka cusub. Waxqabadyada talaalka teraabiyada waxay si toos ah u kicin karaan nidaamka difaaca ama waxay u soo bandhigaan habka difaaca jidhka, ama borotiinka, si loo isticmaalo habka difaaca jidhka.
Tallaallada daaweynta kansarku waa nooc ka mid ah qaababka difaaca jidhka oo loo isticmaalo in lagu daweeyo kansarada hore u jirey. Guud ahaan, tallaallada daaweynta kansarku waa bioloji, ama biopofarmaceuticals. Noocyada kale ee nafleyda waxaa ka mid ah qaybaha dhiigga, daaweynta hidda, daawada xasaasiyadda, iyo tallaalada kale.
Xilligan, tallaalka kaliya ee kansarka ee FDA ay ansaxisay waxaa loo yaqaan 'Provenge' si loo daaweeyo kansarka qanjirka 'prostate' .
Talaalada Daweynta Kansarka
Antigensku waa walxo dhaliya jawaab-celinta habka difaaca jidhka. Tallaallo badan oo daaweynta kansarka ee horumarinta ayaa keena antigens kansarka la xidhiidha unugyada dendritic. Unugyada dendritikku waa unugyada difaaca ee si toos ah ugu dhajiya meesha laga duray (maqaarka) iyo geedi socodka antigen. Waxaa intaa dheer, meco-tallaalka immunostimulating ee ku jirta tallaalka kansarku kor u kiciso, ama kordhiyo wax soo saarka, ee molecules ee loo baahan yahay in ay ugu dambeyn la falgalaan unugyada T. Xasuusnow, antigens kansarka la xiriira waxay noqon kartaa mid gaar ah hal nooc oo ah kansar ama koox kansarro badan ah.
Unugyada dendritic ee firfircoon waxay u haajiraan qanjidhada noodarka, kuwaas oo ah qanjidhada yaryar ee unugyada difaaca jirka ee ku yaalla guud ahaan jirka. Marka unugyada dendritic firfircooni ay u sameeyaan qanjidhada qanjidhada, waxay u soo bandhigaan antigen-ka qotoda gaar ahaan kansarka T-yada. Unugyada firfircoon ee firfircoon ka dibna waxay ku safraan jidhka oo dhan oo bartilmaameedkooda unugyada kansarka ah ee la socda antigen iyo lyse, ama burburaan, unugyada kansarka.
(Farsamooyin badan oo farsameysan, unugyada CD4 + T waxay soo saaraan cytokines kuwaas oo sahlaya korriinka unugyada CD 8, ka dib markii koriinku uu u socdo guud ahaan jirka.)
Sida laga soo xigtay FDA, dhowr tallaal oo kansar ah oo hadda jira horumarinta bakteeriyada, fayraska, ama khamiirka sida baabuurta, ama vectors , si ay u qaadaan antigens. Bakteeriya, fayrusyada, caanaha iyo wixii la mid ah ayaa dabiiciga ah oo immunogenic ah oo kiciya jawaab-celinta difaaca iyaga keligood; Si kastaba ha noqotee, waxaa loo bedelay si aan cudur keenin.
Haddii kale, tallaalka daaweynta kansarka waxaa loo samayn karaa iyada oo la adeegsanayo DNA ama RNA taas oo ah lambarka antigenka. Qalabkani waxa uu ku jiraa unugyada kaas oo markaa soo saaro antigenka. Rajada ayaa ah in unugyada jirka ee la bedelay ka dib ay soo saari doonaan antibiyooti ku filan oo kansar ku filan si ay u yeeshaan jawaab celin xoogan oo difaac ah si ay u disho unugyada tumingka.
Ugu dambeyntii, saddex waa in la buuxiyaa unugyada burooyinka si loo baabiiyo tallaal:
- tiro tiro badan oo ah unugyada difaaca jirka oo leh ciriiri u nugul unugyada kansarku waa in la soo saaraa
- unugyada T waa in ay awood u yeeshaan inay ku dhacaan buro
- unugyada T waa in ay ka shaqeeyaan goobta bukaanka si ay waxyeelo u gaarto goobta
Sidee waxtarkeedu u yahay tallaalka Cancer?
Intii lagu jiray dhowrkii sano ee la soo dhaafay, waxaa la baaray boqolaal kansar (dendritic-cell) tallaal.
