120万元一针的抗癌药，凭什么这么贵？仅仅靠打针真的能将癌细胞清零吗？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><strong style="color: blue;"><strong style="color: blue;"><strong style="color: blue;"><a style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_png/BDvLA7hOQ63sodccllrkIR63A6icdDRNxzRozDJCCZeJZj7wwe0eDMLJYScdicp6T4qcX0I1hV0AZXyPXmyHoLVQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></a></strong></strong></strong></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">大众</span>都<span style="color: black;">晓得</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">癌症是一种治疗<span style="color: black;"><strong style="color: blue;"><span style="color: black;">周期长</span></strong></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">治疗<span style="color: black;"><strong style="color: blue;"><span style="color: black;">难度大</span></strong></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">况且</span>会给<span style="color: black;">病人</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">生命带来巨大威胁</span></strong></span>的<span style="color: black;">疾患</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">但<span style="color: black;">近期</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">网络上<span style="color: black;">显现</span>了一种“神药”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">仅需一针就能将癌细胞清零</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">到底怎么回事呢？</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXYJ4JunlkfRs4iaykmHgRKnK17wgIP2DPYnxW9Z9Bxb9bbvjk4l5x72g/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">今年8月26日，肿瘤<span style="color: black;">病人</span>陈阿姨从上海某医院顺利出院，她刚接受了嵌合抗原受体T细胞免疫疗法，<span style="color: black;">亦</span><span style="color: black;">便是</span><span style="color: black;">咱们</span>说的CAR-T回输治疗。初步<span style="color: black;">评定</span><span style="color: black;">疾患</span>完全缓解，<span style="color: black;">亦</span><span style="color: black;">便是</span><span style="color: black;">媒介</span><span style="color: black;">报告</span>的“<span style="color: black;"><strong style="color: blue;"><span style="color: black;">癌细胞清零</span></strong>”</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">然而，随着陈阿姨一张120万元/袋（约68ml）的“天价账单”<span style="color: black;">揭发</span>，<span style="color: black;">亦</span>引来社会各界的质疑：<span style="color: black;"><strong style="color: blue;"><span style="color: black;">120万元一针</span></strong></span>的抗癌药，凭什么这么贵？仅仅靠打针真的能杀死肿瘤细胞吗？</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">其实，这针抗癌“神药”在咱们四川省肿瘤医院<span style="color: black;">亦</span>能进行，医院从今年9月正式开展基于CART回输治疗的临床<span style="color: black;">实验</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">本期，<span style="color: black;">咱们</span>邀请到四川省肿瘤医院肿瘤<span style="color: black;">基本</span><span style="color: black;">科研</span>中心<span style="color: black;">专家</span>杨牧，为<span style="color: black;">大众</span>讲讲这其中的奥秘。</span></p><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibu0Yia00ScImDpgAaOnVnibx94Y3KH2QwzLM74TnjxPZNbCTtw1vg9nnnwtHviczJzBE6ayAV9loxp9g/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">120万元一针的抗癌神药是啥？</strong></span></p><span style="color: black;">其实，这种治疗<span style="color: black;">办法</span>叫做<span style="color: black;">：<strong style="color: blue;"><span style="color: black;">CAR-T</span></strong></span>，全<span style="color: black;">叫作</span>为嵌合抗原受体T细胞免疫疗法，<span style="color: black;"><strong style="color: blue;"><span style="color: black;">是一种经过人工改造，让T细胞能特异性识别并杀死肿瘤细胞的全新治疗方式。</span></strong></span></span><span style="color: black;">T细胞是人体免疫系统<span style="color: black;">要紧</span>的<span style="color: black;">构成</span>部分，承担着过继免疫的功能，<span style="color: black;">重点</span>负责对病原微生物的<span style="color: black;"><strong style="color: blue;"><span style="color: black;">识别</span></strong>和<strong style="color: blue;"><span style="color: black;">清除</span></strong>。