{"id":3265,"date":"2025-04-03T16:57:06","date_gmt":"2025-04-03T09:57:06","guid":{"rendered":"https:\/\/hienbacsi.com\/?p=3265"},"modified":"2025-04-03T16:57:06","modified_gmt":"2025-04-03T09:57:06","slug":"hoi-dap-ve-lieu-phap-mien-dich-te-bao-cho-ung-thu-bieu-mo-te-bao-gan-hcc","status":"publish","type":"post","link":"https:\/\/hienbacsi.com\/index.php\/2025\/04\/03\/hoi-dap-ve-lieu-phap-mien-dich-te-bao-cho-ung-thu-bieu-mo-te-bao-gan-hcc\/","title":{"rendered":"H\u1ecfi \u0111\u00e1p v\u1ec1 li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch t\u1ebf b\u00e0o cho ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC)"},"content":{"rendered":"\n

ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n<\/mark><\/strong><\/p>\n\n\n\n

Th\u00e0nh vi\u00ean h\u1ed9i Nghi\u00ean C\u1ee9u Gan Ch\u00e2u \u00c2u <\/mark><\/strong><\/p>\n\n\n\n

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<\/h3>\n\n\n\n
<\/figure>\n\n\n\n

1. Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) l\u00e0 g\u00ec v\u00e0 t\u1ea1i sao n\u00f3 nguy hi\u1ec3m?<\/h4>\n\n\n\n

H\u1ecfi:<\/strong> HCC l\u00e0 g\u00ec v\u00e0 t\u1ea1i sao n\u00f3 l\u1ea1i l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u1edbn \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe?
\u0110\u00e1p:<\/strong> Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) l\u00e0 lo\u1ea1i ung th\u01b0 gan nguy\u00ean ph\u00e1t ph\u1ed5 bi\u1ebfn nh\u1ea5t, chi\u1ebfm kho\u1ea3ng 80% c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan. \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong li\u00ean quan \u0111\u1ebfn ung th\u01b0 tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. HCC nguy hi\u1ec3m v\u00ec h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n khi b\u1ec7nh \u0111\u00e3 \u1edf giai \u0111o\u1ea1n mu\u1ed9n, kh\u00f4ng th\u1ec3 ch\u1eefa kh\u1ecfi b\u1eb1ng ph\u1eabu thu\u1eadt hay c\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u00f4ng th\u01b0\u1eddng. C\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 vi\u00eam gan B, vi\u00eam gan C, b\u1ec7nh gan nhi\u1ec5m m\u1ee1 kh\u00f4ng do r\u01b0\u1ee3u v\u00e0 nghi\u1ec7n r\u01b0\u1ee3u l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh. Ti\u00ean l\u01b0\u1ee3ng th\u01b0\u1eddng k\u00e9m v\u00ec c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7n t\u1ea1i ch\u1ec9 mang l\u1ea1i l\u1ee3i \u00edch h\u1ea1n ch\u1ebf.<\/p>\n\n\n\n

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2. Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch l\u00e0 g\u00ec v\u00e0 t\u1ea1i sao n\u00f3 \u0111\u01b0\u1ee3c d\u00f9ng cho HCC?<\/h4>\n\n\n\n
<\/figure>\n\n\n\n

