amakuru

Immunotherapy yazanye impinduka zimpinduramatwara mu kuvura ibibyimba bibi, ariko haracyari abarwayi bamwe badashobora kubyungukiramo. Kubwibyo, biomarkers ikwiye irakenewe byihutirwa mubisabwa kwa muganga kugirango hamenyekane akamaro ka immunotherapie, kugirango bigerweho neza kandi birinde uburozi budakenewe.

FDA yemeye biomarkers

Imvugo ya PD-L1. Isuzumabumenyi ryerekana urwego PD-L1 rwakozwe na immunohistochemie (IHC) ritanga amanota yikigereranyo cyibibyimba (TPS), ni ijanisha ryigice cyangwa igice cyuzuye cyanduye kanseri yibibyimba byingirabuzimafatizo iyo ari yo yose ikomeza kubaho. Mu bigeragezo bivura, iki kizamini ni nk'ikizamini cyo kwisuzumisha cyo kuvura kanseri y'ibihaha yateye imbere itari nto (NSCLC) hamwe na pembrolizumab. Niba TPS yicyitegererezo ari ≥ 1%, imvugo ya PD-L1 irasuzumwa; TPS ≥ 50% yerekana imvugo yo hejuru ya PD-L1. Mu igeragezwa ryambere ryicyiciro cya mbere (KEYNOTE-001), igipimo cy’abarwayi bo mu itsinda rya PD-L1 TPS> 50% bakoresheje pembrolizumab cyari 45.2%, mu gihe hatitawe kuri TPS, igipimo cy’abarwayi bose bahabwa ubwo buvuzi bw’ubudahangarwa (ICI) cyari 19.4%. Ikigeragezo cyakurikiyeho 2/3 (KEYNOTE-024) cyahaye abarwayi abarwayi PD-L1 TPS> 50% kwakira pembrolizumab na chimiotherapie isanzwe, kandi ibisubizo byagaragaje ko hari iterambere ryagaragaye mubuzima rusange (OS) kubarwayi bahabwa imiti ya pembrolizumab.

Ariko, ikoreshwa rya PD-L1 muguhishurira ICI ibisubizo bigarukira kubintu bitandukanye. Ubwa mbere, inzira nziza yubwoko butandukanye bwa kanseri iratandukanye. Kurugero, Pabolizumab irashobora gukoreshwa mugihe ikibyimba PD-L1 cyerekana abarwayi bafite kanseri yo mu gifu, kanseri yo mu nda, kanseri y'uruhago na kanseri y'ibihaha ni 1%, 10% na 50%. Icya kabiri, gusuzuma umubare w'utugingo ngengabuzima twa PD-L1 biratandukanye bitewe n'ubwoko bwa kanseri. Kurugero, kuvura kanseri ya selile isubirwamo cyangwa metastatike kanseri yumutwe nijosi irashobora guhitamo gukoresha ubundi buryo bwemewe bwa FDA bwemewe, amanota meza (CPS). Icya gatatu, nta sano riri hagati yimvugo ya PD-L1 muri kanseri zitandukanye hamwe nigisubizo cya ICI, byerekana ko imiterere yibibyimba ishobora kuba ikintu cyingenzi mu guhanura ibinyabuzima bya ICI. Kurugero, ukurikije ibisubizo byikizamini cya CheckMate-067, agaciro keza ko guhanura imvugo ya PD-L1 muri melanoma ni 45% gusa. Hanyuma, ubushakashatsi bwinshi bwerekanye ko imvugo ya PD-L1 idahuye no gukomeretsa ibibyimba bitandukanye kumurwayi umwe, ndetse no mubyimba bimwe. Muri make, nubwo ibigeragezo byambere byubuvuzi bya NSCLC byatumye ubushakashatsi bwerekana imvugo ya PD-L1 nkibishobora guhanura biomarker, akamaro kayo kavuriro muburyo butandukanye bwa kanseri ntigisobanutse neza.

Tumor mutation umutwaro. Tumor Mutation Burden (TMB) yakoreshejwe nk'ikindi kimenyetso cyerekana ubudahangarwa bw'ikibyimba. Dukurikije ibyavuye mu isuzuma ry’amavuriro ya KEYNOTE-158, mu bwoko 10 bw’ibibyimba bikomeye byateye imbere bivurwa na pembrolizumab, abarwayi bafite byibura mutation 10 kuri megabase (TMB yo hejuru) bafite igisubizo cyinshi kurusha abafite TMB nkeya. Birakwiye ko tumenya ko muri ubu bushakashatsi, TMB yari yarahanuye PFS, ariko ntiyashoboye guhanura OS.