</span></span><img src="https://mmbiz.qpic.cn/mmbiz_gif/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmX1kWSXn4YJr8lRDBFic5Oh1RZfKQkUProap35u2tbDJu50bbYPwMUHEg/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">从<span style="color: black;">日前</span>肿瘤的起源来讲，T细胞<span style="color: black;">显现</span>耗竭或肿瘤细胞对T细胞产生免疫逃逸是肿瘤<span style="color: black;">出现</span>和复发转移的<span style="color: black;">重点</span><span style="color: black;">原因</span>之一。</span><span style="color: black;"><span style="color: black;">因此呢</span>，CAR-T回输治疗的<span style="color: black;">重点</span>机制是对肿瘤<span style="color: black;">病人</span><span style="color: black;">身体</span>的T细胞进行<span style="color: black;">“<strong style="color: blue;"><span style="color: black;">强化</span></strong>”。<span style="color: black;">重点</span>目的有两个：<span style="color: black;">首要</span>是赋予T细胞对肿瘤细胞识别的能力，做到<strong style="color: blue;"><span style="color: black;"><span style="color: black;">精细</span>杀伤</span></strong>。其次是对T细胞进行激活，<span style="color: black;">增多</span>其<strong style="color: blue;"><span style="color: black;">清除肿瘤细胞</span></strong></span>的能力。</span><span style="color: black;">简单来讲，这种治疗<span style="color: black;">重点</span>分为四步：</span><span style="color: black;">1.从肿瘤<span style="color: black;">病人</span>身上分离CD8阳性T细胞。</span><span style="color: black;">2. 利用基因工程技术对CD8阳性T细胞受体进行改造，让它<span style="color: black;">作为</span>能特异性地识别并攻击肿瘤细胞的CAR-T细胞。</span><span style="color: black;">3. <span style="color: black;">经过</span>实验室技术，在<span style="color: black;">保准</span>其活性和特异性的<span style="color: black;">基本</span>上，对CAR-T细胞进行<span style="color: black;">海量</span>扩增。<span style="color: black;">一般</span>来讲，数量在千万级。</span><span style="color: black;">4.将扩增好的CAR-T细胞回输至<span style="color: black;">病人</span><span style="color: black;">身体</span>，<span style="color: black;">同期</span>严密监测治疗效果，<span style="color: black;">病人</span>临床症状缓解和<span style="color: black;">关联</span>副<span style="color: black;">功效</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXibEpOshpjAm7ibc4hYgYgDvmSPiaorGNic2FQlJm1D0ROuR8RtETVmRAqw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">打一针真能让癌细胞清零？</strong></span></p><span style="color: black;">从原理上来讲，<span style="color: black;"><strong style="color: blue;"><span style="color: black;">这种<span style="color: black;">状况</span>是有可能<span style="color: black;">出现</span>的</span></strong></span>。</span><span style="color: black;">CAR-T回输治疗属于免疫细胞回输治疗的一种，<span style="color: black;">经过</span>改造CD8阳性T细胞的受体而<span style="color: black;">最后</span>实现<span style="color: black;">有效</span>和特异性清除肿瘤细胞的目的。</span><span style="color: black;"><span style="color: black;">因此呢</span>，只要能保持肿瘤抗原特异性T细胞的<span style="color: black;"><strong style="color: blue;"><span style="color: black;">数量</span></strong>，<strong style="color: blue;"><span style="color: black;">活性</span></strong>和<strong style="color: blue;"><span style="color: black;">功能</span></strong>，<strong style="color: blue;"><span style="color: black;">完全清除肿瘤<span style="color: black;">无</span>问题</span></strong>。</span></span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXM1mBpRIYzxCP9Zwb5IGwSgBtIC8tCkZpwqRf2zXicAXgjqqD5a07yzQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">初步临床<span style="color: black;">实验</span>结果<span style="color: black;">表示</span>，接受治疗的<span style="color: black;">病人</span>客观缓解率高达<strong style="color: blue;"><span style="color: black;">90%</span></strong>。<span style="color: black;">因此呢</span>，以上初步结果<span style="color: black;">能够</span>用“非常惊人”来形容，<span style="color: black;">亦</span><span style="color: black;">导致</span>社会舆论的<span style="color: black;">极重</span>关注。</span><span style="color: black;"><span style="color: black;">咱们</span>认为，CAR-T回输治疗为一线和二线治疗失败，<span style="color: black;">亦</span><span style="color: black;">便是</span>说对<span style="color: black;">最少</span>两个不同治疗<span style="color: black;">方法</span><span style="color: black;">没</span>效或产生抵抗的血液肿瘤<span style="color: black;">病人</span>带来了巨大<span style="color: black;">期盼</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXWIH4tdrp5GxTTmD1QMdBVGWO71wDXdd2eYHgKXbgpjb0RUGbWYf4cA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">这一针，对<span style="color: black;">那些</span>肿瘤有效？