H\u1ecfi:<\/strong> Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch l\u00e0 g\u00ec? N\u00f3 c\u00f3 vai tr\u00f2 g\u00ec trong \u0111i\u1ec1u tr\u1ecb HCC?
\u0110\u00e1p:<\/strong> Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch l\u00e0 ph\u01b0\u01a1ng ph\u00e1p s\u1eed d\u1ee5ng h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ec3 ch\u1ed1ng l\u1ea1i ung th\u01b0. Trong tr\u01b0\u1eddng h\u1ee3p HCC, h\u1ec7 mi\u1ec5n d\u1ecbch c\u00f3 th\u1ec3 nh\u1eadn bi\u1ebft c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 l\u00e0 \u201ck\u1ebb th\u00f9\u201d v\u00e0 t\u1ea5n c\u00f4ng ch\u00fang. Tuy nhi\u00ean, HCC th\u01b0\u1eddng t\u1ea1o ra m\u1ed9t m\u00f4i tr\u01b0\u1eddng \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, khi\u1ebfn c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch ho\u1ea1t \u0111\u1ed9ng k\u00e9m hi\u1ec7u qu\u1ea3. Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, bao g\u1ed3m c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch (immune checkpoint inhibitors – ICIs) v\u00e0 li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o (cellular therapies), \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng c\u1ee7a h\u1ec7 mi\u1ec5n d\u1ecbch, gi\u00fap n\u00f3 nh\u1eadn di\u1ec7n v\u00e0 ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0 t\u1ed1t h\u01a1n. V\u1edbi HCC, \u0111\u00e2y l\u00e0 h\u01b0\u1edbng \u0111i m\u1edbi \u0111\u1ea7y h\u1ee9a h\u1eb9n v\u00ec c\u00e1c ph\u01b0\u01a1ng ph\u00e1p truy\u1ec1n th\u1ed1ng nh\u01b0 thu\u1ed1c nh\u1eafm m\u1ee5c ti\u00eau (TKIs) hay h\u00f3a tr\u1ecb ch\u1ec9 c\u1ea3i thi\u1ec7n th\u1eddi gian s\u1ed1ng s\u00f3t m\u1ed9t c\u00e1ch khi\u00eam t\u1ed1n.<\/p>\n\n\n\n

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3. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7n t\u1ea1i cho HCC l\u00e0 g\u00ec?<\/h4>\n\n\n\n

H\u1ecfi:<\/strong> Hi\u1ec7n nay HCC \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u01b0 th\u1ebf n\u00e0o?
\u0110\u00e1p:<\/strong> \u0110i\u1ec1u tr\u1ecb HCC ph\u1ee5 thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n b\u1ec7nh:<\/p>\n\n\n\n

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  • Giai \u0111o\u1ea1n s\u1edbm:<\/strong> Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf kh\u1ed1i u, gh\u00e9p gan ho\u1eb7c \u0111\u1ed1t s\u00f3ng cao t\u1ea7n (ablative therapy).<\/li>\n\n\n\n
  • Giai \u0111o\u1ea1n trung gian:<\/strong> \u0110i\u1ec1u tr\u1ecb qua \u0111\u1ed9ng m\u1ea1ch (trans-arterial therapy) nh\u01b0 h\u00f3a t\u1eafc m\u1ea1ch (TACE).<\/li>\n\n\n\n
  • Giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n:<\/strong> S\u1eed d\u1ee5ng thu\u1ed1c nh\u1eafm m\u1ee5c ti\u00eau nh\u01b0 sorafenib (t\u0103ng th\u1eddi gian s\u1ed1ng t\u1eeb 7,9 l\u00ean 10,7 th\u00e1ng), lenvatinib, regorafenib, cabozantinib ho\u1eb7c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng ramucirumab. G\u1ea7n \u0111\u00e2y, li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch k\u1ebft h\u1ee3p atezolizumab (\u1ee9c ch\u1ebf PD-L1) v\u00e0 bevacizumab (\u1ee9c ch\u1ebf VEGF) \u0111\u00e3 tr\u1edf th\u00e0nh ti\u00eau chu\u1ea9n \u0111\u1ea7u tay v\u00ec cho k\u1ebft qu\u1ea3 s\u1ed1ng s\u00f3t t\u1ed1t h\u01a1n sorafenib. Tuy nhi\u00ean, ch\u1ec9 m\u1ed9t s\u1ed1 \u00edt b\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p n\u00e0y, n\u00ean c\u1ea7n c\u00e1c c\u00e1ch ti\u1ebfp c\u1eadn m\u1edbi nh\u01b0 li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o.<\/li>\n<\/ul>\n\n\n\n
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    4. Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch l\u00e0 g\u00ec?<\/h4>\n\n\n\n

