Vanopukunyuka kenza vari kurarama kwenguva yakareba kudarika kare, uye izvi zvinokwakuka uye zvigaro zviri chikamu pamusana pemishonga mitsva. Nhasi kuChicago, pane imwe sangano rezvesayenzi inonzi ASCO - musangano wegore negore weAmerican Society of Clinical Oncology - nyanzvi dzekenza dziri kurwisana nezvinetso zvakakosha mumascology.
Vari kunzwawo kutarisira kwechokwadi, uye dzimwe nguva, kufara.
Late-breaking data inoratidza kuti Gazyva, mushonga mutsva unopesana nekenza , uri kubatsira boka rakasiyana revanhu vari kurwisana nerudzi rwekenza yeropa inozivikanwa sevasiri Hodgkin lymphoma, kana NHL.
Pamusoro peHe-Hodgkin's Lymphoma
Kune miviri miviri mikuru ye lymphoma: Hodgkin's lymphoma uye NHL. Inenge 85 kubva muzana yemakemikari ose akawanikwa anonzi NHL. Maererano neAmerican Cancer Society, zvinotarisirwa kuti vanenge 72 000 vanhu vachaonekwa neNHL muUnited States muna 2015, uye vanenge 20 000 vachafa nehosha.
NezveChidzidzo
Zvisarudzo zvakanaka zvakatovapo kune vanhu vanorwisana nemhando dzakasiyana dzekenza yeropa . Zvisinei, sevanopona vanoziva, dzimwe nguva haisi nyaya yekukunda hondo imwe chete .
Vanhu vakawanda vanoziva rituximab (Rituxan), uye zvinowanikwa mukurarama zvinoshandiswa nekushandiswa kwemashoko ezvinyorwa zveMonoclonal - mapuroteni makuru e-bio-engineered kuti atarise uye kuparadza masero emukenza pamwe chete nechemotherapy zvakanakisisa kupfuura chemotherapy chete.
Chidzidzo chacho chakataurwa paAACO chakashandisa inozivikanwa nemanzwi evanhu vanonzi obinutuzumab iyo yakagamuchirwa neDDA pasi pezita rekutengeserana Gazyva kubva muna 2013 kuitira kurapwa kwechirwere chepachirema lymphocytic leukemia pamwe chete neklorambucil chemotherapy mune varwere-naive varwere.
"Takagadzira Gazyva kuvandudza pamishonga yezvino uye takafara kuona kuti yakapa sei rubatsiro kune vanhu vakamira kupindura maitiro ekutarisira," anodaro Nancy Valente, MD, Vachigaro weMutungamiri wenyika, Global Hematology Development Genentech.
Chidzidzo chacho, chinonzi GADOLIN chidzidzo, chinoratidzira kukwanisa kweGazyva mumamiriro ezvinhu aya. Dr. Valente anoona kuti chirongwa ichi ndechekushandira kugamuchirwa kweGazyva muNHL inobva pane deta iyi uye kuti vari kutarisira kuona zviwanikwa kubva kune dzimwe dzidzo mbiri dzakawanda dziri kuenzanisa musoro weGazyva kune mumwe wavo wakagadziriswa mishonga.
Varwere
Vatori vechikamu muchidzidzo ichi vaiva varume nevakadzi vane kenza - 413 vavo. Vose vakange vaine NHL-inokura-inokura kana kuti isina kunyunyisa iyo yakange ichifambira pasinei nekurapa. Kunyanya, kanzira dzavo dzairamba dzichiratidza rituximab-based therapy - kureva, rituximab kana rituximab pamwe chemotherapy - zvinoreva kuti chirwere chavo chabudirira mukati memwedzi mitanhatu yekurapa .
Mishonga
Vadzidzi vadzidza neNHL yaimbove yakarapwa yakakonzerwa nekukurumidza yakagadzirirwa mumapoka maviri akasiyana, kune mamwe maitiro ekurapa:
- Gazyva plus bendamustine, inoteverwa neGazyva chete
- Bendamustine chemotherapy chete
Mhinduro
- Gazyva-based treatment yakaderedza dambudziko rechirwere chinowedzera kana kufa ne 45 muzana zvichienzaniswa nechemotherapy chete.