Si kastaba ha ahaatee, qiimaha jawaabta tallaaladani aad ayay u hooseeyaan-ilaa 2.6 boqolkiiba. Xaqiiqdii, noocyada kale ee difaaca jirka ayaa loo xaqiijiyay in ay yihiin kuwo aad waxtar u leh, taas oo saameeysay khabiiro badan si ay su'aal uga keenaan "tallaaladayada" tallaalka daweynta kansarka.
Sidaa darteed haddii tallaalka daaweynta kansarku ay aad u yartahay dadka, maxaan ugu sii wadnaa inaan maal-galino dhaqaale iyo waqti si loo horumariyo tallaalka kansarka? Waxaa jira ugu yaraan saddex sababood oo sharxaya danaha noocan ah ee faragelinta.
Ugu horreyntii, tallaalku wuxuu ahaa mid wax ku ool ah ka hortagga kansarka, iyo guushan ayaa loo qaaday daaweynta kansarka tallaalka.
Si kale haddii loo dhigo, shaqada aan qabanay tallaalka ka hortagga kansarka ayaa ina baray wax badan oo ku saabsan immunology ee unugyada kansarka waxayna bixisay habdhaqan ku salaysan horumarinta tallaalka daaweynta kansarka. Waxaa jira laba tallaal oo looga hortago kansarka: tallaalka cagaarshow B wuxuu ka hortagaa kansarka beerka, iyo tallaalka papillomavirus (HPV) ayaa ka hortagaya cunaha, afka ilmagaleenka, futada iyo kansarrada kale
Tan labaad, tallaalka daaweynta kansarka ayaa fududahay in la maamulo waxayna keenaysaa waxyeello xun oo halis ah.
Saddexaad, cilmi-baarayaashu inta badan waxay u adeegsadeen tarjumaadkooda natiijooyinka tijaabooyinka ee ku saabsan tallaalka cudurka kansarka, kaas oo u adeega haadka ku wareegsan nooca wax-ka-qabashada. Gaar ahaan, cilmi-baarayaashu waxay diirada saaraan wax aan micno lahayn, ama isbedel, iyo lymphocyte (T-cell) is-goysyada burooyinka halkii ay diiradda saari lahaayeen isbeddel dhab ah : hoos u dhaca tirada bukaanka ama hagaajinta calaamadaha kiliinikada.
Intaa waxaa dheer, baarayaasha ra'yiga ah ee baaraya tallaalka cudurka kansarka ayaa inta badan isticmaala sharaxaadda marin habaabinta iyo ereyo si ay u muujiyaan natiijooyinka, sida "calaamadaha la waayay", "joojinta kicinta ku-meelgaarka ah ee qaar ka mid ah qiyaasaha shakhsiyaadka," "burka necrosis" iyo "nolol aan la filaynin ah." Haddii aan lahayn faahfaahin dheeraad ah, ereyadani waa yar yihiin.
Daraasad la xidhiidha, cilmi-baaris badan oo kansar ah ayaa lagu sameeyey heerarka caafimaadka aasaasiga ah iyadoo la adeegsanayo qaababka xayawaanka. Mice, maadaama laga yaabo inay ka yaraato cabiraadooda, dabeecadaha iyo muuqaalka muuqaalka, waxay ka duwan yihiin bini'aadamka. Sidaa darteed, guulo kasta oo aan ku aragno daaweynta xayawaankan leh tallaalka daaweynta kansarka ayaan macnaheedu ahayn in aadanaha u turjumi karin.
Inkastoo si gaar ah, in kastoo tallaalka kansarka loo xaqiijiyay in uu noqdo mid wax ku ool ah xayawaanka, wax badan maahan in la ogaado saamaynta noocaas ah ee bini-aadanka ah. Gaar ahaan, waxaa jira hal tallaal oo keliya oo lagu daweeyo kansarka oo ay ansaxisay FDA si loogu daaweeyo kansarka bini'aadanka: Dhidbeel. Si kastaba ha ahaatee, waxaa jira talaal kale oo kaankarada qanjirka 'prostate' ee hadda ee Wajiga 3aad ee tijaabooyin lagu xaqiijiyay in uu yahay mid waxtar leh: Prostvac.
Ka hor intaanan eegin labada Bixiyood iyo Prostac labadaba, yeynaan wax yar ku cusbooneysiineyno aqoontayada kansarka qanjirka 'prostate' .
Cancer Prostate
Marka laga reebo kansarka maqaarka, kansarka qanjirka 'prostate' waa kansarka ugu badan ee saameynaya ragga Maraykanka. Inkasta oo ku dhawaad 1-dii 7 qof oo Maraykan ah uu ku dhaco kansarka qanjirka 'prostate', haddana aad u yar ayaa u dhinta cudurka (qiyaastii 1 ee 39). Halkii, raggu waxay inta badan u dhintaan cudur kale marka hore, sida cudurka wadnaha. Si kastaba ha ahaatee, sannadka 2016, waxaa jiray 26,120 dhimasho ay sababeen kansarka qanjirka 'prostate'.