Igisubizo cyo gukingira indwara giterwa ahanini na T selile yo kumenya antigene nshya. Ubudahangarwa bujyanye na TMB yo hejuru nabwo buterwa nibintu bitandukanye, harimo ikibyimba neoantigen cyatanzwe nikibyimba; Sisitemu yubudahangarwa imenya ikibyimba neoantigens; Ubushobozi bwa nyiricyubahiro gutangiza ibisubizo byihariye bya antigen. Kurugero, amakuru yerekana ko ibibyimba byinjiye cyane mungirangingo zimwe na zimwe z'umubiri birashobora rwose kuba bifite ingirabuzimafatizo ya T selile (Treg) amplification ya clone. Byongeye kandi, urwego rwa TMB rushobora gutandukana nubushobozi bwa TMB neoantigens, kuko ikibanza nyacyo cya mutation nacyo kigira uruhare runini; Imihindagurikire ihuza inzira zitandukanye zo kwerekana antigen irashobora kugira ingaruka ku kwerekana (cyangwa kuterekana) antigene nshya kuri sisitemu y’umubiri, byerekana ko ibibyimba byinjira imbere n’ubudahangarwa bigomba kuba bihamye kugira ngo bitange ibisubizo byiza bya ICI.

Kugeza ubu, TMB ipimwa binyuze mu gisekuru kizaza (NGS), gishobora gutandukana mubigo bitandukanye (imbere) cyangwa urubuga rwubucuruzi rukoreshwa. NGS ikubiyemo ibintu byose bikurikirana (WES), uko genome ikurikirana, hamwe na gahunda ikurikirana, ishobora kuboneka mubice by'ibibyimba no kuzenguruka ibibyimba ADN (ctDNA). Birakwiye ko tumenya ko ubwoko bwibibyimba bitandukanye bifite TMB nyinshi, hamwe nibibyimba bikingira indwara nka melanoma, NSCLC, na kanseri ya selile kanseri ifite urwego rwo hejuru rwa TMB. Muri ubwo buryo, uburyo bwo gutahura bwagenewe ubwoko butandukanye bwibibyimba bufite ibisobanuro bitandukanye byindangagaciro za TMB. Mu bushakashatsi bwakozwe na NSCLC, melanoma, kanseri ya urothelia, na kanseri y'ibihaha ntoya, ubwo buryo bwo gutahura bukoresha uburyo butandukanye bwo gusesengura (nka WES cyangwa PCR gutahura imibare yihariye ya gen bifitanye isano) hamwe n'imbibi (TMB hejuru cyangwa TMB hasi).

Microsatellite ntigihungabana cyane. Microsatellite idahindagurika cyane (MSI-H), nka biomarker ya kanseri yibisubizo bya ICI, ifite imikorere myiza muguhishurira imikorere ya ICI muri kanseri zitandukanye. MSI-H ni ibisubizo byatewe no gusana bidahuye (dMMR), biganisha ku ihinduka ryinshi ry’imihindagurikire, cyane cyane mu turere twa microsatellite, bigatuma habaho umubare munini wa antigene nshya kandi amaherezo bikurura ubudahangarwa bw'umubiri. Bitewe numutwaro mwinshi uhindagurika uterwa na dMMR, ibibyimba bya MSI-H birashobora gufatwa nkubwoko bwumutwaro mwinshi (TMB). Hashingiwe ku bisubizo byo kwa muganga bya KEYNOTE-164 na KEYNOTE-158, FDA yemeye pembrolizumab yo kuvura ibibyimba bya MSI-H cyangwa dMMR. Uyu ni umwe mu miti ya mbere ya kanseri ya kanseri yemejwe na FDA itwarwa na biologiya yibibyimba aho kuba amateka.