</strong></span></p><span style="color: black;"><span style="color: black;">日前</span>，CAR-T回输治疗<span style="color: black;">重点</span>应用于：</span><strong style="color: blue;"><span style="color: black;">1.弥漫性大B细胞淋巴瘤</span></strong><strong style="color: blue;"><span style="color: black;">2.滤泡性淋巴瘤</span></strong><strong style="color: blue;"><span style="color: black;">3.套细胞淋巴瘤</span></strong><strong style="color: blue;"><span style="color: black;">4.多发性骨髓瘤</span></strong><strong style="color: blue;"><span style="color: black;">5.B细胞急性淋巴细胞白血病</span></strong><strong style="color: blue;"><span style="color: black;">6.其他血液系统肿瘤</span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">为啥一针这么贵？</strong></span></p><span style="color: black;"><span style="color: black;">首要</span>，从CAR-T回输治疗中用到的肿瘤抗原特异性CD8阳性T细胞的分离，扩增，乃至肿瘤抗原特异性和免疫杀伤功能<span style="color: black;">得到</span>来讲，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">过程</span>繁琐</span></strong>，且<span style="color: black;">触及</span>到<span style="color: black;">海量</span>流程和质控。</span><span style="color: black;">其次，<span style="color: black;">因为</span><span style="color: black;">病人</span>之间在免疫背景，病情<span style="color: black;">发展</span>，以及<span style="color: black;">自己</span>身体<span style="color: black;">前提</span>等方面的差异，肿瘤抗原特异性CD8阳性T细胞的制备<span style="color: black;">日前</span>只能<span style="color: black;">按照</span>每位<span style="color: black;">病人</span>的<span style="color: black;">状况</span>“<strong style="color: blue;"><span style="color: black;">量身定制</span></strong>”，<span style="color: black;">无</span>办法“批量生产”。</span><span style="color: black;"><span style="color: black;">因此呢</span>，<span style="color: black;">因为</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">没</span>法规模化应用</span></strong>，<span style="color: black;">关联</span>临床和实验室人力成本在<span style="color: black;">短期</span>内很难降低。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXkJU3cYEKnibuUSeGCb2ibDYDVF1DVgePicmrZHKnm63ClpQGibSR2EibBGQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">打这一针有<span style="color: black;">危害</span>吗？</strong></span></p><span style="color: black;">虽然CAR-T回输治疗疗效<span style="color: black;">明显</span>，<span style="color: black;">然则</span>其<span style="color: black;">亦</span>会<span style="color: black;">引起</span>某些<span style="color: black;">平常</span>的<strong style="color: blue;"><span style="color: black;">免疫<span style="color: black;">关联</span>不良反应</span></strong>。</span><span style="color: black;">最<span style="color: black;">平常</span>为“细胞因子风暴”，<span style="color: black;">亦</span><span style="color: black;">便是</span>细胞因子的过量释放，<span style="color: black;">引起</span><span style="color: black;"><strong style="color: blue;">系统性炎症</strong></span>的<span style="color: black;">出现</span>，<span style="color: black;">从而</span>产生多器官<span style="color: black;">损害</span>。</span><span style="color: black;">其次，CAR-T回输治疗对<span style="color: black;">病人</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">中枢神经系统</span></strong>以及<strong style="color: blue;"><span style="color: black;">肠道微生物</span></strong>的影响<span style="color: black;">亦</span>有<span style="color: black;">报告</span>。</span></span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmX5wcrfv3FX7rwJsQBtauAyuB8UAGwqL2ypSLSybnSgNjIibzv3iaKhNibQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><span style="color: black;">平常</span>的临床症状<span style="color: black;">包含</span>系统性炎症，<span style="color: black;">自己</span>免疫性<span style="color: black;">疾患</span>，神经毒性以及肠炎等，<span style="color: black;">少许</span><span style="color: black;">出现</span>严重免疫<span style="color: black;">关联</span>不良反应的<span style="color: black;">病人</span>，还需在重症监护室进行护理。</span><span style="color: black;"><span style="color: black;">然则</span>，<span style="color: black;">咱们</span>相信，随着CAR-T回输治疗在诊疗策略上的改进和完善，以上免疫<span style="color: black;">关联</span>不良反应在<span style="color: black;">必定</span>程度上能得到<span style="color: black;">处理</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXGV8GibwXeV01te8BWF7my1Hlrv9DY78nS3z8zYMYU0vKrDNBCib7gVxw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><span style="color: black;">因此呢</span>，<span style="color: black;">大众</span>应理性看待CAR-T回输治疗这一新疗法，<span style="color: black;">不可</span>将其看作百利而<span style="color: black;">没</span>一害的“灵丹妙药”。