Targeted therapies chirwere chitsva chekenza yemazamu iyo inogona kushandiswa yoga kana inosanganiswa nedzimwe mishonga. Kusiyana netsika dzechemotherapy dzinorwisa masero ose anokurumidza kukura, anotarisirwa kurapwa zvakananga kune masero ekenza kana kuisa nzira dzinoita kuti kukura kwekenza masero. Nokuda kwechikonzero ichi, mishonga yakawanda inogona kunge isina zvigadzirwa zvishoma kupfuura chemotherapy.
Targeted therapies inowanikwa kune avo vane maronda emucherechedzo esterogen-positive , HER 2 kanzvadzi dzekamu dzakanaka , uye kunyange kenza katatu isina mucheche.
Iyi mishonga inogona kushanda zvakanaka pane imwe nguva, asi semimwe mishonga inoshandiswa pakurapa kenza yemasitema, kushorwa kazhinji kunowedzera kwenguva. Mimwe yemishonga iyi inoshandiswa kwekutanga kwekutanga uye kenza yemasasa, asi mamwe anoshandiswa kunyanya kune vanhu vane kenza yematenda emuviri.
Nokuda kweHER2 Positive Cancer
Sezvambotaurwa, munharaunda inenge 25 kubva muzana yehadzi yekenza, geni rinozivikanwa sevanhu epidermal kukura receptor 2 (kana HER 2 / neu) inoguma mukuwedzera kwepurojekiti yeHER 2 (receptors) pamusoro pekenza yepabonde yemvere.
Saizvozvowo, nenzira, kune nzira iyo isrogen receptors inokonzera kuisa kenza yekenza kuti ikure uye iwedzere, HER 2 receptors inogona kukonzera kukura uye kupararira kweHER 2 dzakanaka kanzira.
Mishonga inopesana nemapapiro aya ezvo inopesana nemuenzaniso kune aya masero emukenza, zvichidzivirira kukura kwavo.
Mishonga inotarisa HER 2 inosanganisira:
- Herceptin (trastuzumab) - Herceptin inopiwa IV kazhinji kamwe kamwe pavhiki kana kamwe kamwe kwevhiki nhatu. Zvimwe zvinosanganisa zvinosanganisira fevha uye chills mangwanani. Kukundikana kwemoyo kunogona kukura mumatatu kusvika ku5 muzana yevanhu vanobatwa nemishonga, asi kusiyana nemoyo kusakonzerwa nekemikirini yemishonga yakadai seAdriamycin (doxorubicin), kukanganisa kwemwoyo uku kunogona kuchinjwa apo kurapwa kwaguma. Migumisiro yeHerceptin inowanzovandudza nekufamba kwenguva.
- Kadcyla (ado-trastuzumab) - Kaydcyla mushonga unosanganisira zvose Herceptin uye mishonga yakasimba yemakemotherapy inonzi emtansine. Iro Herceptin chikamu chechirwere chinosungirirwa kune HER 2 chine masero emukenza, asi pane kungovhara mutevedzeri kudzivirira hukura hwekukura kubva pakubatanidzwa, inopa "mubhadharo" wayo-chemotherapy drug-kodzero kumasero ekenza.
Herceptin inobvumira chemotherapy kupinda mumasero ekenza, umo emtansine inosunungurwa. Kunyange zvazvo ichi chemotherapy agent inowanzoendeswa kune kenza masero, panewo kuwedzera kwekushandisa kwechirwere ichi mumusangano wekushambadzira.
Nokuda kwechikonzero ichi, chirwere ichi chinogona kuva nemigumisiro inowanikwa chemhemotherapy mishonga inosanganisira bone marrow kuderedza uye chirwere chepfungwa chinokonzerwa neuropathy. Kaydycla angave akabudirira kunyange kune vanhu avo Herceptin asina kumbobudirira. - Perjeta (pertuzumab) - Perjeta yaiva FDA yakagamuchirwa nekenza yepamusoro yepabonde muna 2013 uye zvidzidzo zvakabva zvawana kuwedzera kwehupenyu hwevakadzi vane kenza yepamusoro yeHIV 2 (HER 2 positive) iyo inorapwa nemishonga. Inogona kushandiswa yoga kana inobatanidza Herceptin kana chemotherapy.
