Ukwelashwa Nokucwaninga Ngomdlavuza Webele Okuthuthukile: Yini esekuHlanga?

-Delile

• Izindlela zokwelashwa ezihlosiwe
• Imithi yokwelapha isiseduze
• Izidakamizwa ze-anti-angiogenesis
• Izidakamizwa ze-Biosimilar
• I-Immunotherapy
• PI3 kinase inhibitors
• Ukuqagela okuthuthukisiwe nokuqapha
• Ukubandakanyeka esivivinyweni somtholampilo

Umdlavuza webele we-metastatic ungalapheka, kepha kaningi izikhathi awunakulapheka. Okwamanje, izinhloso zokwelashwa zifaka ukunciphisa izimpawu zakho, ukuthuthukisa ikhwalithi yempilo yakho, nokwelula impilo yakho.

Ukwelashwa ngokuvamile kubandakanya ukwelashwa kwehomoni, ukwelashwa ngamakhemikhali, ukwelashwa okuhlosiwe, noma inhlanganisela yalokhu.

Nazi ezinye izindlela zokwelashwa zamanje nezesikhathi esizayo ongalindela ukuzwa ngazo uma ngabe usuthole ukuxilongwa komdlavuza webele osezingeni eliphakeme.

Izindlela zokwelashwa ezihlosiwe

Abaphenyi bakhiqize imishanguzo emisha eminingana ekhomba izinguquko ezithile kumaseli. Lezi zinguquko zenza amangqamuzana omdlavuza akhule ngokushesha futhi asakazeke. Lokhu kwehlukile kunokwelashwa ngamakhemikhali, okubhekiswe kuwo wonke amaseli akhula ngokushesha, kufaka phakathi amangqamuzana omdlavuza namaseli anempilo.

Iningi lalezi zidakamizwa ezihlosiwe zivunyelwe ukwelapha umdlavuza webele we-metastatic. Abanye bafundwa ekuhlolweni kwemitholampilo, kanti okunye okuningi kusezivivinyweni zangaphambi kokuhlolwa.

Ezinye izibonelo zokwelashwa okuhlosiwe zifaka:

• I-Lapatinib (Tykerb). Lesi sidakamizwa yi-tyrosine kinase inhibitor. Isebenza ngokuvimba ama-enzyme akhuthaza ukukhula kwamaseli. Itholakala njengephilisi oyiphuza nsuku zonke ukwelapha umdlavuza webele we-metastatic. Ingahlanganiswa nemithi ethile yokwelashwa ngamakhemikhali noma izindlela zokwelapha zamahomoni.
• I-Neratinib (Nerlynx). Lesi sidakamizwa sivunyelwe ukwelapha umdlavuza webele wokuqala we-HER2. Olunye ucwaningo lubonisa ukuthi kungasebenza ekwelapheni abantu abanomdlavuza webele we-metastatic.
• Olaparib (Lynparza). Lokhu kwelashwa kuvunyelwe umdlavuza webele we-HER2-negative kubantu abane-a I-BRCA ukuguquka kwezakhi zofuzo. Itholakala njengephilisi lansuku zonke.

Ama-CDK4 / 6 inhibitors angesinye isigaba semithi yokwelashwa ehlosiwe. Le mithi ivimba amaprotheni athile enza ukuthi amangqamuzana omdlavuza akhule. I-Abemaciclib (Verzenio), palbociclib (Ibrance), ne-ribociclib (Kisqali) ngama-CDK4 / 6 inhibitors avunyelwe yi-Food and Drug Administration (FDA) ekwelashweni komdlavuza webele. Zisetshenziswa ngokuhlangana nokwelashwa kwehomoni ukwelapha umdlavuza webele we-HR-positive kanye ne-HER2-negative metastatic breast.

Imithi yokwelapha isiseduze

Kunezindlela zokwelapha eziningi ezitholakalayo zokwelapha umdlavuza webele we-metastatic, kepha kusenziwa izifundo zokufunda kabanzi ngokuthi la maseli womdlavuza nokuguqulwa kwezakhi zofuzo kusebenza kanjani. Ngezansi kukhona ezinye izindlela zokwelapha ezisacwaningwa.