Nubwo hari intsinzi ikomeye, hari nibibazo ugomba kumenya mugihe ukoresheje status ya MSI. Kurugero, abagera kuri 50% byabarwayi ba kanseri yibara ya dMMR nta gisubizo bafite cyo kuvura ICI, bagaragaza akamaro k’ibindi bice mu guhanura igisubizo. Ibindi bintu biranga ibibyimba bidashobora gusuzumwa nuburyo bugezweho bushobora kuba ibintu. Kurugero, hari amakuru yagiye avuga ko abarwayi bafite ihinduka ryimiterere ya gen zigizwe na catalitiki ikomeye ya polymerase delta (POLD) cyangwa polymerase ε (POLE) mukarere ka ADN babuze ubudahemuka kandi bagaragaza fenotipike ya "super mutation" mubyimba byabo. Bimwe muri ibyo bibyimba byongereye cyane ihungabana rya microsatellite (bityo bikaba ibya MSI-H), ariko poroteyine zo gusana zidahuye ntizabura (kubwibyo ntabwo dMMR).

Byongeye kandi, bisa na TMB, MSI-H nayo yibasiwe nubwoko bushya bwa antigen buterwa no guhungabana kwa microsatellite, kumenyekanisha kwakira ubwoko bushya bwa antigen, no kwakira sisitemu yubudahangarwa. Ndetse no mu bibyimba byo mu bwoko bwa MSI-H, umubare munini w’imihindagurikire ya nucleotide imwe yagaragaye ko ihinduka ry’abagenzi (mutation mutation). Kubwibyo, kwishingikiriza gusa ku mubare wa microsatellite yagaragaye mu kibyimba ntibihagije; Ubwoko nyabwo bwa mutation (bwamenyekanye binyuze mumiterere yihariye ya mutation) burashobora kunoza imikorere yo guhanura iyi biomarker. Byongeye kandi, umubare muto gusa w'abarwayi ba kanseri ni uw'ibibyimba bya MSI-H, byerekana ko hakenewe ubu biomarkers ikoreshwa cyane. Kubwibyo, kumenya izindi biomarkers zifatika zo guhanura imikorere no kuyobora imiyoborere yabarwayi iracyari igice cyingenzi cyubushakashatsi.

Ubushakashatsi bushingiye kuri biomarker

Bitewe nuko uburyo bwibikorwa bya ICI ari uguhindura ingirabuzimafatizo ziterwa n’umubiri aho kwibanda ku buryo butaziguye inzira y’imbere y’uturemangingo tw’ibibyimba, ubundi bushakashatsi bugomba kwibanda ku gusesengura mu buryo bwuzuye gahunda yo gukura kw'ibibyimba n'imikoranire hagati y'uturemangingo tw’ibibyimba na selile immunite, bishobora gufasha mu gusobanura ibintu bigira ingaruka ku gisubizo cya ICI. Amatsinda menshi yubushakashatsi yakoze ubushakashatsi ku kibyimba cyangwa ubudahangarwa bwubwoko bwihariye bwimitsi, nkibibyimba nibiranga ihinduka ryimiterere ya gene, ibibyimba antigen yerekana defisite, cyangwa ibigo byinshi birinda indwara cyangwa ibiterane (nka lymphoide yubatswe), bishobora guhanura ibisubizo byubudahangarwa bw'umubiri.

Abashakashatsi bifashishije NGS kugira ngo bakurikirane ikibyimba na immun exome hamwe na transcriptome yimitsi yabarwayi mbere na nyuma yo kuvura ICI, banakora isesengura ryerekana amashusho. Ukoresheje uburyo bwinshi bwahujwe, buhujwe nubuhanga nka selile imwe ikurikiranye hamwe nu mashusho yerekana ahantu, cyangwa moderi nyinshi za omics, ubushobozi bwo guhanura ibyavuye mubuvuzi bwa ICI bwaratejwe imbere. Byongeye kandi, uburyo bwuzuye bwo gusuzuma ibimenyetso byubudahangarwa bwibibyimba nibiranga ibibyimba byimbere nabyo byagaragaje ubushobozi bukomeye bwo guhanura. Kurugero, uburyo bwuzuye bwo gutondekanya icyiciro icyarimwe gipima ikibyimba nibiranga ubudahangarwa biruta impinduka imwe yisesengura. Ibi bisubizo byerekana ko ari ngombwa kwigana imikorere ya ICI mu buryo bwuzuye, harimo no gushyira mu bikorwa ibisubizo by’isuzuma ry’ubushobozi bw’ubudahangarwa bw'umubiri, ibimenyetso by’ibibyimba biva mu nda, hamwe n’ibigize ubudahangarwa bw’ibibyimba ku barwayi ku giti cyabo kugira ngo bamenye neza abarwayi bazitabira ubudahangarwa bw'umubiri.

