Amanani Okusinda Umdlavuza Webele we-HER2-Positive nezinye Izibalo

-Delile

• Ayini amazinga okusinda?
• Kuyini ukwanda komdlavuza webele we-HER2?
• Ingabe umdlavuza webele we-HER2 ungabuya?
• Yikuphi ukwelashwa okutholakalayo?
• Ukuhlinzwa
• Imisebe
• Ukwelashwa ngamakhemikhali
• Imithi ehlosiwe
• I-Trastuzumab (Herceptin)
• I-Ado-trastuzumab emtansine (Kadcyla)
• I-Neratinib (Nerlynx)
• I-Pertuzumab (Perjeta)
• I-Lapatinib (Tykerb)
• Uyini umbono?

Uyini umdlavuza webele we-HER2?

Umdlavuza webele akusona isifo esisodwa. Empeleni yiqembu lezifo. Lapho uthola umdlavuza webele, esinye sezinyathelo zokuqala ukukhomba ukuthi hlobo luni onalo. Uhlobo lomdlavuza webele lunikeza imininingwane esemqoka mayelana nokuthi umdlavuza ungaziphatha kanjani.

Uma une-biopsy yebele, izicubu zihlolelwa ama-hormone receptors (HR). Ibuye ihlolwe ngento ebizwa nge-human epidermal growth factor receptor 2 (HER2). Ngamunye angabandakanyeka ekwakhekeni komdlavuza webele.

Kweminye imibiko yokugula, i-HER2 ibizwa nge-HER2 / neu noma i-ERBB2 (Erb-B2 receptor tyrosine kinase 2). Ama-hormone receptors atholakala njenge-estrogen (ER) ne-progesterone (PR).

Uhlobo lwe-HER2 lwakha amaprotheni we-HER2, noma ama-receptors. Lawa ma-receptors asiza ukulawula ukukhula nokulungiswa kwamaseli webele. Ukuchazwa ngokweqile kweprotheyini ye-HER2 kubangela ukukhiqizwa okungaphandle kokulawulwa kwamaseli webele.

Umdlavuza webele we-HER2 uvame ukuba nolaka kakhulu kunomdlavuza webele we-HER2-negative. Kanye nesigaba sebele kanye nesigaba somdlavuza, isimo se-HR ne-HER2 sisiza ukunquma izinketho zakho zokwelashwa.

Qhubeka ufunde ukuze ufunde kabanzi ngomdlavuza webele we-HER2-nokuthi yini ongayilindela.

Ayini amazinga okusinda?

Ngalesi sikhathi, akubanga khona ucwaningo oluthile ngamazinga okusinda komdlavuza webele we-HER2-positive kuphela. Ucwaningo lwamanje ngamazinga okusinda komdlavuza webele lusebenza kuzo zonke izinhlobo.

Ngokusho kweNational Cancer Institute (NCI), lawa ngamazinga weminyaka emihlanu yokusinda kwabesifazane abatholakala phakathi kuka-2009 no-2015:

• okwenziwe endaweni: amaphesenti angu-98.8
• kwesifunda: amaphesenti angama-85.5
• kude (noma i-metastatic): amaphesenti angu-27.4
• zonke izigaba zihlanganisiwe: amaphesenti angama-89.9

Kubalulekile ukukhumbula ukuthi lezi yizibalo nje jikelele. Izibalo zokusinda zesikhathi eside zisuselwa kubantu abatholakala eminyakeni edlule, kepha ukwelashwa kuyashintsha ngesivinini esisheshayo.

