這系列的第一集,我們講解了PD1/PDL1的運作原理。525Please respect copyright.PENANAY5kA76bP2i
Link: https://www.penana.com/article/471125525Please respect copyright.PENANArb0okegdCA
525Please respect copyright.PENANAIAZHbgJ49X
第二集我們講述CTLA4與T cell功用的關係。525Please respect copyright.PENANA6R41BGG2y5
Link:https://www.penana.com/article/472480525Please respect copyright.PENANAjfHTEsvboS
525Please respect copyright.PENANADlitgMcLb7
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。525Please respect copyright.PENANAJhWjVBOWmJ
https://www.penana.com/article/479229525Please respect copyright.PENANAaf2FF5rDER
525Please respect copyright.PENANAxVPP5XYnde
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。525Please respect copyright.PENANAuyscZj2N79
525Please respect copyright.PENANArPT0l1qnns
525Please respect copyright.PENANAOLSx4A811d
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。525Please respect copyright.PENANA3y1cMVwJmZ
525Please respect copyright.PENANAkthYsHc1Sh
525Please respect copyright.PENANAyAv91HRGQj
525Please respect copyright.PENANAchITq9phRE
(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。525Please respect copyright.PENANAgQsMZC6wQA
525Please respect copyright.PENANAOJeHOrZsR8
525Please respect copyright.PENANA5kdxvqd6GW
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。525Please respect copyright.PENANA5Pv8ucJeoI
525Please respect copyright.PENANAFzywadcjoT
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)。525Please respect copyright.PENANAX80SVnwxSJ
525Please respect copyright.PENANAlSmvSprlnS
525Please respect copyright.PENANASeoJZxWBdm
(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。525Please respect copyright.PENANAUutj2K0Asr
525Please respect copyright.PENANAe9gNPJRP2e
525Please respect copyright.PENANAlOBoqlZLPi
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,525Please respect copyright.PENANAJ1lN2Yr0NE
因此血液會有癌細胞的DNA。525Please respect copyright.PENANAudJ5Svf6vG
525Please respect copyright.PENANAfygx1vQ0iF
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。525Please respect copyright.PENANAJcouvgYvTY
525Please respect copyright.PENANAA1CLWOtzsd
在這裡,我們暫稱癌細胞在血液中的DNA為ctDNA,Circulating Tumor DNA。525Please respect copyright.PENANAWXiKNHXAWR
525Please respect copyright.PENANAb9i08DoFUb
(圖4)圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。525Please respect copyright.PENANAsYcHtYxwnc
525Please respect copyright.PENANAP73P6Dn4gY
525Please respect copyright.PENANAI0tUOCleST
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。525Please respect copyright.PENANAlB0ttsEQps
525Please respect copyright.PENANAoR4Wsv4B4f
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。525Please respect copyright.PENANABJVqVrW9CU
525Please respect copyright.PENANAwqhIDxnQu7
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。525Please respect copyright.PENANAKebOtfC8sq
525Please respect copyright.PENANAKhZPCGjfwL
525Please respect copyright.PENANA4s7kDE71WP
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。525Please respect copyright.PENANAKICP7CDUuY
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。525Please respect copyright.PENANAcYpvv0IhFv
525Please respect copyright.PENANAU28oqvZa97
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。525Please respect copyright.PENANAXEchOI4UTh
525Please respect copyright.PENANASKWIki9C0f
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。525Please respect copyright.PENANAbbGw4AyWLE
525Please respect copyright.PENANAZSHMawNni9
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。525Please respect copyright.PENANAJEa3mAbdOr
525Please respect copyright.PENANAqMvdCYjX2r
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/toc525Please respect copyright.PENANAhI0IefKlfv
525Please respect copyright.PENANAa4BKq5XAY5
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。525Please respect copyright.PENANAX2oX7jSzbx
525Please respect copyright.PENANACO1OX9V5kv
Link:525Please respect copyright.PENANA1Wn4i1UpD2
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio525Please respect copyright.PENANAn6osbceN9R
525Please respect copyright.PENANAnoAyquzTKe
525Please respect copyright.PENANA3eHshY8Sqg
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。525Please respect copyright.PENANAh6ex4Iq6x5
525Please respect copyright.PENANAqLPIe7gJGN
https://www.instagram.com/potatopigtongue/525Please respect copyright.PENANAGqVXt0o788
525Please respect copyright.PENANAnwXGnwmSBG
525Please respect copyright.PENANA8jsZyVv7eF
Ref1:https://www.nature.com/articles/s43018-020-009525Please respect copyright.PENANAba66Fjsfu9