Bitewe ningorabahizi zo kwinjiza ibibyimba nibintu byakiriwe mubushakashatsi bwibinyabuzima, hamwe nibishobora gukenerwa igihe kirekire cyo guhuza imiterere y’ibidukikije birinda umubiri, abantu batangiye gushakisha ibinyabuzima bakoresheje imashini ya mudasobwa no kwiga imashini. Kugeza ubu, ibyagezweho mu bushakashatsi byagaragaye muri uru rwego, byerekana ejo hazaza ha oncology yihariye ifashwa no kwiga imashini.

Inzitizi zihura na biomarkers

Imipaka yuburyo bwo gusesengura. Bimwe mubimenyetso bya biomarkers bikora neza mubwoko bumwe na bumwe bwibibyimba, ariko ntabwo byanze bikunze mubundi bwoko bwibibyimba. Nubwo ibibyimba byihariye bya gene bifite ubushobozi bwo guhanura kurusha TMB nizindi, ntibishobora gukoreshwa mugupima ibibyimba byose. Mu bushakashatsi bwibanze ku barwayi ba NSCLC, ibimenyetso byahinduwe na gene byagaragaye ko bihanura imikorere ya ICI kuruta TMB yo hejuru (≥ 10), ariko abarenga kimwe cya kabiri cy’abarwayi ntibashoboye kumenya ibimenyetso bya mutation ya gene.

Tumor heterogeneity. Uburyo bwa biomarker tissue bushingiye gusa kumurongo wikibyimba kimwe, bivuze ko gusuzuma ibice byihariye byibibyimba bidashobora kwerekana neza imvugo rusange yibibyimba byose kumurwayi. Kurugero, ubushakashatsi bwerekanye itandukaniro mumagambo ya PD-L1 hagati yibibyimba no mubibyimba, kandi ibibazo bisa nibibaho nibindi bimenyetso.

Bitewe nuburyo bugoye bwibinyabuzima, benshi bakoresheje tissue biomarkers bashobora kuba baroroshe. Byongeye kandi, selile zo muri microen ibidukikije (TME) zisanzwe zigendanwa, bityo imikoranire igaragara mubisesengura ryahantu ntishobora kwerekana imikoranire nyayo hagati ya selile na selile selile. Nubwo biomarkers ishobora kwerekana neza ibidukikije byose mugihe runaka, izi ntego zirashobora guterwa kandi bigahinduka mugihe runaka, byerekana ko ifoto imwe mugihe runaka idashobora kwerekana impinduka zikomeye.

Ihangane ry'abarwayi. Nubwo hamenyekana impinduka zishingiye ku ngirabuzima fatizo zijyanye no kurwanya ICI, abarwayi bamwe bitwaje biomarkers izwi cyane barashobora kubyungukiramo, bishoboka bitewe na molekuline na / cyangwa ubudahangarwa bw'umubiri mu kibyimba no ahantu hatandukanye. Kurugero, ibura rya 2-microglobuline (B2M) rishobora kwerekana imiti mishya cyangwa yungutse, ariko kubera itandukanyirizo ry’ibura rya B2M hagati yabantu no mubibyimba, ndetse n’imikoranire yuburyo bwo gusimbuza ubudahangarwa bw'umubiri muri aba barwayi, kubura B2M ntibishobora guhanura cyane kurwanya ibiyobyabwenge ku giti cye. Kubwibyo, nubwo hariho B2M ibura, abarwayi barashobora kungukirwa nubuvuzi bwa ICI.

Ishirahamwe rishingiye ku burebure bwa biomarkers
Imvugo ya biomarkers irashobora guhinduka mugihe hamwe ningaruka zo kuvura. Isuzuma rihamye kandi rimwe ryibibyimba na immunobiology birashobora kwirengagiza izi mpinduka, kandi impinduka zibyimba TME hamwe ninzego zokwirinda indwara nazo zishobora kwirengagizwa. Ubushakashatsi bwinshi bwerekanye ko kubona ingero mbere no mugihe cyo kuvura bishobora kumenya neza impinduka zijyanye no kuvura ICI. Ibi birerekana akamaro ko gusuzuma biomarker dinamike.

