Kutora Kubva muRopa reKutsvakurudza
Gore roga roga, American Society of Hematology (ASH) inobata musangano unobudisa tsvakurudzo yemazuva ano pamishonga uye mune kumwe kurapwa. Mishonga inokurukurwa pamusangano uyu iri muzvikamu zvakasiyana-siyana zvekugadzirwa kwechiremba. Mune mamwe mazwi, vamwe vavo vari mishonga iye zvino, yakaedzwa uye yechokwadi, yakagamuchirwa uye inoshandiswa, uye vamwe vari kunyatsotsvakurudza mishonga, zvichireva kuti hatizivi zvakawanda pamusoro pavo zvakadaro.
Tora rituximab, somuenzaniso. Muna 2016, Rituximab yaifungidzirwa se "yekare-mishonga" yakashandiswa kwemakore ekubata mhando dzakawanda dzisiri dzeHodgkin lymphoma. Makwegura, mishonga yakasimbiswa inogona kugadzirisa mafambiro pane imwe yemakambani, somuenzaniso, apo kushandiswa kutsva kunowanikwa.
Mimwe mishonga inokurukurwa pa ASH inongova mudanho rekutanga rekugadzirisa-kureva, kuwanikwa kuri kugoverwa kunonyanya kuitika. Kazhinji, zvidzidzo izvi zvinorondedzerwa "chikamu-ini zvidzidzo." Chikamu I ndinotaura kumakiriniki anoedza mishonga kana mushonga mutsva muchikwata chiduku chevanhu-kwenguva yekutanga-kuona kuti chinoshanda here, kuwana chiyero chakachengeteka mararamiro, uye kuziva zvirwere. Miedzo yeChikamu I yakafanana nembeu: iwe ungaguma uwana muchero unopa mubairo kana michero iwe unogona kuratidza muhurumende yakanaka, asi iwe unogonawo kuwana kukundikana kumera kana muti usingabereki zvibereko zvakawanda.
Tsvakurudzo paDLBCL
Kuparadzanisa B-cell lymphoma, kana DLBCL, inokurumidza kukura lymphoma.
Ndiyo yakanyanya kufanana nemararamiro emakirini muvanhu vakuru, uye inouya kubva ku-B-lymphocytes-white blood cells iyo inotungamirira mukugadzirwa kweAnorifone mumuviri wemuviri. Vanhu vakasiyana vane marudzi akasiyana-siyana eDLBCL uye vatsvakurudzi vari kutsvaga nzira itsva dzevarwere vane DLBCL .
Rituximab Plus CHOP kana DA-EPOCH-Rituximab
Chimwe chechikamu chekudzidza III chaiva nevarwere 524 vakanyoreswa (262 pahutachiwana hwehutano) pakati paMay 2005 neMay 2013. Ichi chidzidzo chakaenzanisa r-CHOP kurapa uye DA-EPOCH-R kurapwa, chirwere chinonzi chemotherapy-yakasimba, mune tariro yekuwedzera kupona varwere vane chirongwa chechangobva kuongororwa II kana kupfuura DLBCL.
Vaparidzi vaiva nemakore gumi nemasere uye vane HIV-vasina. Kusvika ikozvino, kazhinji, DA-EPOCH-R yaibatanidza nehuwandu hwehutachiona uye nemigumisiro, uye kwakanga kusina kusiyana pakati pemapoka maererano nemarapirwo aidzidziswa. Kunyange zvakadaro, vatsvakurudzi vari kutarisa kuti vaone nezvemazana mashomanana evanhu vane DLBCL uye kana kana vasingabatsiri neDA-EPOCH-R inoratidzirwa kumasangano. Kuongorora kuri kuenderera mberi.
Obinutuzumab Plus CHOP kana Rituximab Plus CHOP
Ichi chaive chimwe chikamu chechitatu chekudzidza nevanokwana 1,418 vakaongororwa kushanda nekuchengeteka kwebinutuzumab vs. rituximab plus CHOP kune varwere vane DLBCL. Vadzidzi vaiva nemakore makumi mapfumbamwe nemashanu kana kupfuura uye vasati vashandirwa DLBCL. Pasi pose, pakanga pasina kuoneka kwakasiyana pakati pemapoka maviri aya maererano nemararamiro ekupona, uye zvimwe zviitiko zvinotambudza zvakataurwa kune varwere mu obinutuzumab-CHOP kupfuura rituximab-CHOP boka. Kakawanda, kufa kwehuwandu kwaive kwakakwirira uye kubviswa kwehutano hunojairika mune obinutuzumab -CHOP arm.
Zvisinei, vatsva vanoronga kutarisa mazana masangano neDLBCL kuedza nekuwana chero zvipo kana dambudziko risina kuratidzirwa muboka rose.
