Chii Chitsva Mukurapa kweParate Cancer?

Mushonga we metastatic castrate inopesana nekenza yeprostate

Zvinhu zvakawanda zvakachinja mukurapa kenza yeprostate mumakore akawanda apfuura. Izvi zvinonyanya kukosha mukurapa kenza yemasitamende yakagadzikana-resistant prostate (mCRPC). Uyu mukenza weprotate wakakundikana kutanga kurapwa (kuvhiyiwa, kupiswa kwemazizi nezvimwewo) uye wakaenda kunokundikana hutachiona hwehutachiona (androgen blockade kana kukanda).

Izvi zvinoshandawo kuvarwere varipo vane chirwere chemasastatic uye vakundikana ma hormonal treatment. Kusati kwatanga kushandiswa kwekemotherapy kune ava varwere muvhareji weupenyu hwemazuva anenge makore gumi nemana. Chemotherapy yakavandudzwa pane izvi asi haisi kurwisa.

Kubva muna 2010 mishonga yakawanda mitsva yakave yakawanikwa kune varwere vane mCRPC. Izvi zvinotevera tsanangudzo pfupi yezvokurapa zvitsva.

1. Abiraterone Acetate (Zytiga) - Zytiga inhibisa kubudiswa kwevatengesi ve testosterone uye inoderedza maitiro e testosterone. Inowanzopiwa ne prednisone. Zytiga pakutanga yakaratidzwa kune varwere vakange vakundikana docetaxel (chemotherapy) asi zvidzidzo zvenguva pfupi zvakaratidza kubatsiro mumutano wep-pre-chemo. Chimwe chidzidzo chakaratidza kuti kufambira mberi kwemazuva ano-kusununguka kusina (rPFS) kwaiva nemwedzi inopfuura 16 muAbiraterone uye boka re prednisone rinopesana nemwedzi 8 muboka rinodzora.
2. Enzalutamide (Xtandi) - Maitiro akazivikanwa se MDV3100 iyi mishonga yechipiri chizvarwa androgen-receptor blocker. Inoshanda zvose zviri kunze uye mukati memusero. Yakatanga kuratidzwa mumashure-chemotherapy varwere veMCRPC asi zvidzidzo zvakaratidza kubatsiro mumurwere wep-pre-chemo zvakare. ICHOKWADI kuongorora kwakaratidza kuti pavhareji, enzalutamide yakanonoka chidimbu chemotherapy nemwedzi 17 (28 vs. 11). Yakaratidza zvakare kuti kushandiswa kwechirwere ichi kwakaderedza kufambira mberi kwehuwandu hwemashoko ne 81%.

1. Radium 223 Dichloride (Xofigo) - Kunyange iyi iri jekiseni iyo ndiyo chaiyo inonzi radiation inonzi alpha radiation. Iyi kurapwa inoreva kutora masero emukenza weprotate mumapfupa. Mabhete ane kenza yeprostate inofanirwa kutora Xofigo. Radium zvino inodzinga alpha rayation, iyo iri pfupi. Mhedziso ndeyokuuraya maitiro ekenza anoshandiswa ane huwandu husina kunaka kuhutachiona. Izvi zvinofanira kuva zvakanyanya kunangwa kupfuura strontium-89, iyo yakashandiswa kare. Dzidzo dzakaratidza kupona kwakanyanya kune varwere vane mCRPC uye metastasis bone.

1. Sipuleucel-T (Zvigadziro) - Sipuleucel-T chirwere chepachirwere chekurapa kwekenza yeprostate. Izvo zvinorehwa kuti zvive nyore kana zviratidzo zvishoma zvezvirwere vane mCRPC. Izvo zvakasiyana kune umwe neumwe murwere uye inoda kupiwa ropa. Ropa rinoshandiswa pairi uye rinopindira zvakare muvhiki. Kurapa kunopiwa katatu pamusoro pemwedzi. Ndiyo yekutanga FDA inobvumira mushonga wekenza yemapiritsi (kunze kwechirwere chekudzivirira). Kuparara kwepasi rose kwakawedzerwa nekushandiswa kweMugove mune zviratidzo kana zviratidzo zvishoma zvevarwere mCRPC.

Mibvunzo yekutarisira kujekeswa munguva yemberi ndeipi nzira yekuenzanisa zvakanakisisa kurapa idzva idzi? Apo murwere anokundikana mahomoni, mishonga ipi inofanira kushandiswa pakutanga kana chemo inofanira kutanga? Ndeupi mushonga unopa zvakanakisisa kukosha? Ko iyi mishonga inofanira kushandiswa yoga here kana inobatanidza? Kunyange zvazvo kune mibvunzo yakawanda inowanikwa idzi zvinyorwa zvatsva ku cancer yeprostate armamentarium zvechokwadi ichabatsira varwere vakawanda.

_Sources

_{Rathkopf DE, Smith MR, De Bono JS, et al. Yakarongedza kuongorora kwemukati (IA) yeCOU-AA-302, ruzivo rwechikamu chechitatu III rweAbiraterone acetate (AA) muvarwere (pts) ine mastrastration castration-resistant prostate kansa (mCRPC) pasina chikwata chemotherapy. J Clin Oncol. 2013; 31 (mutevedzeri 6, mutsva 5).}

_{Beer TM et. al. Enzalutamide mune varume vane kemotherapy-naive metastatic prostate kanzura (mCRPC): Zvikamu zvechikamu chechitatu KUTANGA kudzidza. J Clin Oncol 32, 2014 (suppl 4; abstr LBA1 ^).}

_{Parker C et al. Alpha Emitter Radium-223 uye Kupona muMetastatic Prostate Cancer. N Engl J Med. 2013; 369: 213.}

_{Longo DL (July 2010). "Mishonga mitsva yemukenza weprotate inopikisa". N. Engl. J. Med. 363 (5): 479-81.}