{"id":19506,"date":"2023-04-14T20:12:31","date_gmt":"2023-04-14T13:12:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19506"},"modified":"2023-04-17T15:50:07","modified_gmt":"2023-04-17T08:50:07","slug":"co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/","title":{"rendered":"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1"},"content":{"rendered":"

Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i nh\u1ea5t, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 k\u00edch th\u00edch h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 ti\u00eau di\u1ec7t c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p nh\u1eefng th\u00f4ng tin c\u01a1 b\u1ea3n v\u1ec1 c\u01a1 ch\u1ebf c\u1ee7a li\u1ec7u ph\u00e1p ti\u00ean ti\u1ebfn n\u00e0y v\u00e0 c\u00e1c thu\u1ed1c th\u01b0\u1eddng d\u00f9ng tr\u00ean l\u00e2m s\u00e0ng.<\/strong><\/p>\n

1. T\u1ed5ng quan v\u1ec1 CTLA-4<\/strong><\/p>\n

CTLA-4 (Cytotoxic T-Lymphocyte Antigen 4) l\u00e0 m\u1ed9t ph\u00e2n t\u1eed protein \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a c\u00e1c t\u1ebf b\u00e0o T, \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c ki\u1ec3m so\u00e1t qu\u00e1 tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o T.<\/p>\n

Ch\u1ee9c n\u0103ng c\u1ee7a CTLA-4 l\u00e0 \u1ee9c ch\u1ebf s\u1ef1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o T, b\u1eb1ng c\u00e1ch c\u1ea1nh tranh v\u1edbi ph\u00e2n t\u1eed CD28 tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a t\u1ebf b\u00e0o T. Khi t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t, ph\u00e2n t\u1eed CD28 \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t \u0111\u1ed3ng th\u1eddi v\u00e0 k\u1ebft n\u1ed1i v\u1edbi ph\u00e2n t\u1eed ligand tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a t\u1ebf b\u00e0o tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean (APC – Antigen Presenting Cell) \u0111\u1ec3 gi\u00fap t\u1ebf b\u00e0o T ti\u1ebft ra c\u00e1c cytokine v\u00e0 th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a ch\u00fang. Tuy nhi\u00ean, khi CTLA-4 \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t, n\u00f3 c\u1ea1nh tranh v\u1edbi ph\u00e2n t\u1eed CD28 \u0111\u1ec3 k\u1ebft n\u1ed1i v\u1edbi ph\u00e2n t\u1eed ligand tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a t\u1ebf b\u00e0o APC, t\u1eeb \u0111\u00f3 ng\u0103n ch\u1eb7n t\u1ebf b\u00e0o T ho\u1ea1t \u0111\u1ed9ng qu\u00e1 m\u1ee9c v\u00e0 t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh trong c\u01a1 th\u1ec3.<\/p>\n

\u0110i\u1ec1u n\u00e0y gi\u00fap b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3 kh\u1ecfi c\u00e1c ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n, nh\u01b0ng \u0111\u1ed3ng th\u1eddi c\u0169ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u0111\u1ed1i ph\u00f3 v\u1edbi c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. Do \u0111\u00f3, CTLA-4 \u0111\u00e3 tr\u1edf th\u00e0nh m\u1ed9t m\u1ee5c ti\u00eau ti\u1ec1m n\u0103ng trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0, v\u00e0 c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi CTLA-4 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a n\u00f3, gi\u00fap t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch trong vi\u1ec7c ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0.<\/p>\n

2. T\u1ed5ng quan v\u1ec1 PD-1<\/strong><\/p>\n

PD-1 (Programmed Cell Death Protein 1) l\u00e0 m\u1ed9t ph\u00e2n t\u1eed protein \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch, \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u ti\u1ebft ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch.<\/p>\n

Ch\u1ee9c n\u0103ng ch\u00ednh c\u1ee7a PD-1 l\u00e0 ki\u1ec3m so\u00e1t s\u1ef1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf ph\u1ea3n \u1ee9ng c\u1ee7a ch\u00fang \u0111\u1ed1i v\u1edbi t\u1ebf b\u00e0o kh\u00e1c. Khi t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t, PD-1 \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t \u0111\u1ed3ng th\u1eddi v\u00e0 k\u1ebft n\u1ed1i v\u1edbi ph\u00e2n t\u1eed ligand tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a t\u1ebf b\u00e0o kh\u00e1c. Qu\u00e1 tr\u00ecnh n\u00e0y gi\u00fap gi\u1ea3m s\u1ef1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch, gi\u00fap ng\u0103n ch\u1eb7n c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c v\u00e0 gi\u1eef cho h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u1ed5n \u0111\u1ecbnh.<\/p>\n

