這系列的第一集,我們講解了PD1/PDL1的運作原理。469Please respect copyright.PENANAwcP1b0y2HC
Link: https://www.penana.com/article/471125469Please respect copyright.PENANAZ7rFgyg6Ck
469Please respect copyright.PENANAJoFxi91MBd
第二集我們講述CTLA4與T cell功用的關係。469Please respect copyright.PENANA5HNyxrfd7N
Link:https://www.penana.com/article/472480469Please respect copyright.PENANABIDX1VZvfz
469Please respect copyright.PENANAuybIM9M0sp
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。469Please respect copyright.PENANAsXoR6hvIpw
https://www.penana.com/article/479229469Please respect copyright.PENANAeVwDcDOSLk
469Please respect copyright.PENANAKgV3kSO5W5
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。469Please respect copyright.PENANA1AWlWZmmQP
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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。469Please respect copyright.PENANAY5Oj2fXvOx
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(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。469Please respect copyright.PENANAeLAGVmQJUF
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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。469Please respect copyright.PENANA2x8sE9CuLO
469Please respect copyright.PENANAKXzGOiZIdz
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)。469Please respect copyright.PENANAxVEdXhr4Ot
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(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。469Please respect copyright.PENANAphA5V7XIUY
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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,469Please respect copyright.PENANA9HBpANEFQC
因此血液會有癌細胞的DNA。469Please respect copyright.PENANA356l7GbMXd
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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。469Please respect copyright.PENANAL0FDLP7gQd
469Please respect copyright.PENANAEhLqard3H8
在這裡,我們暫稱癌細胞在血液中的DNA為ctDNA,Circulating Tumor DNA。469Please respect copyright.PENANA8CjMAcBAA0
469Please respect copyright.PENANACK9w6YXT7G
(圖4)圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。469Please respect copyright.PENANAAxSdb63H9J
469Please respect copyright.PENANA7eIWkSEfIS
469Please respect copyright.PENANA2JHua98Z8A
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。469Please respect copyright.PENANAA7ua7pC7p0
469Please respect copyright.PENANAYIcGn5VDJl
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。469Please respect copyright.PENANAEVDfPeeWLE
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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。469Please respect copyright.PENANAjePDyr2Nc7
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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。469Please respect copyright.PENANA8WAIwOYUrN
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。469Please respect copyright.PENANA7XZSG5aGdX
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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。469Please respect copyright.PENANAXTOKnI62M2
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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。469Please respect copyright.PENANAltWmvJAl6x
469Please respect copyright.PENANAb4htnQONNA
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。469Please respect copyright.PENANAgwbkS5joQY
469Please respect copyright.PENANARbK9IvGmGV
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/toc469Please respect copyright.PENANA54rIB32W6o
469Please respect copyright.PENANA0qVLvT3fMc
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。469Please respect copyright.PENANAmYbOfEylHQ
469Please respect copyright.PENANAiXTQfFPrRs
Link:469Please respect copyright.PENANArS3L2GPjYC
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio469Please respect copyright.PENANAcJuHTs9MHl
469Please respect copyright.PENANAmQ5OpeCE1L
469Please respect copyright.PENANAp9SPtWLqnL
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。469Please respect copyright.PENANA5yx8U0vOHg
469Please respect copyright.PENANAtMU7hSSeK7
https://www.instagram.com/potatopigtongue/469Please respect copyright.PENANAApmhoTxDrk
469Please respect copyright.PENANAIqQoxfDBTr
469Please respect copyright.PENANACqrL6SZS9R
Ref1:https://www.nature.com/articles/s43018-020-009469Please respect copyright.PENANA3N9tyZuTDF
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科普專欄–薯不揀單
Author:
薯仔聞茱莉
ISSUE #94
深入淺出–免疫治療(Immunotherapy)手段醫治癌症(4)
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