Mushonga weMetastatic Stage IV Melanoma Inopa Tariro
Interleukin-2 ye metastatic melanoma ndiyo imwe nzira mbiri dzokurapa dzinogamuchirwa nehosha yacho. Chironda chinopararira kunze kweganda kune nhengo dziri kure chinonzi "metastatic" (kana kuti danho IV ) melanoma. Kunyange zvazvo kusarudzwa kwekurapa ikozvino kwakanyanya kuderera, vamwe vanhu vanopukunyuka chirwere ichi chakakomba chechirwere. Kune huwandu hwekutsvakurudza huripo munharaunda iyi asi kusvika ikozvino, maitiro maviri chete ekurapa akagamuchirwa: interferon-alfa2b uye maune immune system activator interleukin-2 (IL-2).
Kana yako oncologist yakurudzira IL-2, mhedziso iyi inokusimbisa nemashoko anokosha iwe unoda kunzwisisa kuti inoshanda sei, kubudirira kwayo nemigumisiro yaro.
Interleukin-2
Iyo inonziwo Proleukin uye aldesleukin, IL-2 yakagamuchirwa neDain and Drug Administration (FDA) yekurapwa kwechirwere chinonzi melanoma muna 1998. (Zvinosuruvarisa, hapana mimwe mishonga yemaranoma yakabvumidzwa kubvira.)
IL-2 yakasiyana nedzimwe chemotherapy mishonga - iyo inongova chikamu chemuviri wemuviri wemuviri wako. Icho chimiro chenhume inonzi "cytokine" iyo yakavanzwa kubva kune mamwe masero kuti ione mamwe masero pamusoro pevhirwere vanopararira. Mhando gumi nemashanu dzakasiyana-siyana dze interleukins dzakawanikwa kubva kuma1970: IL-2 inozivikanwa kuti inonyatsosimudzira kukura nekutsvaga kwemhando mbiri dzemasero machena eropa, anonzi "T uye B lymphocytes." I-IL-2 inoshandiswa kurapa mastanate yemetamoma haina kubva mumuviri asi pane yakawanda yakagadzirwa, uchishandisa nzira dzei genetic engineering.
Iine maitiro akafanana nehupenyu hwemhuka, asi ine zita rakasiyana zvakasiyana, aldesleukin.
Uchapupu hwekubudirira kweInterukukini-2
Mune zvidzidzo zvakatungamirira kugamuchirwe, 6 muzana yevakasarudzwa varwere (avo vari mumuviri wakanaka uye mupfungwa) nemetanoma yemastastine yaive nemhinduro yakakwana kune-high-dose IL-2, uye 10 muzana yaive nemhinduro.
Mhinduro yakakwana inotsanangurwa seyenguva refu (10+ makore uye kuverenga) kubviswa kwechirwere ichi, kunyange zvisiri zvechokwadi "mushonga." Pasinei neshoko rinoreva, ndiyo chete mishonga inowanikwa iyo kunyange ine mukana wekuita kwakanyanya kwakanaka uye kwenguva refu. Mhinduro dzaionekwa muvarwere vane marudzi akasiyana-siyana emasitosita, kusanganisira mumapapu, chiropa, lymph nodes, zvinyama zvinyoro, zvinyorwa zvinonzi adrenal glands uye subcutaneous (yakadzika) zvikamu zveganda. IL-2, zvisinei, hazvikurudzirwi kune varwere vane hutachiona hunokonzerwa neuropi.
Mune miedzo yekliniki yakave ichiitwa (uye ichiri kuitiswa) mukuedza kuwedzera mhinduro dzemitemo yeI-2 nekuiunganidza pamwe nemimwe mishonga. Semuenzaniso, chidzidzo chakaratidza huwandu hwehutano hwepamusoro apo IL-2 yakapiwa pamwe chete nechirwere (22 muzana) ichienzaniswa naI-2 chete (13 muzana). Zvinosuruvarisa, vazhinji vanoedza kubatanidza IL-2 nemishonga yakasiyana-siyana yemakemikrasi (cisplatin, vinblastine, dacarbazine nevamwe) - nzira inonzi "biochemotherapy" - pamwe chete nedzimwe mishonga ( interferon-alfa2b , etc.), ikozvino yakaratidzwa hapana kuwedzera kunokosha mune nhamba inonyanya kukosha: kupona nguva.
Kushandisa Interleukin-2
IL-2 inopiwa nemaminitsi gumi neminomwe IV kuvhara maawa masere ega kwemazuva mashanu.