Lenalidomide muvarwere vane DLBCL Vakadzokazve
Vanhu vasingakodzeri kuwedzerwa kwemapfupa emapfupa kana vari kurwarazve kana mushure mokunge marrow transplant vane mikana yekurapa, saka rimwe boka rekutsvakurudza rakatarisa kushandisa mishonga yekuwedzera kupona muvarwere ava.
Vakawana kuti mujenya lenalidomide ndiye mufananidzi akakodzera sezvo iri mishonga yemuromo, yakashandura DLBCL iyo inogona kutorwa kwemakore nehuwandu hunogamuchirika hwehutsvina.
Chidzidzo chacho chakaratidza kuti varwere vakwegura vane marudzi akasiyana-siyana eDLBCL vakabatsirwa ne lenalidomide maintenance therapy pamwe nekuvandudza kupona. Kurapa kwekuchengetedza kunoreva kurapwa kwekenza nemishonga, kazhinji inotevera nguva yekutanga yekurapa.
Tsvakurudzo pa Follicular Lymphoma
Follicular lymphoma ndiyo inowanzosiyana-siyana ye indolent-kureva, inononoka-kukura-lymphoma. Kunyange zvazvo obinutuzumab yakanga isingaratidzi kupa zvipo zvacho zvakajeka asi muchidzidzo cheDLBCL chakataurwa pamusoro apa, iyo yakanga isiri iyo ye obinutuzumab mu follicular lymphoma.
Obinutuzumab-Based Therapy Inokurudzira Kufambira Mberi-Kusununguka Muvarwere Nepakutanga Isingazivikanwi Inonzi Follicular Lymphoma
Chirwere cheGALLIUM chaive chikwata chepasi rose chekuenzanisa nekubudirira nekuchengeteka kwe rituximab kana obinutuzumab ine chemotherapy yakatevera nekugadziriswa semutambo wekutanga wekunyora indolent kwete Hodgkin lymphoma.
Muchirwere chekare chisina kutenderwa follicular lymphoma, obinutuzumab-based chemotherapy regimen uye chirongwa chekugadzirisa kwakaguma nekuvandudza kunobatsira mune zvekuchengetedza pasina chirwere ichi chichipfuurira-34 muzana kuderedza mukana wekufambira mberi maererano ne rituximab-based therapy. Obinutuzumab yakanga ine nguva yakakwirira yezvimwe zviitiko zvinotambudza zvakadai sekushushikana kwehutachiona, huwandu hweropa, uye zvirwere. Vatsvakurudzi vakapedzisa ruzivo rwebasa obinutuzumab-based regimen kuva mamiriro matsva ekuchengetedza kune varwere vasiri kutapurirwa ne follicular lymphoma.
Tsvakurudzo paHodgkin Lymphoma
Kune mishanu mhando mikuru yeHodgkin lymphoma (HL) iyo munhu angaonekwa kuti ane. Chikoro cheHodgkin lymphoma ishoko rekare rinoshandiswa kurondedzera boka remazana mana anowanzobatanidzwa pamwe chete anopfuura makumi mapfumbamwe makumi matatu ematambudziko ose eHL munyika dzakabudirira.
Immune Checkpoint Inhibition yekudzorerwa Chikoro cheHodgkin Lymphoma
Chikoro cheHodgkin lymphoma chakaita sechichigadzirisa maitiro aizouita kuti itange kugadziriswa nekirasi idzva remishonga inonzi immune checkpoint inhibitors , zvichibva pane zvidzidzo zvekare. Saka, boka rekutsvakurudza reAHH rakarisa varwere 210 vakarapwa nekuda kwechirwere chekare kana kudzokazve HL kuona kuti checkpoint inhibitor pembrolizumab yaizoita sei.
Mamwe masero emukenza anobudisa yakawanda PD-L1, uye ichi chinhu chinovabatsira kupukunyuka zvirwere zvekuzvidzivirira. Pembrolizumab inogona kubatsira kuisa izvozvo. PD-1 blockade ne pembrolizumab yakashanda mumapoka evarwere vane classic HL avo vakanga vataparidzwa zvikuru nedzimwe mishonga. Pembrolizumab yaiva nehuwandu hwemhinduro kunyange kunyange mune chirwere chakanga chisingadi chemotherapy. Zvimwe zvinowanikwa, kusanganisira kuti nguva yakareba sei mhinduro yakaramba iripo inotarisirwa pamusangano.