Amaraso ashingiye ku binyabuzima
Ibyiza byo gusesengura amaraso biri mubushobozi bwayo bwo gusuzuma ibinyabuzima byose bikomeretsa ibibyimba, bikagaragaza ibyasomwe ugereranije aho wasomye kurubuga, bigatuma bikwiriye cyane cyane gusuzuma impinduka zikomeye zijyanye no kuvura. Ibisubizo byinshi byubushakashatsi byagaragaje ko gukoresha ikibyimba kizunguruka ADN (ctDNA) cyangwa ingirabuzimafatizo ikwirakwiza (CTC) kugirango isuzume indwara nkeya zisigaye (MRD) zishobora kuyobora ibyemezo byo kuvura, ariko ibi bizamini bifite amakuru make yo guhanura niba abarwayi bashobora kungukirwa nubuvuzi nka ICI. Kubwibyo, kwipimisha ctDNA bigomba guhuzwa nubundi buryo bwo gupima ibikorwa byubudahangarwa cyangwa kwakira ubushobozi bwumubiri. Ni muri urwo rwego, intambwe imaze guterwa mu gukingira immunophenotyping ya selile periferique mononuclear selile (PBMCs) hamwe nisesengura rya proteomic ya viticles idasanzwe na plasma. Kurugero, insimburangingo ya immunifike ya selile (nka selile CD8 + T), kwerekana cyane molekile igenzura (nka PD1 kuri selile ya CD8 + T), hamwe no kuzamura urwego rwa poroteyine zitandukanye muri plasma (nka CXCL8, CXCL10, IL-6, IL-10, PRAP1, na VEGFA) byose bishobora kuba inyongera zingirakamaro kuri ctDNA. Ibyiza byubu buryo bushya nuko bashobora gusuzuma impinduka ziri mubyimba (bisa nimpinduka zagaragajwe na ctDNA) kandi birashobora no kwerekana impinduka mumikorere yumubiri wumurwayi.

Imirasire
Ibintu bihanura amakuru yishusho birashobora gutsinda neza imbogamizi za tissue biomarker sampling na biopsy, kandi irashobora kwitegereza ikibyimba cyose hamwe nizindi mbuga zishoboka mugihe icyo aricyo cyose. Kubwibyo, barashobora guhinduka igice cyingenzi cya biomarkers idafite imbaraga. Radiyo ya Delta irashobora kubara muburyo bwo guhindura impinduka mubiranga ibibyimba byinshi (nkubunini bwikibyimba) mugihe gitandukanye, nka mbere na nyuma yo kuvura ICI, mugihe cyo kuvura, no kubikurikirana. Imirasire ya Delta ntishobora guhanura gusa igisubizo cyambere cyangwa ntigisubizo kubuvuzi hakiri kare, ariko kandi irashobora kwerekana uburyo bwo kurwanya ICI mugihe nyacyo kandi ikagenzura ibizagaruka nyuma yo gukira burundu. Uburyo bwo gufata amashusho bwakozwe hifashishijwe ikoranabuhanga ryiga imashini nibyiza cyane kuruta ibisanzwe bya RECIST muguhishurira ibisubizo bivura nibishobora kubaho bibi. Ubushakashatsi bugezweho bwerekana ko ubwo buryo bwa radiomics bufite agace kari munsi yu murongo (AUC) kugeza kuri 0.8 kugeza 0,92 muguhishurira imiti ikingira indwara.

Iyindi nyungu ya radiomics nubushobozi bwayo bwo kumenya neza iterambere rya pseudo. Moderi ya radiomics yubatswe binyuze mumyigire yimashini irashobora gutandukanya neza iterambere ryukuri nibinyoma mugupima imibare ya CT cyangwa PET kuri buri kibyimba, harimo ibintu nkimiterere, ubukana, nuburyo, hamwe na AUC ya 0.79. Izi moderi za radiomics zirashobora gukoreshwa mugihe kizaza kugirango wirinde kurangiza hakiri kare imiti kubera kutamenya neza iterambere ryindwara.

Microbiota yo munda
Biyomarkers yo munda microbiota iteganijwe guhanura igisubizo cya ICI. Ubushakashatsi bwinshi bwerekanye ko microbiota yo mu nda yihariye ifitanye isano rya hafi no kuvura ubwoko butandukanye bwa kanseri mu kuvura ICI. Kurugero, kubarwayi barwaye kanseri ya melanoma na kanseri yumwijima, ubwinshi bwa bagiteri ya Ruminococcaceae ifitanye isano no gukingira indwara ya PD-1. Gutunganyiriza kwa Akkermansia muciniphila bikunze kugaragara ku barwayi barwaye kanseri y'umwijima, kanseri y'ibihaha, cyangwa kanseri y'impyiko, bitabira neza imiti ya ICI.

