
這系列的第一集,我們講解了PD1/PDL1的運作原理。66Please respect copyright.PENANA2SQBIS02Lp
Link: https://www.penana.com/article/47112566Please respect copyright.PENANAZlMCxBjp69
66Please respect copyright.PENANAWZChGYcgmO
第二集我們講述CTLA4與T cell功用的關係。66Please respect copyright.PENANAr6f4habbqe
Link:https://www.penana.com/article/47248066Please respect copyright.PENANARNvpIXdIDx
66Please respect copyright.PENANAD0T9yk5i0f
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。66Please respect copyright.PENANAygH5hjVTjP
https://www.penana.com/article/47922966Please respect copyright.PENANA78VO0cDdhM
66Please respect copyright.PENANA9wX8pHNKjQ
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。66Please respect copyright.PENANAFIxtynESHJ66Please respect copyright.PENANAzkcG3N5f2s
66Please respect copyright.PENANAYPoPHSOsyo
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。66Please respect copyright.PENANAspudjwNOsu
66Please respect copyright.PENANANi4l1DiLDx
66Please respect copyright.PENANAZWmGEmYVNv
66Please respect copyright.PENANAQqNnTFf7S9
(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。66Please respect copyright.PENANArNnh9rO5xN66Please respect copyright.PENANAQfISia0QYu
66Please respect copyright.PENANAVR1hA4TB99
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。66Please respect copyright.PENANAQKXk2TxZN5
66Please respect copyright.PENANAB3mBCFDb08
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)。66Please respect copyright.PENANA5KafteDrTj
66Please respect copyright.PENANAeTMMMQ8190
66Please respect copyright.PENANAoPV7ZvMZnW
(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。66Please respect copyright.PENANALXjp74bfts66Please respect copyright.PENANAav8yeb0zrw
66Please respect copyright.PENANA5N5jIjk79a
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,66Please respect copyright.PENANAX1BPpJxLvr
因此血液會有癌細胞的DNA。66Please respect copyright.PENANAC2HBUYO0z3
66Please respect copyright.PENANAeA75333tYA
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。66Please respect copyright.PENANAdTcnVwsZA5
66Please respect copyright.PENANAYnoDaU7E0M
在這裡,我們暫稱癌細胞在血液中的DNA為ctDNA,Circulating Tumor DNA。66Please respect copyright.PENANASrOB2WkFrq
66Please respect copyright.PENANAci6PIgKYfh
(圖4)圖中為利用阻擋PD1的抗體Pembrolizumab作治療的兩名病人結果。66Please respect copyright.PENANAFzTP31sdXN66Please respect copyright.PENANA3zN6OVBSgi
66Please respect copyright.PENANAJuMBvK3RFH
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。66Please respect copyright.PENANAugf0VN8AYt
66Please respect copyright.PENANAn14A7csCD0
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。66Please respect copyright.PENANA05rKWUS6SS
66Please respect copyright.PENANA0ffWKERA1l
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。66Please respect copyright.PENANA9jaKc2tJiG
66Please respect copyright.PENANA2FpfEQ2yAp
66Please respect copyright.PENANAkrA1QrCnnt
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。66Please respect copyright.PENANAqFkZ1vziT4
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。66Please respect copyright.PENANAI8pIpxw8f7
66Please respect copyright.PENANAey98fIQ9em
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。66Please respect copyright.PENANAkAegek3wrc
66Please respect copyright.PENANAmS1SSIgBQk
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。66Please respect copyright.PENANA50AdvbzBmp
66Please respect copyright.PENANAh8SkJqTsO2
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。66Please respect copyright.PENANAscHmNL1jPg
66Please respect copyright.PENANADCKAf2Bu1C
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/toc66Please respect copyright.PENANARpqbqAVUC6
66Please respect copyright.PENANAUTmOOyxTrF
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。66Please respect copyright.PENANA0kS70Jrj4D
66Please respect copyright.PENANAfbIsAcdVs9
Link:66Please respect copyright.PENANA9VM2qiLPg4
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio66Please respect copyright.PENANAEdQoTvobEs
66Please respect copyright.PENANAXPKXiPEMed
66Please respect copyright.PENANAa7o0v5c5gw
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。66Please respect copyright.PENANALWuW8Qsbmu
66Please respect copyright.PENANAgdQdhwbKCt
https://www.instagram.com/potatopigtongue/66Please respect copyright.PENANAQefGAwd5bj
66Please respect copyright.PENANAWCXi4BJexU
66Please respect copyright.PENANAumty7RhCvj
Ref1:https://www.nature.com/articles/s43018-020-00966Please respect copyright.PENANA1ZK2fknu00
copyright protection62PENANAYsrY3aKrly