</span><span style="color: black;">CAR-T<span style="color: black;">日前</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">重点</span>应用于其他治疗<span style="color: black;">方法</span><span style="color: black;">没</span>效或耐受后的备选<span style="color: black;">方法</span>，而非首选。</span></strong></span></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">癌症治疗的新<span style="color: black;">将来</span>到了？</strong></span></p><span style="color: black;"><span style="color: black;">日前</span>，CAR-T回输治疗在<span style="color: black;"><strong style="color: blue;"><span style="color: black;">血液系统肿瘤的治疗</span></strong></span>上有<span style="color: black;">明显</span>的效果。</span><span style="color: black;">纵观<span style="color: black;">日前</span>肿瘤的<span style="color: black;">出现</span>率以及发病趋势，CAR-T回输治疗对实体瘤的治疗<span style="color: black;">功效</span>才是<span style="color: black;">咱们</span><span style="color: black;">将来</span>开展的<span style="color: black;">重点</span><span style="color: black;">科研</span>方向。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXZZn5YTkZuGJT1cDaNZsV1fSwTbEA4F0IXG7yYGhDSB8ibaGUkrmkCkw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">从原理上来讲，CAR-T回输治疗针对不同起源于器官的实体肿瘤<span style="color: black;">亦</span>有良好的效果，<span style="color: black;">然则</span><span style="color: black;">必须</span><span style="color: black;">创立</span>在坚实的临床<span style="color: black;">实验</span><span style="color: black;">基本</span>以及规范的诊疗策略上，<span style="color: black;">亦</span><span style="color: black;">便是</span>说，随着进一步厘清CAR-T回输治疗的机制以及完善治疗前各项辅助<span style="color: black;">检测</span>，尤其是CD8阳性T细胞精细亚群，免疫学功能和特异性等问题，<span style="color: black;">咱们</span>相信CAR-T回输治疗适应症人群会更加广泛。</span><span style="color: black;"><span style="color: black;">另一</span>，从<span style="color: black;">日前</span>的治疗<span style="color: black;">花费</span>上来讲， 120万元中国绝大部分家庭<span style="color: black;">来讲</span>是一个天文数字。<span style="color: black;">然则</span>，随着诊疗技术的<span style="color: black;">加强</span>，程序的标准化，乃至国家<span style="color: black;">关联</span>政策的出台，<span style="color: black;">病人</span>及家属所<span style="color: black;">必须</span>承担的<span style="color: black;"><strong style="color: blue;"><span style="color: black;">治疗<span style="color: black;">花费</span></span></strong>肯定会<strong style="color: blue;"><span style="color: black;">有所下降</span></strong>。</span></span><img src="https://mmbiz.qpic.cn/mmbiz_gif/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXnd0Y8uZDJJvQocBVfHUpX74LcoklOurFGzhDxhGJuHGAgPXlq0wWtQ/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">最后，<span style="color: black;">做为</span>有望治愈癌症的<span style="color: black;">要紧</span>治疗方式，<span style="color: black;">没</span>论是CAR-T还是免疫检测点<span style="color: black;">控制</span>剂治疗，<span style="color: black;">针对</span><span style="color: black;">日前</span>部分适应症<span style="color: black;">病人</span>的生活质量和<span style="color: black;">存活</span>周期都带来了重大益处，是<span style="color: black;">日前</span>肿瘤诊疗<span style="color: black;">要紧</span>的发展方向。</span><span style="color: black;"><span style="color: black;">综上所述，CAR-T回输治疗<span style="color: black;">没</span>论在<span style="color: black;">全世界</span>范围，还是在我国，仍<span style="color: black;">处在</span>起步<span style="color: black;">周期</span>。其中的机制，<span style="color: black;">关联</span>诊疗策略，适应症，乃至经济毒性<span style="color: black;">原因</span>等问题还有待进一步探索，<span style="color: black;">因此</span><span style="color: black;">大众</span><span style="color: black;">必定</span>要</span><span style="color: black;"><strong style="color: blue;">理性看待！</strong></span></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/8zPGaMG1jibs311RQ6UmOd1BpAsibfwjmXSMJzHLHRoaRAxXZPhoHvWXianmPZJ6ibO7HPmia8dqiaQjegFVGu3Hf7Zw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">源自</span>：四川省肿瘤医院</span></p>
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