单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:"One more chance to survive": the experiences of patients with advanced melanoma and their partners with tumor-infiltrating lymphocyte therapy-a qualitative study and recommendations for future care.
临床数据支持 TIL 疗法在晚期黑色素瘤治疗中的作用。
目的:一线治疗无效的晚期黑色素瘤患者需要有效的二线治疗选择。近期一项 III 期试验显示,TIL(肿瘤浸润淋巴细胞)过继性细胞疗法作为晚期黑色素瘤二线治疗具有良好前景。然而,患者及其伴侣对 TIL 疗法的实际体验仍不清楚,而这对于评估和改善照护质量至关重要。方法:对晚期黑色素瘤患者及其伴侣进行半结构式访谈,了解 TIL 治疗体验;访谈分别在治疗后 2–4 周(短期)及治疗后超过 6 个月(长期)进行。结果:共开展 25 次访谈,受访者包括接受 TIL 治疗的晚期黑色素瘤患者(n = 13)及其伴侣(n = 12);其中多数为短期访谈(n = 17)。总体而言,患者和伴侣认为 TIL 疗法过程强度很高,主要挑战包括 TIL 培养能否成功的不确定性、多种治疗相关毒性及长期住院。有年幼子女或其他照护责任的患者及伴侣在治疗期间面临的困难最多。不过,所有患者均报告,除疲劳外,治疗相关毒性在 2–4 周内均已恢复。结论:临床数据支持 TIL 疗法用于治疗晚期黑色素瘤。鉴于 TIL 疗法与当前标准照护方式明显不同,本文提出以患者为中心的建议,以进一步提升 TIL 治疗的照护质量。对癌症幸存者照护的启示:预计未来会有更多晚期黑色素瘤患者接受 TIL 治疗,本研究结果可纳入这一新型晚期黑色素瘤幸存者群体的康复照护计划。
PURPOSE: Patients with advanced melanoma refractory to first-line treatment have a need for effective second-line treatment options. A recent phase 3 trial showed promising results for adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) as second-line therapy in patients with advanced melanoma. However, it remains unknown how patients and their partners experience TIL therapy, which is key to evaluate and improve the quality of care. METHODS: Semi-structured interviews about the experience of TIL therapy were conducted with patients with advanced melanoma and their partners 2-4 weeks post-treatment (short term) and >6 months after treatment (long term). RESULTS: In total, 25 interviews were conducted with advanced melanoma patients treated with TIL (n=13) and their partners (n=12), with the majority being short-term interviews (n=17). Overall, patients and partners experienced TIL therapy as intense (uncertainty of successful TIL culture, multiple treatment-related toxicities, and extensive hospitalization). Patients and partners with young children or other caregiving responsibilities encountered the most challenges during TIL therapy. All patients, however, reported a recovery of all treatment-related toxicities within 2-4 weeks (except fatigue). CONCLUSION: Clinical data justify the role of TIL therapy in the treatment of advanced melanoma. With the distinct nature of TIL therapy compared to the current standard of care, we have provided patient-centered recommendations that will further enhance the quality of TIL therapy. IMPLICATIONS FOR CANCER SURVIVORS: As more patients with advanced melanoma are expected to receive TIL therapy in the future, our findings could be incorporated into survivorship care plans for this novel group of advanced melanoma survivors treated with TIL.
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