Lapho ucabangela umbono wakho, udokotela wakho kufanele ahlaziye izici eziningi. Phakathi kwazo kukhona:

• Isigaba sokuxilongwa: Umbono ungcono uma umdlavuza webele ungasakazekanga ngaphandle kwebele noma usabalele esifundeni kuphela lapho kuqala ukwelashwa. Umdlavuza webele we-Metastatic, okuwumdlavuza osudlulele ezindaweni ezikude, kunzima ukwelashwa.
• Usayizi nebanga lesimila sokuqala: Lokhu kukhombisa ukuthi umdlavuza unolaka kangakanani.
• Ukubandakanyeka kwe-lymph node: Umdlavuza ungasakazeka usuke ezindaweni ezingama-lymph uye ezithweni nakwezinye izicubu ezikude.
• Isimo se-HR ne-HER2: Imithi ehlosiwe ingasetshenziselwa umdlavuza webele we-HR-positive ne-HER2-positive.
• Impilo isiyonke: Ezinye izindaba zezempilo zingase zibe nzima ukwelashwa.
• Impendulo ekwelashweni: Kunzima ukubikezela ukuthi ukwelashwa okuthile kuzosebenza yini noma kuzokhiqiza imiphumela engemiyo engabekezeleleki.
• Ubudala: Abesifazane abancane nalabo abaneminyaka engaphezu kwengama-60 bavame ukuba nombono omubi kunabesifazane abaneminyaka ephakathi, ngaphandle kwalabo abanomdlavuza webele wesigaba 3.

E-United States, kulinganiselwa ukuthi abesifazane abangaphezu kuka-41,000 bazobulawa ngumdlavuza webele ngo-2019.

Kuyini ukwanda komdlavuza webele we-HER2?

Cishe abesifazane abangamaphesenti ayi-12 e-United States bazoba nomdlavuza webele ongenayo ngesinye isikhathi. Noma ngubani, ngisho namadoda, angahlakulela umdlavuza webele we-HER2. Kodwa-ke, kungenzeka ukuthi kuthinte abesifazane abasebasha. Cishe amaphesenti angama-25 awo wonke umdlavuza webele ane-HER2-positive.

Ingabe umdlavuza webele we-HER2 ungabuya?

Umdlavuza webele we-HER2 unolaka kakhulu futhi kungenzeka ukuthi uphinde ubuye kunomdlavuza webele we-HER2-negative. Ukuphindaphinda kungenzeka noma kunini, kepha kuvame ukwenzeka kungakapheli iminyaka emihlanu yokwelashwa.

Izindaba ezimnandi ukuthi ukuphindeka mancane amathuba namuhla kunanini ngaphambili. Lokhu ikakhulukazi kungenxa yokwelashwa okuhlosiwe kwakamuva. Eqinisweni, abantu abaningi belashelwa isigaba sokuqala somdlavuza webele we-HER2 ababuyeli emuva.

Uma umdlavuza wakho webele ubuye ube ne-HR-positive, ukwelashwa kwamahomoni kungasiza ekunciphiseni ubungozi bokuphindeka.

Isimo se-HR nesimo se-HER2 singashintsha. Uma umdlavuza webele uphinde wabuya, isimila esisha kufanele sihlolwe ukuze ukwelashwa kungabuyekezwa kabusha.

Yikuphi ukwelashwa okutholakalayo?

Uhlelo lwakho lokwelashwa cishe luzofaka inhlanganisela yezindlela zokwelapha ezinjenge:

• ukuhlinzwa
• imisebe
• ukwelashwa ngamakhemikhali
• ukwelashwa okubhekiswe

Ukwelashwa kweHormone kungaba yindlela kubantu abanomdlavuza obuye ube ne-HR.

Ukuhlinzwa

Ubukhulu, indawo, kanye nenani lezimila kusiza ekunqumeni isidingo sokuhlinzwa okugcina amabele noma i-mastectomy, nokuthi kufanele kususwe ama-lymph node.

Imisebe

Ukwelashwa ngemisebe kungakhomba noma yimaphi amangqamuzana omdlavuza angahlala ngemuva kokuhlinzwa. Ingasetshenziselwa ukunciphisa izicubu.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelashwa okuhlelekile. Izidakamizwa ezinamandla zingafuna futhi zibhubhise amangqamuzana omdlavuza noma yikuphi emzimbeni. Umdlavuza webele we-HER2 uvame ukuphendula kahle ekwelashweni ngamakhemikhali.