    H\u1ecfi:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch l\u00e0 g\u00ec v\u00e0 n\u00f3 kh\u00e1c g\u00ec v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c?
    \u0110\u00e1p:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch (adoptive cellular therapy – ACT) l\u00e0 m\u1ed9t d\u1ea1ng c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, trong \u0111\u00f3 c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch (th\u01b0\u1eddng l\u00e0 t\u1ebf b\u00e0o T) \u0111\u01b0\u1ee3c l\u1ea5y t\u1eeb c\u01a1 th\u1ec3 b\u1ec7nh nh\u00e2n, \u0111\u01b0\u1ee3c c\u1ea3i ti\u1ebfn trong ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng t\u1ea5n c\u00f4ng ung th\u01b0, sau \u0111\u00f3 \u0111\u01b0a tr\u1edf l\u1ea1i c\u01a1 th\u1ec3. C\u00e1c lo\u1ea1i ch\u00ednh bao g\u1ed3m:<\/p>\n\n\n\n

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    • T\u1ebf b\u00e0o T th\u1ee5 th\u1ec3 kh\u00e1ng nguy\u00ean chimeric (CAR-T):<\/strong> T\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c g\u1eafn m\u1ed9t th\u1ee5 th\u1ec3 nh\u00e2n t\u1ea1o \u0111\u1ec3 nh\u1eadn di\u1ec7n kh\u00e1ng nguy\u00ean tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o ung th\u01b0.<\/li>\n\n\n\n
    • T\u1ebf b\u00e0o T th\u1ee5 th\u1ec3 T c\u1ea3i ti\u1ebfn (TCR-T):<\/strong> T\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c ch\u1ec9nh s\u1eeda \u0111\u1ec3 nh\u1eadn di\u1ec7n kh\u00e1ng nguy\u00ean b\u00ean trong t\u1ebf b\u00e0o ung th\u01b0 qua ph\u1ee9c h\u1ee3p MHC.<\/li>\n\n\n\n
    • T\u1ebf b\u00e0o ti\u00eau di\u1ec7t g\u00e2y ra b\u1edfi cytokine (CIK):<\/strong> T\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch kh\u00f4ng \u0111\u1eb7c hi\u1ec7u kh\u00e1ng nguy\u00ean, \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi cytokine.<\/li>\n\n\n\n
    • Lympho x\u00e2m nh\u1eadp kh\u1ed1i u (TILs):<\/strong> T\u1ebf b\u00e0o T l\u1ea5y t\u1eeb kh\u1ed1i u, \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng s\u1ed1 l\u01b0\u1ee3ng v\u00e0 \u0111\u01b0a l\u1ea1i c\u01a1 th\u1ec3.
      Kh\u00e1c v\u1edbi thu\u1ed1c, li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o nh\u1eafm tr\u1ef1c ti\u1ebfp v\u00e0o t\u1ebf b\u00e0o ung th\u01b0 b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng \u201cqu\u00e2n \u0111\u1ed9i\u201d mi\u1ec5n d\u1ecbch c\u1ee7a ch\u00ednh b\u1ec7nh nh\u00e2n, mang l\u1ea1i ti\u1ec1m n\u0103ng \u0111i\u1ec1u tr\u1ecb c\u00e1 nh\u00e2n h\u00f3a.<\/li>\n<\/ul>\n\n\n\n
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      5. T\u1ebf b\u00e0o CIK ho\u1ea1t \u0111\u1ed9ng nh\u01b0 th\u1ebf n\u00e0o trong \u0111i\u1ec1u tr\u1ecb HCC?<\/h4>\n\n\n\n