Sababtoo ah baaritaan ballaaran oo loogu talagalay antigen-ka, borotiinka kansarka qanjirka 'prostate', waxaan awoodnay inaan ogaanno kiisaska kansarka qanjirka 'prostate' ka hor, inkastoo kansarku weli ku jiro qanjirka 'prostate', marar dhif ah, ragga ayaa qaba kansarka qanjirka 'prostate' taas oo la qiyaasey ama ku faafay lafaha waxayna noqotey dhimasho.
Calaamadaha sii kordhaya khatarta kansarka qanjirka 'prostate' waxaa ka mid ah da 'weyn, jinsiyadda Afrikaanka ah iyo taariikhda qoyska.
Inta badan dadka qaba kansarka qanjirka 'prostate' uma baahna daaweyn iyo halkii ay daaweyn lahaayeen dhakhtarkooda. Daaweynta kansarka qanjirka 'prostate' waxaa ka mid noqon kara maaraynta rajada (firfircoonida), qalliin (prostatectomy ama ka saarista prostate), radiotherapy iyo xajiin, ama hoormoonka galmada,
Bixi
Kala-bixinta ama "sniperel-T" waa tallaal dendritic-cell kaas oo ay ansixisay FDA 2010-kii. Ciriiri waa waxa loo yaqaan ' immunotherapy cell otomotherapy' waxaana loo isticmaalaa in lagu daaweeyo cudurada faafa ee aan horay u sii fidin (sida ugu yar). Intaa waxaa dheer, Kelyo-boodhka wuxuu daaweeyaa kansarka qanjirka 'prostate' ee aan xasaasiyad u lahayn hoormoonka (hormoonnada hormoonka).
Qoraalka la xidhiidha, kansarka hormoonnada ee hormoonka ah ayaa ka jawaabaya daaweynta hormoonada, ama daroogada la jahawareeriyo, ama hormoonnada jinsiga (ka fikir in qofka la xiro).
Bixinta waxaa loo diyaariyey iyadoo la isticmaalayo unugyada dhiigga cad ee unugyada dhiigga (unugyada unugyada unugyada mononuclear-ka ah) oo lagu xakameynayo borotiin la yiraahdo factor of granulocyte-macrophage-colony-stimulating factor (GM-CSF) iyo fosfatase prostatic acid, ama PAP, antigen-ka qanjirka 'prostate'.
Sababta keenta GM-CSF waxaa la siiyaa PAP antigen antagonistku waa sababta oo ah cilmi-baarayaashu waxay aaminsan yihiin in GM-CSF ay fududeeyso soo bandhigidda antigen. Xasuusta, unugyada mononuclear-ka ah ee unugyada jirka u adeega sida unugyada dendritic ee antigen-ka la soo bandhigo.
Nasiib darro, Qaadiddu waxay ku kordhineysaa nolosha kaliya illaa 4 bilood. Si kastaba ha ahaatee, waqtigan ayaa u oggolaan kara qof inuu arimihiisa ku soo laabto oo uu waqti badan ku qaato qoyskiisa.
Saamaynta xun ee aaruunada waxaa ka mid ah kuwan soo socda:
- qandho
- qarqaryo
- daal
- xanuunka dhabarka
- madax xanuun
Intii lagu jirey tijaabooyin caafimaad oo ah daawo, dhowr nin ayaa la kulmay waxyeelo halis ah oo ay ka mid yihiin neefta oo ku adagtahay, xanuunka feeraha, garaaca wadnaha oo aan caadi ahayn, isdifaacid wareer iyo isbeddelka cadaadiska dhiigga. Sidaa darteed, dadka qaba dhibaatooyinka wadnaha iyo sanbabadu waa inay kala hadlaan xaaladahaas daryeel bixiyahooda.
Prostvac
Farsamada Prostvac waxay ka duwan tahay Baasaboorka.
Prostvac wuxuu ka kooban yahay växvirus (fowlpox) vektor, antigen-prostate-specific antigen (PSA) iyo kakoobid qiimeeyn ah oo loo yaqaan TRICOM. Talaalkan PSA-TRICOM wuxuu ku dhacaa unugyada antigen-soo bandhigaya iyaga oo u horseedaya inay muujiyaan borotiinada borotiinka ee qanjidhada kaadida ee qanjidhada dusha sare. Unugyadaas daaweynta antigen-ka soo baxa waxay markaa keenaan unugyada T-da waxayna ku tababaraan inay weeraraan unugyada kansarka qanjirka 'prostate'.
