這系列的第一集,我們講解了PD1/PDL1的運作原理。486Please respect copyright.PENANANjcqZBH7MA
Link: https://www.penana.com/article/471125486Please respect copyright.PENANAf6eJMnpV7c
486Please respect copyright.PENANA8r7qN4w9WH
第二集我們講述CTLA4與T cell功用的關係。486Please respect copyright.PENANA9ZFjfblcpi
Link:https://www.penana.com/article/472480486Please respect copyright.PENANAj3ggxmxRT9
486Please respect copyright.PENANAYqkADgTKE7
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。486Please respect copyright.PENANAdB3Zi9QjEW
https://www.penana.com/article/479229486Please respect copyright.PENANAInWaiqdx2L
486Please respect copyright.PENANALDGnu3feOV
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。486Please respect copyright.PENANA7ZfTZHEfRD
486Please respect copyright.PENANAHLJ9c8ql9D
486Please respect copyright.PENANAhskz54TF4r
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。486Please respect copyright.PENANAtloECA1E9M
486Please respect copyright.PENANAJhhgM1Owrr
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486Please respect copyright.PENANAG2kTQy2LBS
(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。486Please respect copyright.PENANAnJCJTjvYoS
486Please respect copyright.PENANAovKL6SGQzL
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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。486Please respect copyright.PENANAfYLsiesKOz
486Please respect copyright.PENANAtyiXbnhlwk
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)。486Please respect copyright.PENANAptUadH7RqH
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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。486Please respect copyright.PENANAidN79XoZAE
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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,486Please respect copyright.PENANAKUNzEznqUo
因此血液會有癌細胞的DNA。486Please respect copyright.PENANAhaer2s5prr
486Please respect copyright.PENANAyhTcx9e9EC
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。486Please respect copyright.PENANAIUuT6CNPQQ
486Please respect copyright.PENANA7CC8oqszo1
在這裡,我們暫稱癌細胞在血液中的DNA為ctDNA,Circulating Tumor DNA。486Please respect copyright.PENANAmxXZabr1B4
486Please respect copyright.PENANAFvefp0Rkw3
(圖4)圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。486Please respect copyright.PENANAHAkNKKZeaK
486Please respect copyright.PENANAZXNB6O99s5
486Please respect copyright.PENANAyzAMxPOrGk
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。486Please respect copyright.PENANA6pR0tAy0e9
486Please respect copyright.PENANAxqFfdx2M81
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。486Please respect copyright.PENANATFupIZQJj3
486Please respect copyright.PENANA9WGxspiMlj
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。486Please respect copyright.PENANAmgw0hFDLcE
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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。486Please respect copyright.PENANAbqGXzbbuha
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。486Please respect copyright.PENANALstjQw8DLC
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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。486Please respect copyright.PENANAh1TLNg3eIe
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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。486Please respect copyright.PENANADZw45nwLQH
486Please respect copyright.PENANAKpI6wYcVaR
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。486Please respect copyright.PENANAPdqGKO1ciW
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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/toc486Please respect copyright.PENANAwCZ7wbzsTW
486Please respect copyright.PENANAhUsjPszG2b
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。486Please respect copyright.PENANA5YpqV2duUy
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Link:486Please respect copyright.PENANAoui6Bz9dkg
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio486Please respect copyright.PENANAcDf2V3W66q
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有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。486Please respect copyright.PENANAzaT0anoVnQ
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https://www.instagram.com/potatopigtongue/486Please respect copyright.PENANAq8p7NcggUd
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Ref1:https://www.nature.com/articles/s43018-020-009486Please respect copyright.PENANA4ih4pcXXCF