      H\u1ecfi:<\/strong> T\u1ebf b\u00e0o CIK l\u00e0 g\u00ec v\u00e0 ch\u00fang gi\u00fap \u00edch g\u00ec cho b\u1ec7nh nh\u00e2n HCC?
      \u0110\u00e1p:<\/strong> T\u1ebf b\u00e0o CIK (Cytokine-Induced Killer cells) l\u00e0 m\u1ed9t lo\u1ea1i t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch (CD3+ CD56+) \u0111\u01b0\u1ee3c t\u1ea1o ra t\u1eeb m\u00e1u ngo\u1ea1i vi ho\u1eb7c m\u00e1u d\u00e2y r\u1ed1n, k\u00edch ho\u1ea1t b\u1eb1ng c\u00e1c cytokine nh\u01b0 IL-2, IL-1\u03b1 v\u00e0 IFN\u03b3. Ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0 m\u00e0 kh\u00f4ng c\u1ea7n qua MHC (kh\u00e1c v\u1edbi t\u1ebf b\u00e0o T th\u00f4ng th\u01b0\u1eddng).<\/p>\n\n\n\n

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      • Hi\u1ec7u qu\u1ea3:<\/strong> C\u00e1c nghi\u00ean c\u1ee9u giai \u0111o\u1ea1n I cho th\u1ea5y CIK gi\u1ea3m t\u00e1i ph\u00e1t \u1edf b\u1ec7nh nh\u00e2n HCC giai \u0111o\u1ea1n s\u1edbm sau ph\u1eabu thu\u1eadt ho\u1eb7c TACE, \u0111\u1ed3ng th\u1eddi l\u00e0m ch\u1eadm t\u0103ng tr\u01b0\u1edfng kh\u1ed1i u v\u00e0 gi\u1ea3m t\u1ea3i l\u01b0\u1ee3ng virus vi\u00eam gan B \u1edf b\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n mu\u1ed9n. Khi k\u1ebft h\u1ee3p v\u1edbi TACE, CIK t\u0103ng th\u1eddi gian s\u1ed1ng kh\u00f4ng ti\u1ebfn tri\u1ec3n (PFS) v\u00e0 s\u1ed1ng s\u00f3t to\u00e0n b\u1ed9 (OS) so v\u1edbi TACE \u0111\u01a1n thu\u1ea7n (OS: 31 th\u00e1ng so v\u1edbi 10 th\u00e1ng).<\/li>\n\n\n\n
      • An to\u00e0n:<\/strong> CIK \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t, \u00edt g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 b\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 (GvHD).
        Hi\u1ec7n nay, CIK \u0111ang \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m th\u00eam, \u0111\u1eb7c bi\u1ec7t khi k\u1ebft h\u1ee3p v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nh\u01b0 t\u1ebf b\u00e0o dendritic (DCs) ho\u1eb7c sorafenib.<\/li>\n<\/ul>\n\n\n\n
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        6. TILs l\u00e0 g\u00ec v\u00e0 ch\u00fang c\u00f3 \u0111\u01b0\u1ee3c d\u00f9ng cho HCC kh\u00f4ng?<\/h4>\n\n\n\n

        H\u1ecfi:<\/strong> TILs l\u00e0 g\u00ec? Ch\u00fang c\u00f3 hi\u1ec7u qu\u1ea3 v\u1edbi HCC kh\u00f4ng?
        \u0110\u00e1p:<\/strong> TILs (Tumor Infiltrating Lymphocytes) l\u00e0 t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c l\u1ea5y t\u1eeb kh\u1ed1i u c\u1ee7a b\u1ec7nh nh\u00e2n, m\u1edf r\u1ed9ng s\u1ed1 l\u01b0\u1ee3ng trong ph\u00f2ng th\u00ed nghi\u1ec7m v\u00e0 \u0111\u01b0a tr\u1edf l\u1ea1i c\u01a1 th\u1ec3 \u0111\u1ec3 t\u1ea5n c\u00f4ng ung th\u01b0. Ch\u00fang \u0111\u00e3 th\u00e0nh c\u00f4ng trong ung th\u01b0 h\u1eafc t\u1ed1 (melanoma) v\u1edbi t\u1ef7 l\u1ec7 \u0111\u00e1p \u1ee9ng 49-72%.<\/p>\n\n\n\n