Imithi ehlosiwe

Ukwelashwa okuhlosiwe komdlavuza webele we-HER2 kufaka:

I-Trastuzumab (Herceptin)

I-Trastuzumab isiza ukuvimba amangqamuzana omdlavuza ekutholeni izimpawu zamakhemikhali ezikhuthaza ukukhula.

Ucwaningo lwango-2014 lwabesifazane abangaphezu kuka-4,000 lubonise ukuthi i-trastuzumab inciphise kakhulu ukuphindaphinda nokuthuthuka kokuphila lapho ingezwa ekhemotherapy ekuqaleni komdlavuza webele we-HER2-positive. Uhlobo lwe-chemotherapy luqukethe i-paclitaxel ngemuva kwe-doxorubicin ne-cyclophosphamide.

Izinga lokusinda leminyaka eli-10 lenyuke lisuka kumaphesenti angama-75.2 ngamakhemikhali kuphela laya kumaphesenti angama-84 ngokungezwa kwe-trastuzumab. Amanani okusinda ngaphandle kokuphindeka nawo aqhubeka nokuthuthuka. Izinga lokusinda elingenazifo iminyaka engu-10 lenyuke lisuka kumaphesenti angama-62.2 laya kumaphesenti angama-73.7.

I-Ado-trastuzumab emtansine (Kadcyla)

Lesi sidakamizwa sihlanganisa i-trastuzumab nesidakamizwa se-chemotherapy esibizwa nge-emtansine. I-Trastuzumab ihambisa i-emtansine ngqo kumaseli omdlavuza we-HER2-positive. Ingasetshenziselwa ukunciphisa izicubu nokwandisa ukusinda kwabesifazane abanomdlavuza webele we-metastatic.

I-Neratinib (Nerlynx)

I-Neratinib iyindlela yokwelashwa ethatha unyaka wonke esetshenziswa ezigabeni zokuqala zomdlavuza webele we-HER2. Inikwa abantu abadala asebevele sebeqedile umuthi wokwelashwa ofaka i-trastuzumab. Inhloso ye-neratinib ukunciphisa amathuba okuphindeka.

Imithi ehlosiwe ivame ukusebenza ngaphandle kweseli ukuvimba izimpawu zamakhemikhali ezikhuthaza ukukhula kwesimila. I-Neratinib, ngakolunye uhlangothi, ithinta izimpawu zamakhemikhali ezivela ngaphakathi kweseli.

I-Pertuzumab (Perjeta)

I-Pertuzumab yisidakamizwa esisebenza kakhulu njenge-trastuzumab. Kodwa-ke, inamathela engxenyeni ehlukile yamaprotheni e-HER2.

I-Lapatinib (Tykerb)

ILapatinib ivimba amaprotheni abangela ukukhula kweseli okungalawulwa. Kungasiza ukubambezela ukuqhubeka kwesifo lapho umdlavuza webele we-metastatic ungazweli ku-trastuzumab.

Uyini umbono?

Ngokwezibalo, abesifazane abangaphezu kwezigidi eziyi-3.1 e-United States banomlando womdlavuza webele.

Umbono womdlavuza webele we-HER2 uyahlukahluka kuye ngomuntu. Ukuthuthuka kwezindlela zokwelashwa ezihlosiwe kuyaqhubeka nokwenza ngcono umbono wesigaba sokuqala kanye nesifo se-metastatic.

Lapho ukwelashwa komdlavuza webele onganqamuki kuphele, usazodinga ukuhlolwa ngezikhathi ezithile ukuthola izimpawu zokuphindeka. Imiphumela emibi eminingi yokwelashwa izothuthuka ngokuhamba kwesikhathi, kepha eminye (njengezinkinga zokuzala) ingahlala unomphela.

Umdlavuza webele we-Metastatic awucatshangwa ukuthi uyelapheka. Ukwelashwa kungaqhubeka inqobo nje uma kusebenza. Uma ukwelashwa okuthile kuyeka ukusebenza, ungashintshela kolunye.