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。785Please respect copyright.ＰＥＮＡＮＡ7qzcALBrsU
Link: https://www.penana.com/article/471125785Please respect copyright.ＰＥＮＡＮＡ8RzTX28DPJ
785Please respect copyright.ＰＥＮＡＮＡDwFAlaaVdo
第二集我們講述CTLA4與T cell功用的關係。785Please respect copyright.ＰＥＮＡＮＡD1piCEu1M9
Link:https://www.penana.com/article/472480785Please respect copyright.ＰＥＮＡＮＡx0Ig2bQgG5
785Please respect copyright.ＰＥＮＡＮＡYZXXiytO7r
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。785Please respect copyright.ＰＥＮＡＮＡbfLaPvPy42
https://www.penana.com/article/479229785Please respect copyright.ＰＥＮＡＮＡyQllFdh1ec
785Please respect copyright.ＰＥＮＡＮＡMUwo8AESuG
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。785Please respect copyright.ＰＥＮＡＮＡ175X0yGyMh
785Please respect copyright.ＰＥＮＡＮＡC9imTbB1CO
785Please respect copyright.ＰＥＮＡＮＡWQWUEvNpbc
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。785Please respect copyright.ＰＥＮＡＮＡXmTFPFrfVY
785Please respect copyright.ＰＥＮＡＮＡz8BtLBTnqh
785Please respect copyright.ＰＥＮＡＮＡP7Bsko3GwE
785Please respect copyright.ＰＥＮＡＮＡJ2MDXporFq
（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。785Please respect copyright.ＰＥＮＡＮＡd7S3TriaSQ
785Please respect copyright.ＰＥＮＡＮＡhQ8o07eWZl
785Please respect copyright.ＰＥＮＡＮＡK28DNgP0Wc
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。785Please respect copyright.ＰＥＮＡＮＡmCro9M6LPk
785Please respect copyright.ＰＥＮＡＮＡhUV3zqQ97s
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)。785Please respect copyright.ＰＥＮＡＮＡuIqlsQMTQd
785Please respect copyright.ＰＥＮＡＮＡgQfrN2D2rf
785Please respect copyright.ＰＥＮＡＮＡB0oS6Pk72v
(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。785Please respect copyright.ＰＥＮＡＮＡ2mMhLQxcHF
785Please respect copyright.ＰＥＮＡＮＡywlouwWnAc
785Please respect copyright.ＰＥＮＡＮＡFQNrf9gLXX
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，785Please respect copyright.ＰＥＮＡＮＡ65X89xp3eF
因此血液會有癌細胞的DNA。785Please respect copyright.ＰＥＮＡＮＡ1eUaSeYKPI
785Please respect copyright.ＰＥＮＡＮＡSuSyiiodQO
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。785Please respect copyright.ＰＥＮＡＮＡLhnnZj6S9f
785Please respect copyright.ＰＥＮＡＮＡHvLcUYDrGI
在這裡，我們暫稱癌細胞在血液中的DNA為ctDNA，Circulating Tumor DNA。785Please respect copyright.ＰＥＮＡＮＡfNSl4YBHWu
785Please respect copyright.ＰＥＮＡＮＡE632FzRxmH
（圖4）圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。785Please respect copyright.ＰＥＮＡＮＡKqEPFZ7cQi
785Please respect copyright.ＰＥＮＡＮＡAqU8PJypBm
785Please respect copyright.ＰＥＮＡＮＡkhhdzvshd6
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。785Please respect copyright.ＰＥＮＡＮＡwk5JscxT22
785Please respect copyright.ＰＥＮＡＮＡKCzfMKey88
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。785Please respect copyright.ＰＥＮＡＮＡmXh3IARhtR
785Please respect copyright.ＰＥＮＡＮＡHdm9yLH1MC
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。785Please respect copyright.ＰＥＮＡＮＡ0rjsDwhKbB
785Please respect copyright.ＰＥＮＡＮＡVSTr7ZgOm5
785Please respect copyright.ＰＥＮＡＮＡO08t759Mnq
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。785Please respect copyright.ＰＥＮＡＮＡueiJooRGIj
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。785Please respect copyright.ＰＥＮＡＮＡbKfnglIxvI
785Please respect copyright.ＰＥＮＡＮＡKq3W6ddhdy
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。785Please respect copyright.ＰＥＮＡＮＡWaPPTjpZhU
785Please respect copyright.ＰＥＮＡＮＡChfVhJaSoD
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。785Please respect copyright.ＰＥＮＡＮＡMxUbGGFw8o
785Please respect copyright.ＰＥＮＡＮＡd6ZX2Gloq2
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。785Please respect copyright.ＰＥＮＡＮＡYjui5yHEd1
785Please respect copyright.ＰＥＮＡＮＡK499Tj2Gd6
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/toc785Please respect copyright.ＰＥＮＡＮＡeshyqolGWR
785Please respect copyright.ＰＥＮＡＮＡnXunzYE219
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。785Please respect copyright.ＰＥＮＡＮＡ88Wi0MSkJw
785Please respect copyright.ＰＥＮＡＮＡdWLj4yCHhT
Link:785Please respect copyright.ＰＥＮＡＮＡShhywSw3t5
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio785Please respect copyright.ＰＥＮＡＮＡne9S4sQVcO
785Please respect copyright.ＰＥＮＡＮＡFIQB6yySgr
785Please respect copyright.ＰＥＮＡＮＡ7sRgmKSttj
有興趣接收科學資訊的話，歡迎follow IG: potatopigtongue。785Please respect copyright.ＰＥＮＡＮＡaLPidubmLu
785Please respect copyright.ＰＥＮＡＮＡy4zn7t7cIo
https://www.instagram.com/potatopigtongue/785Please respect copyright.ＰＥＮＡＮＡ1gBOBwCdXS
785Please respect copyright.ＰＥＮＡＮＡzxNjZ2KOxf
785Please respect copyright.ＰＥＮＡＮＡx1NKM3G95Z
Ref1:https://www.nature.com/articles/s43018-020-009785Please respect copyright.ＰＥＮＡＮＡeHA0hqEzc3

ns216.73.216.141da2

介面主題:

字體大小:

行距:

段距:

自動加載下一章