Tsvakurudzo pamusoro peAukemia
Kurapa Kwokurapa Kwevarwere Ne AML - Eltrombopag
Mune varwere vanotapukirwa nemakemikari yakasimba nokuda kwechirwere chinonzi myelogenous leukemia (AML) , dzimwe nguva maplatelet anoverengeka anoramba akasara pashure pemakemikari, uye izvi zvinogona kutungamirira kune ngozi dzakawanda dzokubuda ropa, kudiwa kweplatelet transfusion akawanda, uye varwere vanogona kukudziridza maitiro ekudzivirira kumaplatelets, izvo zvose zvinoshumira kudzivisa kufambira mberi.
Muna 2016 boka rakashuma richishandisa eltrombopag, mushonga unobatsira muviri kuti uite maplatelet akawanda, kune vanhu vakwegura vakanga vachirapa AML.
Zvigumisiro zvaive zvekutanga-izvi zvaive chikamu chekutanga chekuongorora-asi ivo vakaita sevari kubudirira nekuita kuti vanhu vape nekukurumidza kubva chemo kuitira kuti varege kudikanwa seplatelet transfusion. Pakanga pane kuve nekutya kuti sendimi yakadai sealtrombopag inogona kukurumidza kufambira mberi kweukama, nekuwedzera kune zvingabatsira kuburikidza nekubatsira maplatelets achidzoka, zvisinei, kusvika ikozvino mukudzidza uku hakuna humwe uchapupu hwengozi iyo ndeyechokwadi.
Kudzorerwa kana Kuyeuka Acute Lymphoblastic Leukemia (ALL)
Hapana hurumende yepamusoro yekudzorerwa ALL. Inotuzumab ozogamicin chirongwa che FDA-chakasarudzwa kuburikidza nevarwere vakadzokorora kana kuti vanoratidzira acute lymphoblastic leukemia (ALL). Mune imwe kliniki yekuedzwa, inotuzumab ozogamicin yakabudisa kuchinja kukuru pamusoro pemishonga inokonzerwa nemakirini akasiyana-siyana anokanganisa, kana kuti kwete kupindura, mamwe mishonga.
Inotuzumab ozogamicin ipfungwa yekuongorora-anti-mishonga yakasanganiswa yakagadzirwa neAntiyopiyo inosanganiswa neaiti inogona kuuraya masero emukenza. Apo mishonga inonamatira pamutambo unonzi CD22 pamakemikirini emukenza, inopindira muisero iyo inokonzera DNA kuputsa, zvichiita kuti sero kufa.
Zvinotsvakurudzwa Nekutsvakurudza
Apo misangano inowanzotarisirwa kugovera vhigiri vezvokurapa nekutsvakurudza kwemazuva ano, ruzivo runowanzove rwunofadza kune avo vanoongororwa vane mamiriro ezvinhu, pamwe nevanoda vavo. Apo iwe unoshanyira chiremba wako kubvunza pamusoro pezvitsva mumunda-kuva mune zivo zvinogona kukubatsira kunzwa uchitowedzera mukudzora hutano hwako.
> Sources:
> 469 Phase III Randomized Chidzidzo cheR-CHOP Versus DA-EPOCH-R uye Molecular Analysis yeZvenhema Dzisina Kupararira B-Cell Lymphoma: CALGB / Alliance 50303
> 474 Lenalidomide Maintenance Inonyanya Kuvandudza Upenyu Hwokuchengetedzwa Muvarwere Nezvekudzoka Kupararira Kukuruka B-Cell Lymphoma (rDLBCL) Avo Vasingakwanisi Kubvumira Kwemagetsi Anokwidza Masero (ASCT): Zvigumisiro Zvokupedzisira zveMatricentre Phase II Muedzo
> 470 Obinutuzumab kana Rituximab Plus CHOP muVarwere Vepakutanga Vasingazivikanwi Vakaparadzaniswa Zvikuru B-Cell Lymphoma: Zvigumisiro Zvokupedzisira kubva muGwaro Rakazaruka, Randomized Phase 3 Chidzidzo (GOYA)
> 1107 Pembrolizumab muChechi / Refractory Classical Hodgkin Lymphoma: Primary End Point Kuongororwa kweShoko 2 Keynote-087 Chidzidzo
> 447 Simba Rinoga, Phase II Kudzidza Eltrombopag Kuvandudza Platelet Kuverenga Kuwana Muvanhu Vakwegura Vanorwara Myeloid Leukemia Inobvuma Kuregererwa Kurapa Induction
> 6 Obinutuzumab-Based Induction uye Maintenance Zvishoma Nekuwedzera Kubudirira-Kusapona-Kukunda (PFS) muVachipatendi Vaimbove Vasingazivikanwi Follicular Lymphoma: Zvibereko Zvikuru zveRandomized Phase 3 GALLIUM Yokudzidza