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        • \u1ee8ng d\u1ee5ng trong HCC:<\/strong> Trong HCC, TILs th\u01b0\u1eddng b\u1ecb ki\u1ec7t s\u1ee9c (exhausted), bi\u1ec3u hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u nh\u01b0 TIM-3 v\u00e0 LAG-3, l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng ti\u1ebft cytokine ch\u1ed1ng ung th\u01b0. C\u00e1c nghi\u00ean c\u1ee9u ti\u1ec1n l\u00e2m s\u00e0ng cho th\u1ea5y vi\u1ec7c ch\u1eb7n TIGIT v\u00e0 PD-1 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a TILs. Tuy nhi\u00ean, hi\u1ec7n t\u1ea1i ch\u1ec9 c\u00f3 m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng (NCT04538313) \u0111ang nghi\u00ean c\u1ee9u TILs cho HCC t\u00e1i ph\u00e1t nguy c\u01a1 cao, v\u00e0 ch\u01b0a c\u00f3 nhi\u1ec1u d\u1eef li\u1ec7u l\u00e2m s\u00e0ng. C\u1ea7n th\u00eam nghi\u00ean c\u1ee9u \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ti\u1ec1m n\u0103ng c\u1ee7a TILs trong HCC.<\/li>\n<\/ul>\n\n\n\n
          \n\n\n\n

          7. CAR-T l\u00e0 g\u00ec v\u00e0 n\u00f3 \u0111\u01b0\u1ee3c d\u00f9ng th\u1ebf n\u00e0o cho HCC?<\/h4>\n\n\n\n

          H\u1ecfi:<\/strong> CAR-T l\u00e0 g\u00ec? N\u00f3 ho\u1ea1t \u0111\u1ed9ng ra sao trong \u0111i\u1ec1u tr\u1ecb HCC?
          \u0110\u00e1p:<\/strong> CAR-T (Chimeric Antigen Receptor T-cells) l\u00e0 t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c ch\u1ec9nh s\u1eeda gen \u0111\u1ec3 mang m\u1ed9t th\u1ee5 th\u1ec3 nh\u00e2n t\u1ea1o (CAR) nh\u1eadn di\u1ec7n kh\u00e1ng nguy\u00ean tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o ung th\u01b0 m\u00e0 kh\u00f4ng c\u1ea7n qua MHC. CAR-T \u0111\u00e3 r\u1ea5t th\u00e0nh c\u00f4ng trong ung th\u01b0 m\u00e1u (nh\u01b0 CD19-CAR-T cho b\u1ec7nh b\u1ea1ch c\u1ea7u).<\/p>\n\n\n\n

