Ibrutinib, Brentuximab, Blinatumomab uye Idelalisib
IAmerican Society of Hematology (ASH) ndiyo inonyanya kushandiswa kwevanhu vanoona nezvezvinokonzera uye kurapwa kwezvirwere zveropa. Gore roga roga, rakanakisisa uye rakanyanya kupenya kubva kumativi ose enyika rinouya kuzopinda ASH.
Gore rino, pakanga pane sangano pamusoro pemishonga itsva yeDAA yakagamuchirwa nemamiriro ezvinhu ehematologic. Yakaitwa nokuti vanachiremba vaida mamwe mashoko pamusoro pezvimwe zvekupedzisira kweDAA.
Vatauri vanoongorora huwandu hwemashoko nezvemishonga mitsva, kusanganisira ibrutinib (Imbruvica), uye idelalisib (Zydelig).
Kune vakawanda, musangano weDisemba weAH unoshanda semuenzaniso wekufambira mberi kwakaitwa mugore rakapfuura mu hematology uye oncology. Pano pane zvishoma zvezvinhu izvo vanhu vaitaura nezvazvo.
Ibrutinib (Imbruvica)
Mapuroteni akasiyana-siyana kana zvakanyanyisa, zvakadai semakemikari, anotamba basa mukuisa chiratidzo-cheitiro iyo masero "anoteerera" uye anopindura pamagetsi emakemikari. Bruton's Tyrosine Kinase (BTK), enzyme iyo inobatanidzwa mubasa rinokosha muB-cell kukura, ndiyo muenzaniso weiyo enzyme inodzora kushandiswa kwekamuri. Ibrutinib ikamukana kemukoro inodzivirira BTK enzyme.
Nokudzivisa iyi enzyme, ibrutinib inovhiringidza nzira yekucherechedza iyo mamwe maitiro emukenza anovimba nayo. Kubva pane kubudirira kusvika ikozvino, FDA yakaronga ibrutinib sechirwere chekugadzirisa, uye ine basa mukurapa zvinotevera zvinonyadzisa:
- Chronic lymphocytic leukemia (CLL) varwere vakagamuchira mushure mekutanga kurapwa
- Chronic lymphocytic leukemia (CLL) varwere vane 17p deletion
- Mantle cell lymphoma (MCL) varwere vakagamuchira mushure mekutanga kurapwa
Ibrutinib ipiritsi inotorwa kamwe chete pazuva uye yakanyatsorambidzwa. Kushandisa kwemajeri kuri kuongororawo mukurapa kweimwe kenza, zvose zviri zviviri uye pamwe chete nemishonga yakasiyana-siyana.
Idelalisib (Zydelig)
Idelalisib is FDA-inogamuchirwa kune vanhu vakadzokorora chronic lymphocytic leukemia (CLL) , vakadzokerazve follicular B-cell kwete Hodgkin lymphoma (FL), uye vakadzokazve duku lymphocytic lymphoma (SLL, imwe rudzi rweHodgkin lymphoma).
Kubvumirwa kwakavakirwa pane zvakawanikwa zvekuedzwa mu 220 varwere vakadzokera zvakare kuCLL, uko kemikirini yemagetsi yakanga isina kurongwa. Iro regimen yaiva idelalisib + rituximab kana placebo + rituximab. Mhosva yacho yakaratidza kuderedzwa kwe 82% muhutano hwekufambisa kenza ne idelalisib, saka vakaimisa kare, vachirega nzvimbo yeboyo + rituximab varwere vachiziva zvose nezve idelalisib uye ichivapa mushonga mutsva. Vose vevarwere vari mumuedzo we rituximab + placebo boka ndokubva vatanga kugamuchira idelalisib.
Brentuximab vedotin (Adcetris)
Uyu mujeri mujena wekudzivirira mukati. Brentuximab vedotin ine nzira inofadza yekuita. Icho chinopesana neinjiniki - inosanganiswa nejaira rinobatsira kuuraya masero emukenza kana vachisvika pakatarisana navo. Inotarisirwa kupuroteni inonzi CD30, inowanikwa muClassical Hodgkin lymphoma (HL) uye mu systemic kuplastiki huru cell lymphoma (sALCL).
Dzidzo yakakurukurwa pa ASH ndiyo yekutanga mu lymphoma kuratidza kuti kuwedzerwa kwemishonga yekuchengetedza mushure mokunge kuwedzerwa kunogona kunyatsogadzirisa zvirwere zvevarwere.
Mumhosva yeAETHERA, inenge 63% yevarwere vepachiremera chepamusoro-lymphoma avo vaibatwa nemishonga yakagadziriswa kwemwedzi makumi maviri nemaviri-kusununguka-kusina kufanana ne 51% yevarwere vakagamuchira placebo.
Blinatumomab (Blincyto)
Ichi chemishonga ndiyo yekutanga yemishonga yeBITE (Bi-specific T Cell Engager) inotenderwa. Yakaratidza basa rinokosha muB-cell acute lymphocytic leukemia (ALL) varwere vane zvishoma zvishoma zvinosara zvirwere mushure mekurovedzwa kwechirwere , maererano nevatsvakurudzi ve ASH. Blinatumomab yakabvisa masara ekurapa masero kubva 78% zve 112 akarapwa.
Maererano neNational Cancer Institute, blinatumomab inonzi antibody inogadziriswa inoita kuti zvose zvigadzirire maitiro ezvirwere zvekuzvidzivirira uye iende shure kwekenza ine mabasa anonzi antiineoplastic.
I-FDA inobvumira blinatumomab kuti inoporesa varwere vane Philadelphia chromosome -negative precursor B-cell acute lymphoblastic leukemia (B-cell ALL), chimiro chisingawanzo che ALL.
Tarisa Niccola Gokbuget, MD, tsanangura kuti blinatumomab inoshanda sei.
MITAMBO Kutungamirira Kuregererwa KOSE
Yenguva yakareba data kubva mumuedzo unoshandisa chimeric antigen receptor (CAR) masero eT akaratidza masero aya akadzokorora anoramba achitenderera kwechinguva, achiita basa ravo, achiita kuti aende kwenguva refu. Vakawanda vari munharaunda yezesayenzi vane tariro pamusoro pemhando iyi yehutachiona hwemhando dzakasiyana dzekenza dzisina kuoma kuitora.
Cherechedza pamigumisiro yechiri
Nhoroondo, dzose idzi dzinoshanda dzine migumisiro yechirwere, dzimwe dzingangove dzakaoma, uye dzimwe dzingave dzichigere kuzivikanwa. Sezvo nemishonga yose, chisarudzo chekubata chinoshandiswa neicho chinozivikanwa nezvengozi dzakagadziriswa uye zvakabatsiro zvehutano uye zvinhu zvinorwara nemunhu mumwe nomumwe.
Sources
National Cancer Institute. Blinatumomab ruzivo ruzivo. http://www.cancer.gov/drugdictionary?cdrid=487684. Yakasvika muna December 2014.
MedPageToday. http://www.medpagetoday.com/MeetingCoverage/ASHHematology/48998. Yakasvika muna December 2014.