Tuy nhi\u00ean, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, s\u1ef1 k\u00edch ho\u1ea1t qu\u00e1 m\u1ee9c c\u1ee7a PD-1 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 s\u1ee9c kh\u1ecfe, bao g\u1ed3m gi\u1ea3m kh\u1ea3 n\u0103ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u0111\u1ed1i ph\u00f3 v\u1edbi c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. Do \u0111\u00f3, c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi PD-1 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a n\u00f3, gi\u00fap t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch trong vi\u1ec7c ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0. C\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi PD-1 nh\u01b0 pembrolizumab v\u00e0 nivolumab \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0.<\/p>\n

3. M\u1ed1i li\u00ean quan gi\u1eefa CTLA-4 v\u00e0 PD-1 trong li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch<\/strong><\/p>\n

\"C\u01a1
C\u01a1 ch\u1ebf c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1<\/figcaption><\/figure>\n

Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i nh\u1ea5t, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 k\u00edch th\u00edch h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 ti\u00eau di\u1ec7t c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. C\u01a1 ch\u1ebf c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y li\u00ean quan \u0111\u1ebfn vi\u1ec7c \u1ee9c ch\u1ebf s\u1ef1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c ph\u00e2n t\u1eed “checkpoints” tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch, bao g\u1ed3m CTLA-4 v\u00e0 PD-1.<\/p>\n

CTLA-4 l\u00e0 m\u1ed9t ph\u00e2n t\u1eed checkpoint \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o T, n\u01a1i n\u00f3 \u0111\u00f3ng vai tr\u00f2 trong vi\u1ec7c ki\u1ec3m so\u00e1t qu\u00e1 tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o T. Khi t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t, CTLA-4 \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t v\u00e0 g\u1eafn v\u00e0o b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o T \u0111\u1ec3 \u1ee9c ch\u1ebf s\u1ef1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang. S\u1ef1 \u1ee9c ch\u1ebf n\u00e0y gi\u00fap ng\u0103n ch\u1eb7n s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o T qu\u00e1 m\u1ee9c, tr\u00e1nh vi\u1ec7c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh trong c\u01a1 th\u1ec3. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0, CTLA-4 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng c\u1ee7a t\u1ebf b\u00e0o T t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o ung th\u01b0, d\u1eabn \u0111\u1ebfn s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a kh\u1ed1i u.<\/p>\n

PD-1 l\u00e0 m\u1ed9t ph\u00e2n t\u1eed checkpoint kh\u00e1c \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o T. PD-1 \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t sau khi t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t v\u00e0 g\u1eafn v\u00e0o b\u1ec1 m\u1eb7t c\u1ee7a t\u1ebf b\u00e0o \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 t\u1ea5n c\u00f4ng c\u1ee7a ch\u00fang \u0111\u1ed1i v\u1edbi t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh trong c\u01a1 th\u1ec3. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0, t\u1ebf b\u00e0o ung th\u01b0 c\u00f3 th\u1ec3 s\u1ea3n xu\u1ea5t m\u1ed9t lo\u1ea1t c\u00e1c ph\u00e2n t\u1eed g\u1eafn k\u1ebft PD-1, g\u00e2y ra s\u1ef1 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch v\u00e0 gi\u00fap ch\u00fang tr\u00e1nh \u0111\u01b0\u1ee3c s\u1ef1 ph\u00e1t hi\u1ec7n v\u00e0 ti\u00eau di\u1ec7t c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch.<\/p>\n

Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 nh\u1eafm v\u00e0o vi\u1ec7c \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c ph\u00e2n t\u1eed checkpoint n\u00e0y, gi\u00fap t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng ti\u00eau di\u1ec7t c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. Khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi, c\u00e1c li\u1ec7u ph\u00e1p n\u00e0y c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 k\u00e9o d\u00e0i th\u1eddi gian s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n ung th\u01b0.<\/p>\n

