科普專欄–薯不揀單 - 深入淺出–免疫治療(Immunotherapy)手段醫治癌症(4)

這系列的第一集，我們講解了PD1/PDL1的運作原理。784Please respect copyright.ＰＥＮＡＮＡa5hKp1KK7a
Link: https://www.penana.com/article/471125784Please respect copyright.ＰＥＮＡＮＡgELyEWvLTN
784Please respect copyright.ＰＥＮＡＮＡTENL1hiedr
第二集我們講述CTLA4與T cell功用的關係。784Please respect copyright.ＰＥＮＡＮＡIcM0M806TT
Link:https://www.penana.com/article/472480784Please respect copyright.ＰＥＮＡＮＡDnCWrm04ZR
784Please respect copyright.ＰＥＮＡＮＡb1Qrzc6cT0
第三集我們講述增加T cell順利到達癌細胞位置的其中一種手段。784Please respect copyright.ＰＥＮＡＮＡhnjrZGodn5
https://www.penana.com/article/479229784Please respect copyright.ＰＥＮＡＮＡvmynyF8PDJ
784Please respect copyright.ＰＥＮＡＮＡZjhEEuDZlN
而這一集我們將講解一道關於檢測阻擋PD1的抗體Pembrolizumab成效的研究。784Please respect copyright.ＰＥＮＡＮＡEq07WOfq2V
784Please respect copyright.ＰＥＮＡＮＡDrkJY8VSFs
784Please respect copyright.ＰＥＮＡＮＡrvBE8m2UKj
關於阻檔PD1的原理及初心，可參閱第一集，其後可直接跳過第二第三集來到第四集本集。784Please respect copyright.ＰＥＮＡＮＡ9PH5aDecNF
784Please respect copyright.ＰＥＮＡＮＡzyKYqK381F
784Please respect copyright.ＰＥＮＡＮＡclAhWC3mF8
784Please respect copyright.ＰＥＮＡＮＡNwGZWAEg3L
（圖2）現今約只有20%的病人能夠從免疫治療中獲取長遠且持續的正面效果。784Please respect copyright.ＰＥＮＡＮＡxEu7bhD6Jo
784Please respect copyright.ＰＥＮＡＮＡ4WWUuQ7WiT
784Please respect copyright.ＰＥＮＡＮＡPg6DZV65Mc
其有效的程度實屬可圈可點，如果有方法能夠盡快得知免疫治療沒有預期成效的話，那就可以即時轉用其他治療手段，把握時候嘗試用第二種方法入手打擊癌症。784Please respect copyright.ＰＥＮＡＮＡxN9iaN2TcA
784Please respect copyright.ＰＥＮＡＮＡu6c5ykg2Zc
對此，有科學家嘗試量度血液中癌細胞的DNA含量，觀察能否藉此方法預判免疫治療的效果（Ref1)。784Please respect copyright.ＰＥＮＡＮＡRXXqCW7hbO
784Please respect copyright.ＰＥＮＡＮＡ4ifp7l2O6u
784Please respect copyright.ＰＥＮＡＮＡP3ZmV3I2xJ
(圖3）癌細胞DNA之所以會出現在血液中，主要由兩大途徑所成。784Please respect copyright.ＰＥＮＡＮＡOkmbvcaLka
784Please respect copyright.ＰＥＮＡＮＡ2p2N7BTuPU
784Please respect copyright.ＰＥＮＡＮＡ9E2rm14h4l
1.癌細胞會利用血液循環系統或者淋巴系統轉移到第二個位置，784Please respect copyright.ＰＥＮＡＮＡNKu9LRVGJ1
因此血液會有癌細胞的DNA。784Please respect copyright.ＰＥＮＡＮＡfDksao1DGL
784Please respect copyright.ＰＥＮＡＮＡwsQmcoT46T
2.癌細胞亦會往外釋出名Exosome的物質，裡頭亦含有癌細胞的DNA。784Please respect copyright.ＰＥＮＡＮＡZNO3wcvnCO
784Please respect copyright.ＰＥＮＡＮＡUB3PWaPtme
在這裡，我們暫稱癌細胞在血液中的DNA為ctDNA，Circulating Tumor DNA。784Please respect copyright.ＰＥＮＡＮＡhmWiLvUDkc
784Please respect copyright.ＰＥＮＡＮＡI0Q4C5SxOt
（圖4）圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。784Please respect copyright.ＰＥＮＡＮＡlMqffCgPUu