            \n
          • \u1ee8ng d\u1ee5ng trong HCC:<\/strong> CAR-T \u0111ang \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m cho HCC v\u1edbi c\u00e1c m\u1ee5c ti\u00eau nh\u01b0:\n
              \n
            • Glypican-3 (GPC3):<\/strong> M\u1ed9t protein tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o HCC (72% tr\u01b0\u1eddng h\u1ee3p), \u00edt xu\u1ea5t hi\u1ec7n \u1edf m\u00f4 l\u00e0nh. Th\u1eed nghi\u1ec7m giai \u0111o\u1ea1n I cho th\u1ea5y CAR-T nh\u1eafm GPC3 an to\u00e0n, v\u1edbi 1\/13 b\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng m\u1ed9t ph\u1ea7n (PR), nh\u01b0ng hi\u1ec7u qu\u1ea3 c\u00f2n h\u1ea1n ch\u1ebf (OS trung b\u00ecnh 1 n\u0103m l\u00e0 42%).<\/li>\n\n\n\n
            • Alpha-fetoprotein (AFP):<\/strong> M\u1ed9t protein trong t\u1ebf b\u00e0o HCC, \u0111\u01b0\u1ee3c nh\u1eafm qua MHC. CAR-T nh\u1eafm AFP cho th\u1ea5y hi\u1ec7u qu\u1ea3 trong m\u00f4 h\u00ecnh ti\u1ec1n l\u00e2m s\u00e0ng, nh\u01b0ng th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng (NCT03349255) \u0111\u00e3 b\u1ecb d\u1eebng m\u00e0 ch\u01b0a c\u00f3 k\u1ebft qu\u1ea3.<\/li>\n\n\n\n
            • c-MET:<\/strong> M\u1ed9t th\u1ee5 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u0103ng tr\u01b0\u1edfng kh\u1ed1i u, CAR-T nh\u1eafm c-MET + PD-L1 cho k\u1ebft qu\u1ea3 t\u1ed1t trong m\u00f4 h\u00ecnh ti\u1ec1n l\u00e2m s\u00e0ng.<\/li>\n\n\n\n
            • MUC1:<\/strong> M\u1ed9t protein m\u00e0ng li\u00ean quan \u0111\u1ebfn di c\u0103n, \u0111ang th\u1eed nghi\u1ec7m (NCT02587689).<\/li>\n\n\n\n
            • NKG2DL:<\/strong> M\u1ed9t protein tr\u00ean HCC, CAR-T nh\u1eafm NKG2DL hi\u1ec7u qu\u1ea3 trong m\u00f4 h\u00ecnh ti\u1ec1n l\u00e2m s\u00e0ng, nh\u01b0ng ch\u01b0a c\u00f3 d\u1eef li\u1ec7u l\u00e2m s\u00e0ng r\u00f5 r\u00e0ng.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
            • Th\u00e1ch th\u1ee9c:<\/strong> CAR-T g\u1eb7p kh\u00f3 kh\u0103n trong HCC do thi\u1ebfu kh\u00e1ng nguy\u00ean \u0111\u1eb7c hi\u1ec7u, m\u00f4i tr\u01b0\u1eddng \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch trong kh\u1ed1i u v\u00e0 nguy c\u01a1 \u0111\u1ed9c t\u00ednh ngo\u00e0i m\u1ee5c ti\u00eau. C\u00e1c th\u1ebf h\u1ec7 CAR-T m\u1edbi (th\u1ebf h\u1ec7 3, 4) v\u1edbi cytokine nh\u01b0 IL-15\/IL-21 \u0111ang \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3.<\/li>\n<\/ul>\n\n\n\n
              \n\n\n\n

              8. TCR-T l\u00e0 g\u00ec v\u00e0 n\u00f3 kh\u00e1c CAR-T nh\u01b0 th\u1ebf n\u00e0o?<\/h4>\n\n\n\n

              H\u1ecfi:<\/strong> TCR-T l\u00e0 g\u00ec? N\u00f3 kh\u00e1c CAR-T \u1edf \u0111i\u1ec3m n\u00e0o khi \u0111i\u1ec1u tr\u1ecb HCC?
              \u0110\u00e1p:<\/strong> TCR-T (T-Cell Receptor Transduced T-cells) l\u00e0 t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c ch\u1ec9nh s\u1eeda gen \u0111\u1ec3 mang th\u1ee5 th\u1ec3 TCR \u0111\u1eb7c hi\u1ec7u nh\u1eadn di\u1ec7n kh\u00e1ng nguy\u00ean b\u00ean trong t\u1ebf b\u00e0o ung th\u01b0 qua ph\u1ee9c h\u1ee3p MHC.<\/p>\n\n\n\n