4. C\u00e1c lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng<\/strong><\/p>\n

C\u00e1c lo\u1ea1i thu\u1ed1c li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 bao g\u1ed3m:<\/p>\n

    \n
  • Kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi CTLA-4:<\/strong> Ipilimumab<\/strong> l\u00e0 kh\u00e1ng th\u1ec3 \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 d\u1ef1a tr\u00ean CTLA-4. N\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 da v\u00e0 ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng.<\/li>\n
  • Kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi PD-1:<\/strong> C\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi PD-1 bao g\u1ed3m pembrolizumab, nivolumab, cemiplimab, v\u00e0 atezolizumab<\/strong>. C\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u lo\u1ea1i ung th\u01b0 nh\u01b0 ung th\u01b0 ph\u1ed5i, ung th\u01b0 da non-melanoma, ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng v\u00e0 ung th\u01b0 v\u00fa.<\/li>\n
  • Kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi c\u1ea3 CTLA-4 v\u00e0 PD-1:<\/strong> M\u1ed9t s\u1ed1 lo\u1ea1i kh\u00e1ng th\u1ec3 c\u00f3 kh\u1ea3 n\u0103ng \u0111\u1ed3ng th\u1eddi \u1ee9c ch\u1ebf c\u1ea3 CTLA-4 v\u00e0 PD-1, nh\u01b0 ipilimumab v\u00e0 nivolumab (k\u1ebft h\u1ee3p), v\u00e0 durvalumab v\u00e0 tremelimumab.<\/strong> Ch\u00fang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng, ung th\u01b0 gan v\u00e0 ung th\u01b0 ph\u1ed5i.<\/li>\n<\/ul>\n

    C\u00e1c lo\u1ea1i thu\u1ed1c li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00e0 \u0111\u00e3 mang l\u1ea1i nhi\u1ec1u k\u1ebft qu\u1ea3 kh\u1ea3 quan. Tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd c\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n cho b\u1ec7nh nh\u00e2n.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i nh\u1ea5t, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 k\u00edch th\u00edch h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 ti\u00eau di\u1ec7t c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p nh\u1eefng th\u00f4ng tin c\u01a1 b\u1ea3n […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"\nC\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec<\/title>\n<meta name=\"description\" content=\"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-14T13:12:31+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T08:50:07+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-12-at-23.21.13.png\" \/>\n<meta name=\"author\" content=\"Phu Pham\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Phu Pham\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/\",\"name\":\"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-14T13:12:31+00:00\",\"dateModified\":\"2023-04-17T08:50:07+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/d1ff6c1232842b1dc8185f0a7f0391ed\"},\"description\":\"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/d1ff6c1232842b1dc8185f0a7f0391ed\",\"name\":\"Phu Pham\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/2e40cd35d82629134715ab35f6e3d9b6?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/2e40cd35d82629134715ab35f6e3d9b6?s=96&d=mm&r=g\",\"caption\":\"Phu Pham\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/phuphamctumpgmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec","description":"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec","og_description":"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/","og_site_name":"Vinmec","article_published_time":"2023-04-14T13:12:31+00:00","article_modified_time":"2023-04-17T08:50:07+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-12-at-23.21.13.png"}],"author":"Phu Pham","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Phu Pham","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/","name":"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-14T13:12:31+00:00","dateModified":"2023-04-17T08:50:07+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/d1ff6c1232842b1dc8185f0a7f0391ed"},"description":"Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cao.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/co-che-lieu-phap-mien-dich-dua-tren-ctla-4-va-pd-1\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"C\u01a1 ch\u1ebf li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean CTLA-4 v\u00e0 PD-1"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/d1ff6c1232842b1dc8185f0a7f0391ed","name":"Phu Pham","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/2e40cd35d82629134715ab35f6e3d9b6?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/2e40cd35d82629134715ab35f6e3d9b6?s=96&d=mm&r=g","caption":"Phu Pham"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/phuphamctumpgmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/19506"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=19506"}],"version-history":[{"count":3,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/19506\/revisions"}],"predecessor-version":[{"id":20453,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/19506\/revisions\/20453"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=19506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=19506"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=19506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}