- Tykerb (lapatinib) - Tykerb anorwisawo HER 2 maitiro emukenza wepamu, asi nenzira yakasiyana naHercceptin. Tykerb, iyo isina kufanana naHercceptin haisi anti-antibody, inogona kushandiswa yoga, kana kusanganiswa neHerceptin kana chemotherapy. Zvipembenene zvinowanzozivikanwa ndezvokuputika kunoita sezvinofanana nemakona (asi hazvirevi semapurisa) uye chirwere.
Migumisiro Yechirwere yeMishonga Iyi
Herceptin, Kaydcyla, uye Perjeta vane nzira dzakadaro dzekuita uye naizvozvo, zvakafanana nemigumisiro. Chimwe chezvinhu zvine chokuita nemigumisiro yemishonga iyi inokanganisa mwoyo. Your oncologist inogona kukurudzira kuongororwa miedzo yemwoyo wako usati watanga mishonga iyi uye ichakurudzira iwe zviratidzo zvinoratidza kuti unofanira kudana.
For Estrogen Receptor Positive Cancer
Kune vakadzi vane kenza yemapurogiramu yemakemhoni yehomoni, inotarisirwa kurapwa inowanikwawo zvakare. Iyi mishonga inoshandiswa kune vakadzi vanonzi postmenopausal (kana kuti avo vanonzi premenopausal uye vakagamuchira ovarian kuderedza chirwere) kuti hutachiona hwemishonga huve nani.
Zvinodhaka zvinosanganisira:
- Ibrance (palbociclib ) - Ichi chinodhaka chinopesana nemakemikari anonzi cyclin-dependent kinases (CDK4 uye CDK6) uye inoshandiswa mushure mekuberekwa kwetrogen-yakagadzirisa kenza yemazamu mumukadzi we postmenopausal inoramba isinganzwisisi nehutoni. Inogona kushandiswa pamwe chete ne aromatase inhibitor yakadai se Femara (letrozole) kana nemishonga inorwisa anti-estrogen Faslodex (fulvestrant.)
- Afinitor (everolimus) - Ichi chinodhaka chinodzivirira puroteni mumuviri unozivikanwa seMTOR. Anogadzirisa zvinowanzoshandiswa kune anrogen receptor akanaka uye HER 2 mutezo usina kunaka mushure mekunge unopikisa kune aromatase inhibitor yakadai seAromatase (exemastine).
KweTatu Nechirwere Chechirwere Chechirwere
Mishonga inonzi estrogen receptor negative, progesterone receptor yakaipa, uye HER 2 yakaipa (katatu isina kenza yemazamu) inogona kuva yakaoma yekurapa, sekurapa kwemahomoni uye HER 2 kurapa kazhinji kusingabatsiri. Kunyange zvazvo yakashandiswa zvisingaiti panguva ino, chirongwa chinotarisirwa Avastin chinogona kuonekwa kune vamwe vanhu.
- Avastin (bevacizumab) - Izvi hazvisati zvichishandiswa zvakare kurwisa kenza yebonde zvichida dzimwe nguva kubuda ropa kwakanyanya. Inotsanangurwa seaniogogenesis inhibitor. Izwi rokuti angiogenesis rinoreva "ropa idzva" uye rinoreva misha mutsva yeropa iyo inoda kuumba kubvumira kanzera kukura.
Angiogenesis inhibitors inoshanda kuburikidza nekudzivirira kanzira kubva pakukura mitsva yeropa itsva, uye inowanzo "nzara" kenza.
> Sources:
> DeVita, Vincent., Et al. Kanzira: Mitemo & Practice of Oncology. Kanzira yeBretiti. Wolters Kluwer, 2016.
> Liedtke, C., naH. Kolberg. Utachiona hweChirongwa Chekuwedzera / Metastatic Breast Cancer-Iyezvino Uchapupu uye Ramangwana Dhana. Breast Care . 2016. 11 (4): 275-281.