自杀式基因治疗:让前列腺癌细胞“自杀”!
医脉通 · 2015/12/18
休斯顿的研究人员最近进行了一项长期临床试验,发现通过联合“自杀式基因治疗”与放疗可以安全有效地治疗前列腺癌。所谓“自杀式基因治疗”是一种新的技术,通过对前列腺癌细胞的基因进行修饰,使患者的免疫系统可以识别并攻击癌细胞。


休斯顿的研究人员最近进行了一项长期临床试验,发现通过联合“自杀式基因治疗”与放疗可以安全有效地治疗前列腺癌。所谓“自杀式基因治疗”是一种新的技术,通过对前列腺癌细胞的基因进行修饰,使患者的免疫系统可以识别并攻击癌细胞。该研究在线发表于12月12日的《Journal of Radiation Oncology》上。

研究人员对比了两组患者5年的总存活率,分别为97%和94%,比既往治疗方式改善了5%-20%。从1999年到2003年,共有66名前列腺癌患者被分成两组进行临床II期试验。A组为非转移性前列腺癌患者,他们只接受放疗,同时在研究过程中额外进行2次基因治疗;B组为恶性前列腺癌患者,他们同时进行放疗和化疗,并且在研究过程中额外进行3次基因治疗。

E. Brian Butler博士说:“我们计划性地将一种类似于流感病毒的腺病毒送入肿瘤细胞中,同时带入基因治疗药物——通常是胸苷激酶或者是一种可以诱导细胞产生胸苷激酶的疱疹病毒。在疱疹病毒基因进入肿瘤细胞并开始产生胸苷激酶后,我们向患者给予抗疱疹药物“伐昔洛韦”。之后,放射线和药物就会一起攻击疱疹DNA,产生胸苷激酶的肿瘤细胞自我毁灭。这就是我们称其为“自杀式基因治疗”的原因。”

伐昔洛韦在攻击肿瘤细胞的同时,也会向之前未发现癌细胞的免疫系统发出警报,从而使免疫系统对癌细胞发起大规模攻击。“这相当于是通过患者自身的癌细胞创造了疫苗。”

这种疗法的前途不可估量。研究结果表明,两组62名完成临床试验的患者,其5年治疗成功率为94%和91%。治疗后24个月对患者前列腺进行活检,结果显示A组83%为阴性,B组79%为阴性。所有评估均显示:基因治疗联合放疗的治疗效果要明显优于单独放疗。


上图中,左边为高度侵袭性前列腺癌患者治疗前的活检病理,可见恶性程度较高的前列腺癌细胞;右侧围基因联合放疗治疗后,患者的前列腺活检病例,未见癌细胞。该实验中大部分患者几乎没有产生任何副作用或并发症。此外,该疗法的临床III期试验正在进行。

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