Baaritaannada baaritaanka ee Prostvac 2 ayaa waxaa ka mid ahaa 82 ka mid ah 42 ka mid ah oo helay Prostvac. Prostvac nolol dheerta ee kooxda tijaabada ah by qiimaha dhexe ee 8.5 bilood. Waqtigaan, Prostvac wuxuu ku jiraa Wajiga 3aad ee bukaan-socodka, cilmi-baarayaashu maaha kaliya inay isku dayaan inay xaqiijiyaan faa'iidada badbaadada ee daroogada laakiin waxay sidoo kale isku dayayaan in la ogaado haddii tallaalka GM-CSF lagu daro tallaalka.
Xilliga Marxaladda 2aad ee tijaabada caafimaadka, saamaynta xun ee Prostvac ayaa lagu daray waxyaalahan soo socda:
- dareen-celinta goobta (xanuun, barar, casaan iyo wixii la mid ah)
- daal
- qandho
- barar
- qarqaryo
- xanuunka wadajirka ah
- dawakhaad
- lallabbo
- matagid
- shuban
- caloosha
Tallaalka kansarka qanjidhka 'prostate' looma jeedo in loo isticmaalo daaweynta kowaad ee kansarka qanjirka 'prostate'. Taa bedelkeeda, waxaa lagu maamulaa marka lagu daro kiimiko.
Waa Maxay?
Sannadka 2015, FDA waxay ogolaatay Imlygic, tallaalka oncolytic ee daaweynta ama Melanoma malignanteed oo aan shaqeyn karin. Inkasta oo aan farsamo ahaan ahayn tallaalka cudurka kansarka, Imlygic wuxuu leeyahay saameyno kale oo la mid ah tallaallada daaweynta kansarka.
Fayrasyada Onkolytic waa nooc ka mid ah talobixinada difaaca jirka oo fayruska hiddo ahaan lagu dhajiyo si toos ah loogu duro buro melan ah iyo lyses ama jabto unugyada burooyinka. Marka laga reebo in la jabiyo unugyada, fayrasyadani waxay leeyihiin saameyn guud oo ka yimaada saameynta antitumor oo la mid ah tallaallada anticancer.
Tallaalka Hibada ee Cancer iyo I
Waqtigan xaadirka ah, isticmaalka tallaalka kansarka ee goobaha caafimaadka ayaa xadidan. Intaa waxaa dheer, sida hore loogu soo sheegay, dhab ahaantii way adagtahay in la helo tallaalka kansarka oo saameyn ku leh ka qaybgalayaasha aadanaha. Maaha in aan aragno tallaalka kansarka loo isticmaalo in lagu daaweeyo noocyo kala duwan oo kansar ah waqti kasta.
Si kastaba ha ahaatee, tallaalka kansarka ayaa matala horumarinta habka difaaca jirka iyo sidoo kale barta immunotherapy. Si ka fiican ayaan u fahansanahay nidaamka difaaca jirka, si ka fiican ayaan u beegsan karnaa daaweynta oo laga yaabo in ay nolol ka badbaadiso.
Ilaha:
Goswami S, Allison JP, Sharma P. Immuno-Oncology. In: Kantarjian HM, Wolff RA. eds. Buugga MD Anderson ee Bukaanka Caafimaadka, 3e . New York, NY: McGraw-Hill; 2016. Waxaa la hellay May 19, 2016.
Kantoff PW et al. Falanqaynta Guud ee Badbaadinta ee Wajiga 2 Kantaroolka La Xakameynayo ee Kantaroolka ah ee Poxviral-ku saleysan PGD-Targeted Immunotherapy ee Kansarka Qanjidhka Dambiyada ee Kacsan ee Kacbada. J Clin Oncol. 2010 Mar 1; 28 (7): 1099-1105.
Pienta KJ. Cutubka 96aad. Kansarka Prostate-ka. Gudaha: Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S. eds. Hazzard ee Geriatric Medicine iyo Gerontology, 6e . New York, NY: McGraw-Hill; 2009. Helitaanka May 22, 2016.
Rosenberg SA, Yang JC Restifo NP. Immunotherapy Kansarka: Ka gudba tallaalka hadda. Nat Med . 2004 Sebtembar: 10 (9): 909-915.