Byongeye kandi, uburyo bushya bwo kwiga imashini burashobora kwigenga kubwoko bwibibyimba no guhuza genera yihariye ya bagiteri hamwe nigisubizo cyo kuvura immunotherapie. Ubundi bushakashatsi bwerekanye kandi uruhare rwihariye amatsinda ya bagiteri agira mu kugenzura sisitemu y’umubiri yakira, bikomeza gushakisha uburyo bwo kwirinda cyangwa guteza imbere ubudahangarwa bw’uturemangingo twa kanseri.

Ubuvuzi bwa Neoadjuvant
Isuzuma rifatika ryibinyabuzima ryibibyimba birashobora kuyobora ingamba zo kuvura indwara. Ikigeragezo cya neoadjuvant gishobora gusuzuma ingaruka zo kuvura hakoreshejwe uburyo bwo kuvura indwara ziterwa no kubaga. Mu kuvura melanoma, igisubizo cyibanze cy’indwara (MPR) kijyanye no kubaho kwubusa kubaho. Mu igeragezwa rya PRADO, abashakashatsi bagena ingamba zikurikira zo gutabara kwa muganga, nko kubaga no / cyangwa kuvura bivura, bishingiye ku makuru yihariye yo kuvura abarwayi.

Mu bwoko butandukanye bwa kanseri, uburyo bushya bwo kuvura butandukanye buracyafite umutwe wo kugereranya umutwe. Kubwibyo, guhitamo hagati yubudahangarwa bwa mitiweli cyangwa kuvura bivura akenshi bifatirwa ibyemezo na muganga witabye umurwayi. Kugeza ubu, abashakashatsi bakoze gamma ya interferon (IFN gamma) ikubiyemo genes 10 nka biomarker yo guhanura indwara ya melanoma nyuma yo kuvura neoadjuvant. Bongeye kwinjiza ibyo bintu muri algorithm kugirango bahitemo abarwayi bafite ibisubizo bikomeye cyangwa bidakomeye kubuvuzi bwa neoadjuvant. Mu bushakashatsi bwakurikiranye bwiswe DONIMI, abashakashatsi bakoresheje aya manota, bafatanije n’isesengura rigoye, atari uguhitamo gusa igisubizo cy’ubuvuzi, ahubwo banamenye icyiciro cya III abarwayi ba melanoma bakeneye kongeramo inzitizi ya histone deacetylase inhibitor (HDACi) kugirango bongere igisubizo ku buvuzi bwa neoadjuvant ICI.

Tumor moderi ikomoka kubarwayi
Muri vitro tumor yibyitegererezo bifite ubushobozi bwo guhanura ibisubizo byumurwayi. Bitandukanye na vitro ya platifomu ikoreshwa mugusuzuma imiti isesengura imiti mibi ya hematologique, ibibyimba bikomeye bihura ningorabahizi bitewe na microstructure idasanzwe yibibyimba hamwe nubudahangarwa bw'umubiri. Umuco woroheje wibibyimba ntushobora kwigana byoroshye ibyo bintu bigoye. Muri iki gihe, ikibyimba nk'ingingo cyangwa imitwe ikomoka ku barwayi irashobora kwishyura izo mbogamizi zishingiye ku miterere, kuko zishobora kurinda imiterere y'utugingo ngengabuzima tw’umwimerere kandi zigereranya imikoranire na lymphoide na myeloid immun selile kugira ngo zisuzume ibisubizo bya ICI mu buryo bwihariye bw’umurwayi, bityo bigaragaze neza ibimenyetso by’ibinyabuzima mu bidukikije bifatika.

Ubushakashatsi bwinshi bwagezweho mu Bushinwa no muri Amerika bwakoresheje ubu buryo bushya bwo kwizerwa butatu mu buryo bwa vitro tumor. Ibisubizo byerekana ko ubwo buryo bushobora guhanura neza kanseri y'ibihaha, kanseri y'amara, kanseri y'ibere, melanoma n'ibindi bibyimba kuri ICI. Ibi birashiraho urufatiro rwo kurushaho kugenzura no kugereranya imikorere iteganijwe yizi ngero.