- Chidzidzo chacho chakamiswa mangwanani nemhaka yepamusoro-soro yebatsiro yakaonekwa muboka raGazyva rakaenzaniswa neboka re bendamustine - kureva kuti, haringave rakanaka rekuchengetedza boka reBendamustine rakapofumadzwa sekutsvaga muboka reGazyva.
Kwakange kusina zviratidzo zvekuchengetedzwa zvisingatarisirwi zvakaonekwa neGazyva.
Zvinoreva Izvi
Munhu ane NHL indolent anowanzoenda kumativi ose ekudzoka zvakare nekuregererwa, uye zvisarudzo zvingave zvisingakwanisi kana rituximab-based treatment inomira kushanda. Saka, kusanganiswa kutsva kunoratidzika kushanda zvakajeka muvanoratidzira varwere mashoko akanaka.
"Vanhu vazhinji vane Indwelling NHL vanoramba vachidzoka, uye nzira dzokurapa dzinowedzera kuderera uye kupindura kurapwa kunowanzova kusingagumi nguva dzose kana chirwere chinodzoka.Ndinokurudzirwa nemashoko eGADOLIN nokuti obinutuzumab uye bendamustine inosanganiswa inooneka rinoshanda kwazvo, "anodaro Laurie Sehn, MD, Medical Oncologist paC BC Cancer Agency uye Clinical Associate Purofesa paYunivhesiti yeBritish Columbia.
NezveGazyva
Mukati yemazuva ano lymphoma kudzidza, Gazyva yakawedzera nguva iyo vanhu vane pfungwa dzisingatauri NHL vaigara vasina zvirwere zvavo zvichiwedzera. Genentech naRoche, makambani e biotechnology anosimudzira mishonga iyi, achapa ruzivo kubva pane ichi chidzidzo kune hurumende dzekutonga muUnited States, Europe uye pasi rose kuti zvibvumirwe kuongororwa.
Gazyva inogadzirwa neoconoclonal antibody yakagadzirirwa kunamatira kuCD20, puroteni inowanikwa paB-seli chete, puroteni imwechete iyo inotarisirwa ne rituximab. Gazyva inoparadza CD20 inotakura masero pamwe chete uye pamwe chete nemuviri wemuviri wemuviri. Gazyva inofungidzirwa kuva nehuwandu hukuru hwekuita zvakananga kusero kwekufa uye inoita basa rakakura mukushandura kunoita masimba emuviri kurwisa B-seli - anti-anti-dependent cellular cytotoxicity, kana ADCC - kana ichienzaniswa ne-rituximab.
Migumisiro Yechiri uye Zviitiko Zvakaipa
Kana ikashandiswa yoga, migumisiro yeGazyva,, kazhinji, shoma shomanana kupfuura migumisiro ye chemotherapy agents. Zvimwe zvinowanzovhiringidza neGazyva zvinokonzerwa nekudzivirira, kupera kwechichena chemajeri eropa, kuwanda kweplatelet chiyero, pasi tsvuku yeropa rekuyera, fever, kuokera, kushungurudza ropa, uye chirwere.
Gazyva inogona kukonzera zviitiko zvakakomba kana kuti zvinotyisa zviitiko: Hepatitis B reactivation, progressive multifocal leukoencephalopathy, kana PML, kupindira kwekamukira, tumor lysis syndrome uye zvirwere. Uyewo, Gazyva inogona kukonzera kugadzikana, kupera muchechi yeropa rekuyera uye kuderera mumatareti eplatelet zvinogona kuva zvakakomba kana kupisa upenyu.
Sources
GADOLIN: Zvibereko zvakakonzerwa nechikamu chechitatu III chebinutuzumab plus bendamustine yakaenzaniswa ne bendamustine chete kune varwere vane rituximab-refractory indolent kwete Hodgkin lymphoma. J Clin Oncol 33, 2015 (suppl; abstr LBA8502).
Targeted kurapwa kwechirwere lymphocytic leukemia: hutano hwehutano hwebinutuzumab. Pharmacogenomics uye Personalized Medicine. 2014; Dec 22; 8: 1-7.