Nzira imwe neimwe yekurapa inosanganisira miviri miviri yezuva yekurapa maitiro akaparadzaniswa nezuva rezororo remazuva 9, uye zvidzidzo zvakawanda zvinowanzoitika. Iwe unowanzofungidzirwa pamusoro pemwedzi pashure pokupedzisa kurapa kwako kokutanga. Kana iwe uri kupindura, iwe ungangove wakapiwa kosi yechipiri yerapi kwevhiki 6 kusvikira ku12 pashure pokupedzisa kosi yekutanga. Kuti uve akakodzera kuI-2 kurapwa, unofanirwa kunge uri munyama chaiyo, nemwoyo wakanaka, mapapu, chiropa, uye mafungiro.
Zvichida Zvimwe Maitiro
IL-2 inogara ichida, inowanzotadza uye dzimwe nguva inouraya migumisiro. Inofanira kupiwa muchipatara pasi pekutarisirwa kwechiremba anokwanisa anoziva mukushandiswa kweanticancer agents.
Chirongwa chekuchengetedza kwakanyanya uye nyanzvi dzine unyanzvi mune mishonga yemardialulmonary kana yakasimba inofanirwa kunge iripo. Chiyero chekufa kwechirwere chinokonzerwa nemishonga mumakiriniki ekuongororwa kwevanhu vanonzi metastatic melanoma avo vakagamuchira IL-2 vaiva 2%.
Zvakawanda zvemigumisiro inokonzerwa ne "capillary leak," iyo inotanga pakarepo mushure mokurapa yatanga. Kufutika kwemapapiro kunokonzera kuputika kwemapuroteni kubva muropa izvo zvino zvinokonzera kuderera kweropa. Zvimwe zvinowanzovhiringidza zvinotevera:
- kushungurudza, kurutsa, chirwere, kurasikirwa kwechido
- kusimba uye kuneta
- zvirwere-fanana zviratidzo (fever, chills, headache uye muscle aches)
- low blood pressure
- kurwadziwa kukuru, kurwadziwa kwepfupa (angina)
- Kufemerwa matambudziko kubva pamvura mumapapu
- kuwedzera kuwanda, kushandiswa kwemvura
- mafungiro (kupera, maitiro, kurasikirwa)
- kunyorera, kutarisa ganda
- anemia (low red blood cell count)
- low platelet count (kuwedzera ngozi yekubuda ropa)
- akachena masero masero eropa
- kuora kweiyo
- maronda emuromo
Izvi zvinokonzerwa nehutano asi zvakataurwa kune vamwe vanhu vachitora IL-2:
- kusava nemwoyo mwoyo rhythm, mwoyo yekurwa
- kupera simba
- zvirwere zvakakomba
- utumbo hunopa ropa
- matambudziko e thyroid
- chiropa chinetso
- kuora kukuru, kupera simba
Muchenjeri / Kutaurirana
IL-2 inogona kuita kuti migumisiro yemimwe mishonga nezvirwere zvirambe zvakanyanya kuipa, saka taurira chiremba wako kana une:
- itsvo zvinetso
- chirwere chemoyo
- chiropa chiropa
- chirwere chemapapu
- chirwere chekudzivirira
- thyroid disorder
- zvirwere
- chero upombwe
- chero zvirwere zvekudzivirira zvirwere
Uyewo rega chiremba wako azive nezvemhando ipi zvayo-in-counter kana mishonga yemishonga yaunoshandisa iwe, kunyanya corticosteroids, indomethacin, ropa rezvinodhaka zvinodhaka, antidepressants, anti-anxiety drugs kana mamwe mishonga yekurapa. Usatanga kana kumira chero mushonga usina chiremba chibvumirano.
Cherechedza: Tsanangudzo iyi haifaniri kuvhara zvose zvinogona kutarisirwa, kusangana kana kuipa kwechirwere ichi. Kana uine mibvunzo chero ipi zvayo pamusoro pemishonga ipi zvayo yaunotora, iva nechokwadi chekutarisa neunyanzvi hwehutano hwako.
Sources:
"Melanoma." National Comprehensive Cancer Network. V.1.2009. 27 Januwari 2009.
"Proleukin Kutsanangura Mashoko." Novartis Pharmaceuticals Corp. 27 January 2009.
Smith FO, Downey SG, Klapper JA, et al. Kurapa kwema-melanoma metastatic uchishandisa interleukin-2 chete kana pamwe chete nemishonga. Clin Cancer Res 2008 14: 5610-5618. 27 Januwari 2009.