Izidakamizwa ze-anti-angiogenesis

I-Angiogenesis yinqubo lapho kwenziwa khona imithambo yegazi emisha. Izidakamizwa ze-anti-angiogenesis zenzelwe ukunciphisa ukunikezwa kwegazi emithanjeni. Lokhu kunciphisa amangqamuzana omdlavuza wegazi elidingekayo ukuze likhule.

Umuthi olwa ne-angiogenesis bevacizumab (Avastin) njengamanje uvunyelwe yi-FDA ukwelapha amanye amagciwane. Lesi sidakamizwa sakhombisa ukusebenza kahle kwabesifazane abanomdlavuza webele osezingeni eliphezulu, kepha i-FDA yahoxisa ukuvunyelwa kwalokhu kusetshenziswa ngo-2011. I-Bevacizumab neminye imishanguzo elwa ne-angiogenesis isacwaninga ngokwelashwa komdlavuza webele we-metastatic.

Izidakamizwa ze-Biosimilar

Izidakamizwa ze-Biosimilar ziyefana nezidakamizwa zegama lomkhiqizo, kepha zingabiza kancane. Ziyindlela yokwelashwa esebenzayo.

Izidakamizwa eziningi ze-biosimilar zomdlavuza webele ziyafundwa. Uhlobo lwe-biosimilar lwe-trastuzumab (Herceptin), umuthi we-chemotherapy, ukuphela kwe-biosimilar evunyelwe ukwelashwa komdlavuza webele we-HER2-positive. Ibizwa nge-trastuzumab-dkst (Ogivri).

I-Immunotherapy

I-Immunotherapy iyindlela yokwelapha esiza amasosha omzimba uqobo ekubhubhiseni amangqamuzana omdlavuza.

Isigaba esisodwa semithi ye-immunotherapy yi-PD1 / PD-L1 inhibitors. IPembrolizumab (Keytruda) ivunyelwe ukwelapha umdlavuza wamaphaphu. Kwenziwa ukuhlolwa kwemitholampilo ukuhlola ukusebenza kwayo ezigulini ezinomdlavuza webele we-metastatic negative kathathu.

PI3 kinase inhibitors

I- PIK3CA isakhi sofuzo sisiza ukulawula i-PI3 kinase, i-enzyme ebangela ukukhula kwezimila. I-PI3 kinase inhibitors yakhelwe ukuphazamisa nokumisa ukukhula kwe-enzyme ye-P13. Lokhu kufundelwa ukwelashwa komdlavuza webele we-metastatic.

Ukuqagela okuthuthukisiwe nokuqapha

Ngeshwa, abantu bangakhula ukumelana nokwelashwa okuthile komdlavuza. Lokhu kudala ukuthi ukwelashwa kuyeke ukusebenza ngempumelelo. Abaphenyi basungula izindlela ezintsha zokuqapha ukuthi iziguli zisabela kanjani ekwelashweni.

Ukuhlaziywa kwe-tumor yesifo sokujikeleza (okwaziwa nangokuthi yi-liquid biopsy) kufundwa njengendlela yokuqondisa ukwelashwa. Abaphenyi bazama ukuthola ukuthi ngabe lokhu kuhlolwa kunenzuzo yini ekuqapheleni iziguli ezinomdlavuza webele we-metastatic kanye nokubikezela ukuthi bazophendula kanjani ekwelashweni.

Ukubandakanyeka esivivinyweni somtholampilo

Ukubamba iqhaza esivivinyweni somtholampilo kungasiza abacwaningi ukuthi bathole ukuthi ukwelashwa okusha kuzosebenza yini. Uma unentshisekelo yokujoyina eyodwa, indawo enhle yokuqala i-ClinicalTrials.gov, i-database eseshayo yezifundo ezithathwa njengamanje emhlabeni jikelele. Futhi hlola izinhlelo ezifana neMetastatic Breast Cancer Project. Le nkundla esetshenziswa nge-inthanethi ixhuma abantu abanomdlavuza webele we-metastatic nososayensi abasebenzisa ubuchwepheshe ukutadisha izimbangela zomdlavuza.

Khuluma nomhlinzeki wakho wezokunakekelwa kwempilo ukuze ubone ukuthi ukujoyina isilingo somtholampilo kulungile yini kuwe. Bangakusiza ukunquma ukuthi ufanelekile yini futhi bakusize ubhalise.