784Please respect copyright.ＰＥＮＡＮＡG3zbOZIXWu
784Please respect copyright.ＰＥＮＡＮＡHgxjs1Iee2
紅線為電腦斷層掃描觀察癌細胞大小的影像，而黑線為量度癌細胞在血液(ctDNA)的含量，可見黑線(量度ctDNA的含量)能夠更快預判免疫治療結果成效。784Please respect copyright.ＰＥＮＡＮＡJNMG6zVdDU
784Please respect copyright.ＰＥＮＡＮＡ0Pc2LlYw7T
而且，有另外10名接受免疫治療的病人在初期(服用藥物後6-7星期)錄得ctDNA完全下降，亦同樣能夠比電腦斷層掃描觀察更早一步預判成效。784Please respect copyright.ＰＥＮＡＮＡhatdvFOfTt
784Please respect copyright.ＰＥＮＡＮＡT1ympj1HRH
而研究中有45名免疫治療的病人在初期沒有錄得任何的ctDNA跌幅，癌細胞的體積在其後亦沒有明顯縮細。784Please respect copyright.ＰＥＮＡＮＡwd7VyeV8GU
784Please respect copyright.ＰＥＮＡＮＡXiiehA2B71
784Please respect copyright.ＰＥＮＡＮＡZbXomYVtgc
對比含放射性的電腦斷層掃描，量度血液的ctDNA只需抽取病人的血液便可，明顯簡單且快捷。784Please respect copyright.ＰＥＮＡＮＡ4DzyPu4Skb
只不過每名病人的ctDNA排組均不一樣，先前需要拿取部份癌細胞組織，才能夠有效設計檢測ctDNA的方針。784Please respect copyright.ＰＥＮＡＮＡ2N1EXQNbGJ
784Please respect copyright.ＰＥＮＡＮＡLWejNL5Iew
無論如何，若然日後能有研究進一步確立此方法的成效及可信性，定必大可增加對抗癌症的效益。784Please respect copyright.ＰＥＮＡＮＡ7lFPoylh7v
784Please respect copyright.ＰＥＮＡＮＡ9QCje6ZN4m
另一方面，透過檢測血液的DNA來預先得知癌細胞的存在，亦是日後檢驗及預防癌症的主流大方向。784Please respect copyright.ＰＥＮＡＮＡAVJTTkRmBE
784Please respect copyright.ＰＥＮＡＮＡNiBi7hfjIl
如果想我快啲出文的話，請入去Penana網站科普專欄–薯不揀單俾一個like以及Bookmark，這對我非常之重要。784Please respect copyright.ＰＥＮＡＮＡJnvaaGINMh
784Please respect copyright.ＰＥＮＡＮＡk7u5gJMBWA
Link: https://www.penana.com/story/66244/%E7%A7%91%E6%99%AE%E5%B0%88%E6%AC%84-%E8%96%AF%E4%B8%8D%E6%8F%80%E5%96%AE/toc784Please respect copyright.ＰＥＮＡＮＡIJfH5oPRZw
784Please respect copyright.ＰＥＮＡＮＡ7rlBQdAr7G
同時亦可以在Penana網站裡按「買一嚿/半嚿薯仔」，以課金的方式推動我繼續搜羅資料寫文，多謝。784Please respect copyright.ＰＥＮＡＮＡx1uClYZt4G
784Please respect copyright.ＰＥＮＡＮＡGLEdHa14yT
Link:784Please respect copyright.ＰＥＮＡＮＡBKKs9PnsgO
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio784Please respect copyright.ＰＥＮＡＮＡqnu8qq3PC4
784Please respect copyright.ＰＥＮＡＮＡTRhjelua1x
784Please respect copyright.ＰＥＮＡＮＡ4KETIu7P4m
有興趣接收科學資訊的話，歡迎follow IG: potatopigtongue。784Please respect copyright.ＰＥＮＡＮＡRTJxL04mch
784Please respect copyright.ＰＥＮＡＮＡiIS7Ags77Q
https://www.instagram.com/potatopigtongue/784Please respect copyright.ＰＥＮＡＮＡUiufbf1zwt
784Please respect copyright.ＰＥＮＡＮＡdBHHaR8MlN
784Please respect copyright.ＰＥＮＡＮＡpXntAQFE3c
Ref1:https://www.nature.com/articles/s43018-020-009784Please respect copyright.ＰＥＮＡＮＡC0J2K86TGu

ns216.73.216.141da2

介面主題:

字體大小:

行距:

段距:

自動加載下一章