Imbruvica (ibrutinib) chirwere chinoshanduka-piragi chinomiririra gungwa kuchinja maitiro atinoita chirwere chronic lymphocytic leukemia (CLL) nemamwe B-cell malignancies. Kunyanya kunyanya, Imbruvica shift leukemia kurapwa kure nemabhakitiriro emakemikrasi anovhiringidza ku-sniper-kufanana neenzymatic finesse.
Chinonzi CLL Chii?
Chronic lymphocytic leukemia ndiyo yakanyanya kufanana neukemikari yemarudzi munyika dzekuMadokero.
(Chirwere ichi chinowanzokonzera vatsvene uye chakawisira pasi vashoma veAfrica America, vanhu veSpain, uye vaAsia.) Chirwere ichi chinowanikwa kune vanhu vakwegura vane makore akaenzana ekuongororwa kwe 72.
Chronic lymphocytic leukemia chirwere cheB lymphocyte iyo inowanzopa hutachiona hwemhepo uye inoshumira sechinhu chinokosha chemuviri wedu wezvirwere.
NeCLL, kusagadzikana kwemakemikari e leukemic B kuunganidza uye kubuda kunze kwemasero eropa mumapfupa eropa, ropa uye lymph nodes. Nechirwere chemasero eropa ayo muviri wedu unoda semasero matsvuku eropa nemasero machena eropa, CLL inogona kuparadza zvakakwana kukwanisa kwedu kurwisana nehutachiona uye kunokonzera chirwere chekushaya ropa.
Zviratidzo zvevanhu vane CLL vanomhanya. Vamwe vanhu vane mukana uye vanorarama kwemakumi emakore vane indolent kana pasi-key key iyo inoda kusarapwa. Vamwe, zvisinei, vanotambura nzira yakaoma zvikuru iyo inopikisa chemotherapy.
Zviratidzo zvinowanikwa kune avo vanotambura zvakanyanya kufambira mberi CLL vanosanganisira zvinotevera:
- kuneta
- kuonda
- fever
- usiku sweats
- akawedzera lymph nodes
- kuwedzera spleen kana chiropa zvichiita kuti tinyatsoona satiety (kutanga kwekunzwa kwekuzara)
- maitiro anowanzoitika
Muna 2015, National Cancer Institute inofungidzira kuti yematambudziko 14620 eCLL akaonekwa, paiva nevakafa 4650.
Chii Chinokosha Pamusoro peImbruvica
Kusvikira munguva pfupi yapfuura, kurapwa kweCLL kwaive kwakakwana chemotherapy pamwe chete ne immunotherapy kana chemoimmunotherapy.
Kunyange zvazvo chemotherapy pachayo inongoratidzira vamwe vevaya vane CLL, kunyanya kuwedzerwa kwe rituximab, ine immunotherapy drug, kunogona kubatsira kupedzera kupona kuburikidza nekuderedza kuregererwa. Kunyanya kunyanya, rituximab inopindira CD20 antigen paB bymphocyte B. Zvinosuruvarisa, imwe ssetseti yevanhu (avo vane del [17p] / TP53 kuchinja kana kubviswa mu chromosome 17) vanopindura zvisina kunaka chemoimmunotherapy.
Chemotherapy yeCLL inosanganisira parenteral administration (injection) yevashandi vakasiyana-siyana kuitira kuti vauraye kwete kungoparadzanisa masero emagetsi asi kazhinji kugovana nemitsara yesero, zvakare. Iyi nzira yekushandisa inotsanangura kuti sei vanhu vari chemo vanotambura nemhando dzakasiyana-siyana zvinosanganisira kusuruvara kwemafupa, kuora kwepamuviri, uye, mune zvakaitika kune CLL, kunyanya kuwedzerwa myelosuppression kana hutsinye hwemhando.
Nepo chemo inobvumirana nekunyora kwekliniki yeketani yakaonekwa, Imbruvica yakafanana neyachiremba chechiremba uye yakanyatsogadziriswa. Kunyanya, Imbruvica inokonzera enzyme inonzi Bruton's tyrosine kinase (Btk) yakasiyana nemasero anouraya kana eropa. Nokusakanganisika kusungira Btk, Imbruvica inokanda monkey wrench mumagetsi anogara aine B inogadzirisa nzira saka ichidzivisa kushamba kwekamuri, kupararira, uye kupona kwemasero anouraya B.
Zvinofadza kuti vanotsvakurudza vanoti Imbruvica inogona kushanda neimwe nzira inobatanidza iyo inosanganisira kuputira microenvironment umo masero emurasi anowedzera. Kunyanya, uye sezvinotsanangurwa mubhuku rinonzi Nature Biotechnology , Imbruvica inogona "kudzivisa chemokine receptor uye kujekesa kuwirirana nekudzivirira BTK, uye naizvozvo kushamba kwemasero nekubatanidza kumasero emadzimai ari mu lymph node." Pashure pe Imbruvica administration, CLL masero anowedzera muropa uye anogona vanofira ikoko, vanoshayiwa simba rekuchengetedza microenvironment rinopiwa ne lymph node. "
Kunze kweLLL, Imbruvica inobatsirawo nezvimwe zvakasiyana-siyana zveB-cell malignancies.
Nekudaro, kuwedzera kune CLL, FDA yakabudisa ichi chirwere chinotsvaga-chengetedzwa kana chichirongwa chirongwa chinonzi Waldenström's macroglobulinemia uye mantle cell lymphoma. Hapana imwe mishonga yakagamuchira iyi yakawanda kurapwa kwezvirwere zvirongwa!
Kana iwe kana munhu waunoda ane chirwere cheLLL kana imwe B-cell kuipa, kutanga kwaImbruvica ndechimwe chinhu chingafadzwa nazvo. Nekuremekedza kuuraya kweropa, Imbruvica inotarisirwa kubudirira inogona kuenzaniswa ne rituximab. Uyezve, Imbruvica haisi yakakosha chete kupfuura rituximab se monotherapy asiwo inowanikwa mumuromo uye inobatsira nekurwisa uye kurwara zvakare.
Sources:
Chinyorwa chakanzi "Imbruvica-inotevera huru yemishonga mukenza weB-cell-yakagamuchirwa naDDA" naMalini Guha yakabudiswa muChina Biotechnology muna 2014.
Chinyorwa chinonzi "Ibrutinib (Imbruvica): A Nechirongwa Targeted Therapy ye Chronic Lymphocytic Leukemia" neS S Parmar uye vanyori vanyori vakaparidzirwa mu P & T muna 2014.