                \n
              • Kh\u00e1c bi\u1ec7t v\u1edbi CAR-T:<\/strong>\n
                  \n
                • CAR-T nh\u1eafm kh\u00e1ng nguy\u00ean b\u1ec1 m\u1eb7t, kh\u00f4ng c\u1ea7n MHC, trong khi TCR-T nh\u1eafm kh\u00e1ng nguy\u00ean n\u1ed9i b\u00e0o qua MHC, \u0111\u00f2i h\u1ecfi kh\u1edbp HLA (th\u01b0\u1eddng l\u00e0 HLA-A*02:01).<\/li>\n\n\n\n
                • TCR-T c\u00f3 th\u1ec3 nh\u1eafm c\u00e1c m\u1ee5c ti\u00eau s\u00e2u h\u01a1n trong t\u1ebf b\u00e0o, nh\u01b0ng b\u1ecb gi\u1edbi h\u1ea1n b\u1edfi y\u00eau c\u1ea7u HLA, l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                • \u1ee8ng d\u1ee5ng trong HCC:<\/strong>\n
                    \n
                  • AFP:<\/strong> TCR-T nh\u1eafm AFP 158\u2013166 (NCT03132792) cho th\u1ea5y 5\/5 b\u1ec7nh nh\u00e2n \u0111\u1ea1t \u1ed5n \u0111\u1ecbnh b\u1ec7nh (SD) \u1edf li\u1ec1u th\u1ea5p, 1\/3 \u0111\u1ea1t PR \u1edf li\u1ec1u cao, an to\u00e0n t\u1ed1t.<\/li>\n\n\n\n
                  • HBV:<\/strong> TCR-T nh\u1eafm kh\u00e1ng nguy\u00ean virus vi\u00eam gan B (HBsAg) gi\u1ea3m t\u1ea3i l\u01b0\u1ee3ng virus \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n sau gh\u00e9p gan m\u00e0 kh\u00f4ng g\u00e2y h\u1ea1i m\u00f4 l\u00e0nh.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                  • Ti\u1ec1m n\u0103ng:<\/strong> TCR-T ph\u00f9 h\u1ee3p cho HCC li\u00ean quan \u0111\u1ebfn HBV, nh\u01b0ng c\u1ea7n c\u1ea3i thi\u1ec7n \u0111\u1ed9 nh\u1ea1y v\u00e0 gi\u1ea3m nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan l\u00e0nh.<\/li>\n<\/ul>\n\n\n\n
                    \n\n\n\n

                    9. Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o c\u00f3 an to\u00e0n kh\u00f4ng? C\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 g\u00ec?<\/h4>\n\n\n\n

                    H\u1ecfi:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o c\u00f3 r\u1ee7i ro g\u00ec kh\u00f4ng? T\u00f4i c\u00f3 th\u1ec3 g\u1eb7p t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0o?
                    \u0110\u00e1p:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o c\u00f3 ti\u1ec1m n\u0103ng nh\u01b0ng c\u0169ng \u0111i k\u00e8m r\u1ee7i ro:<\/p>\n\n\n\n

                      \n
                    • CIK:<\/strong> Th\u01b0\u1eddng an to\u00e0n, \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng, kh\u00f4ng g\u00e2y GvHD.<\/li>\n\n\n\n
                    • TILs:<\/strong> Ch\u01b0a c\u00f3 d\u1eef li\u1ec7u l\u00e2m s\u00e0ng \u0111\u1ee7 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1, nh\u01b0ng c\u00f3 th\u1ec3 g\u00e2y m\u1ec7t m\u1ecfi do IL-2 d\u00f9ng k\u00e8m.<\/li>\n\n\n\n
                    • CAR-T:<\/strong>\n
                        \n
                      • H\u1ed9i ch\u1ee9ng gi\u1ea3i ph\u00f3ng cytokine (CRS): 69% b\u1ec7nh nh\u00e2n GPC3-CAR-T g\u1eb7p CRS (nh\u1eb9), 1\/13 t\u1eed vong do CRS c\u1ea5p 5.<\/li>\n\n\n\n
                      • \u0110\u1ed9c t\u00ednh ngo\u00e0i m\u1ee5c ti\u00eau: C\u00f3 th\u1ec3 t\u1ea5n c\u00f4ng m\u00f4 l\u00e0nh n\u1ebfu kh\u00e1ng nguy\u00ean xu\u1ea5t hi\u1ec7n \u1edf \u0111\u00f3.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                      • TCR-T:<\/strong> An to\u00e0n t\u1ed1t trong th\u1eed nghi\u1ec7m AFP, nh\u01b0ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan l\u00e0nh \u1edf HCC li\u00ean quan HBV.
                        C\u00e1c nh\u00e0 khoa h\u1ecdc \u0111ang ph\u00e1t tri\u1ec3n \u201cc\u00f4ng t\u1eafc an to\u00e0n\u201d (nh\u01b0 h\u1ec7 th\u1ed1ng tet-on v\u1edbi doxycycline) \u0111\u1ec3 ki\u1ec3m so\u00e1t ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o T, gi\u1ea3m \u0111\u1ed9c t\u00ednh.<\/li>\n<\/ul>\n\n\n\n
                        \n\n\n\n

