I-Immunotherapy ye-Metastatic Renal Cell Carcinoma

-Delile

• Yini i-immunotherapy?
• AmaCytokines
• I-Interleukin-2 (IL-2)
• I-Interferon-alfa
• Izivimbeli zokuhlola
• I-Nivolumab (Opdivo)
• I-Ipilimumab (Yervoy)
• Imiphumela emibi engaba khona
• Ukudla okudlela endlini

Ukubuka konke

Kunezindlela zokwelapha eziningana ze-metastatic renal cell carcinoma (RCC), kufaka phakathi ukuhlinzwa, ukwelashwa okuhlosiwe, kanye nokwelashwa ngamakhemikhali.

Kepha kwezinye izimo, ungayeka ukuphendula ekwelashweni okuqondisiwe. Ngezinye izikhathi, izidakamizwa zokwelashwa ezihlosiwe zingadala imiphumela emibi kakhulu noma ukusabela okweqile.

Uma lokhu kwenzeka, udokotela wakho angancoma enye indlela yokwelashwa ebizwa nge-immunotherapy. Nakhu ukubuka okuningiliziwe kokuthi iyini i-immunotherapy, nokuthi ilungile yini kuwe.

Yini i-immunotherapy?

I-Immunotherapy wuhlobo lokwelashwa komdlavuza olusebenzisa izinto zemvelo nezokufakelwa ukushintsha indlela amaseli emzimbeni wakho aziphatha ngayo. Ezinye izinhlobo ze-immunotherapy zisebenza ukulwa noma ukubhubhisa amangqamuzana omdlavuza. Abanye baqinisa noma baqinisa amasosha akho omzimba futhi basize ukuphatha izimpawu nemiphumela emibi yomdlavuza wakho.

Kunezinhlobo ezimbili eziyinhloko zokwelashwa kwe-immunotherapy kwe-metastatic RCC: ama-cytokines nama-checkpoint inhibitors.

AmaCytokines

AmaCytokines yizinhlobo ezenziwe ngamaprotheni emzimbeni ezenza futhi zithuthukise amasosha omzimba. Ama-cytokines amabili asetshenziswa kakhulu ukwelapha umdlavuza wezinso yi-interleukin-2 ne-interferon-alpha. Bakhonjiswe ukuthi basiza ukunciphisa umdlavuza wezinso ngamaphesenti amancane eziguli.

I-Interleukin-2 (IL-2)

Le yi-cytokine ephumelela kunazo zonke yokwelapha umdlavuza wezinso.

Ukweqiwa okuphezulu kwe-IL-2, noma kunjalo, kungadala imiphumela emibi kakhulu futhi kwesinye isikhathi ebulalayo. Le miphumela emibi ifaka ukukhathala, umfutho ophansi wegazi, ukuphefumula kanzima, ukwanda koketshezi emaphashini, ukopha emathunjini, isifo sohudo nokuhlaselwa yinhliziyo.

Ngenxa yemvelo engaba yingozi enkulu, i-IL-2 imvamisa inikezwa kuphela abantu abaphilile ngokwanele ukumelana nemiphumela emibi.

I-Interferon-alfa

I-Interferon-alfa ingenye i-cytokine kwesinye isikhathi esetshenziselwa ukwelapha umdlavuza wezinso. Ngokuvamile unikezwa njengomjovo ongaphansi komhlaba kathathu ngesonto. Imiphumela yaso emibi ifaka phakathi izimpawu ezinjengomkhuhlane, isicanucanu nokukhathala.

Ngenkathi le miphumela emibi ingaphansi kwe-IL-2, i-interferon ayisebenzi kahle uma isetshenziswa yodwa. Ngenxa yalokho, ivame ukusetshenziswa ngokuhlanganiswa nomuthi ohlosiwe obizwa nge-bevacizumab.

Izivimbeli zokuhlola

Amasosha akho omzimba azivimbela ekuhlaseleni amangqamuzana ajwayelekile emzimbeni wakho ngokusebenzisa “izindawo zokuhlola.” Lawa ngamangqamuzana kumaseli akho omzimba adinga ukuvulwa noma ukuvulwa ukuqala impendulo yomzimba. Khansela amaseli kwesinye isikhathi asebenzise lezi zingosi ukugwema ukuqondiswa amasosha omzimba.

Ama-inhibitors okuhlola ayizidakamizwa ezibhekise ezindaweni ezinjalo zokuhlola. Zisiza ukugcina ukuphendula kwamasosha akho omzimba kumaseli womdlavuza kuhlolwe.

I-Nivolumab (Opdivo)

I-Nivolumabis i-immune checkpoint inhibitor ekhomba futhi ivimbele i-PD-1. I-PD-1 yiprotheni kumaseli ama-T immune system akho awavimbela ekuhlaseleni amanye amaseli emzimbeni wakho. Lokhu kusiza ukukhulisa ukuphendula komzimba wakho kumaseli womdlavuza futhi kwesinye isikhathi kunganciphisa usayizi wamathumba.

INivolumab inikezwa ngemithambo yegazi kanye njalo emavikini amabili. Kuyindlela esebenzayo kubantu i-RCC yayo eqale ukukhula futhi ngemuva kokusebenzisa ezinye izindlela zokwelapha.

I-Ipilimumab (Yervoy)

I-Ipilimumab ingenye ye-immune system inhibitor ehlose iprotheni ye-CTLA-4 kuma-T cell. Inikezwa ngemithambo, imvamisa kanye njalo emavikini amathathu ekwelashweni okune.

I-Ipilimumab nayo ingasetshenziswa ngokuhlanganiswa ne-nivolumab. Lokhu kwenzelwa abantu abanomdlavuza wezinso osezingeni eliphezulu abangakatholi ukwelashwa.

Le nhlanganisela ikhonjisiwe ukuthi inyuse kakhulu amazinga okusinda jikelele. Ngokuvamile inikezwa ngemithamo emine, ilandelwe inkambo ye-nivolumab iyodwa.

Imininingwane evela kulolu cwaningo eshicilelwe ku-New England Journal of Medicine ikhombise isilinganiso esihle sokusinda sezinyanga eziyi-18 ngokwelashwa okuhlanganisiwe kwe-nivolumab ne-ipilimumab.

Ngo-Ephreli 16, 2018, i-FDA ivume le nhlanganisela yokwelashwa kwabantu abane-renal cell carcinoma esezingeni eliphansi futhi eliphakathi.

Imiphumela emibi engaba khona

Imiphumela emibi kakhulu ye-immune checkpoint inhibitors ukukhathala, ukuqubuka kwesikhumba, ukulunywa nokuhuda. Ezimweni ezingavamile, i-PD-1 ne-CTLA-4 inhibitors zingaholela ezinkingeni ezinkulu zomzimba ezingasongela impilo.

Uma njengamanje uthola ukwelashwa nge-immunotherapy ngomunye noma yomibili yale mithi bese uqala ukuhlangabezana nanoma yimiphi imiphumela emibi, ibikele kudokotela wakho ngokushesha.

Ukudla okudlela endlini

Indlela yokwelashwa wena nodokotela wakho enizonquma ngayo incike ezicini eziningana. Uma uhlala ne-metastatic RCC, khuluma nodokotela wakho ngezinketho zakho zokwelashwa.

Ngokubambisana, ningaxoxa ngokuthi kungaba yindlela yokwelashwa esebenzayo yini kini. Bangakhuluma nawe futhi nganoma yikuphi ukukhathazeka onakho ngemiphumela emibi noma ubude bokwelashwa.