                        10. T\u01b0\u01a1ng lai c\u1ee7a li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o cho HCC l\u00e0 g\u00ec?<\/h4>\n\n\n\n

                        H\u1ecfi:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o s\u1ebd ph\u00e1t tri\u1ec3n nh\u01b0 th\u1ebf n\u00e0o \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n HCC trong t\u01b0\u01a1ng lai?
                        \u0110\u00e1p:<\/strong> Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o cho HCC c\u00f2n \u1edf giai \u0111o\u1ea1n \u0111\u1ea7u, nh\u01b0ng c\u00f3 nhi\u1ec1u h\u01b0\u1edbng ph\u00e1t tri\u1ec3n:<\/p>\n\n\n\n

                          \n
                        • C\u1ea3i thi\u1ec7n CAR-T:<\/strong> T\u0103ng kh\u1ea3 n\u0103ng nh\u1eadn di\u1ec7n kh\u1ed1i u, v\u01b0\u1ee3t qua m\u00f4i tr\u01b0\u1eddng \u1ee9c ch\u1ebf (d\u00f9ng cytokine nh\u01b0 IL-15\/IL-21), gi\u1ea3m \u0111\u1ed9c t\u00ednh b\u1eb1ng c\u00f4ng ngh\u1ec7 m\u1edbi.<\/li>\n\n\n\n
                        • TCR-T:<\/strong> T\u1ed1i \u01b0u h\u00f3a \u0111\u1ed9 nh\u1ea1y TCR, m\u1edf r\u1ed9ng \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n qua c\u00e1c HLA kh\u00e1c.<\/li>\n\n\n\n
                        • K\u1ebft h\u1ee3p li\u1ec7u ph\u00e1p:<\/strong> D\u00f9ng CIK, CAR-T ho\u1eb7c TCR-T v\u1edbi ICIs, TKIs ho\u1eb7c TACE \u0111\u1ec3 t\u0103ng hi\u1ec7u qu\u1ea3.<\/li>\n\n\n\n
                        • C\u00e1 nh\u00e2n h\u00f3a:<\/strong> Ph\u00e2n t\u00edch kh\u1ed1i u \u0111\u1ec3 ch\u1ecdn m\u1ee5c ti\u00eau t\u1ed1t nh\u1ea5t cho t\u1eebng b\u1ec7nh nh\u00e2n.
                          D\u00f9 c\u00f2n nhi\u1ec1u th\u00e1ch th\u1ee9c (nh\u01b0 chi ph\u00ed, s\u1ea3n xu\u1ea5t ph\u1ee9c t\u1ea1p), li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o h\u1ee9a h\u1eb9n s\u1ebd tr\u1edf th\u00e0nh m\u1ed9t ph\u1ea7n quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb HCC trong t\u01b0\u01a1ng lai.<\/li>\n<\/ul>\n\n\n\n
                          \n\n\n\n

                          <\/p>\n","protected":false},"excerpt":{"rendered":"

                          ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n Th\u00e0nh vi\u00ean h\u1ed9i Nghi\u00ean C\u1ee9u Gan Ch\u00e2u \u00c2u 1. Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) l\u00e0 g\u00ec v\u00e0 t\u1ea1i sao n\u00f3 nguy hi\u1ec3m?…<\/p>\n","protected":false},"author":1,"featured_media":3263,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[131],"tags":[67,84,52,69],"jetpack_featured_media_url":"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7500-1.jpg","_links":{"self":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3265"}],"collection":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/comments?post=3265"}],"version-history":[{"count":1,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3265\/revisions"}],"predecessor-version":[{"id":3266,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3265\/revisions\/3266"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media\/3263"}],"wp:attachment":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media?parent=3265"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/categories?post=3265"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/tags?post=3265"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}