Chii Chinofanira Kuziva Nezve Immuotherapy Drug Opdivo?
Kana iwe kana munhu waunoda wakanyorerwa immunotherapy drug Opdivo (nivolumab), chii chaunoda kuziva? Izvi zvinoshanda sei? Ndezvipi zvinogona kukonzera mishonga iyi? Ndeapi anowanzoshanda Opdivo uye rudzi rwemhinduro dzave nevanhu? Pakupedzisira, ndezvipi zvinowanzova nemigumisiro?
Opdivo (Nivolumab) -Definition
Opdivo (nivolumab) inofungidzirwa sechimiro che immunotherapy mishonga, iyo yekutanga mishonga iyi iyi yakagamuchirwa nekenza yemapapu (muna 2015) uye ikozvino inogamuchirwa kune dzimwe kenza dzakawanda.
Immunotherapy iyi ndiyo mhando itsva yemishonga yemukenza iyo inoshandisa maitiro ezvirwere zvemuviri kana maitiro ezvirwere zvekudzivirira zvirwere mumuviri.
Iko kune marudzi akasiyana-siyana e-immunotherapy. Opdivo inoonekwa se "checkpoint inhibitor" (iyo yatichakurukura mberi pasi apa).
Opdivo (nivolumab) yave ichiwedzera kuwedzerwa mukurapa kenza mumakore mashomanana adarika, uye zvizhinji zvechifaro hachisi kungoita hupi. Vamwe vanhu vave nemhinduro kumishonga yaive isinganzwisisiki kunyange makore mashanu akapfuura. Zvinosuruvarisa, Opdivo haishandi kune munhu wese, asi kana ichishanda inogona kuguma nemhinduro yakasimba (inotsanangurwa pasi apa). Migumisiro yakaipa inowanzoonekwa, asi kazhinji yakaoma kudarika migumisiro inowanikwa nemakemikirini akawanda emakemikari.
Iko Opdivo (Nivolumab) Chirongwa Chemotherapy?
Vanhu vazhinji vanovhiringika pamusoro pekuti makotherapy uye immunotherapy zvakabatana sei. Is immunotherapy, uye kunyanya nivolumab, rudzi rwemakemikrasi?
Dzimwe nguva, chemotherapy inoshandiswa zvisina kufanira kutsanangura chero rudzi rwemishonga inopiwa kupa kurwisa kenza. Muchiitiko ichi, immunotherapy mishonga dzimwe nguva inganzi inonzi chemotherapy. Asi pane kune kusiyana kwakakosha pamwe chete. Izwi rokuti "chemotherapy" rinowanzoreva kushandiswa kwezvinodhaka zvinokanganisa kusanganisa kwemasero emaseli ose anokura.
Izvozvo zvinozivikanwa nemigumisiro yechemotherapy inomuka nokuti, kunze kwekurwisana nemasero ekenza, madhiragi aya anokonzerawo masero anowanzoparadzana anoparadzaniswa nokukurumidza. Icho chiito che chemotherapy pane masero ane utano, akadai seaya ari mumapfupa emafuta (zvichiita kuti muchengeti wepamusoro uye kuwedzera), bvudzi follicles (zvichiita bvudzi rinorasikirwa), uye chirwere chekudya (chinokonzerwa neuseusea) chinoita kuti zvive nyore madhara.
Kusiyana neizvi, immunotherapy mishonga yakagadzirirwa zvakananga kuchinja masimba emumuviri kana kushandisa zvinhu zvakaitwa nemajoni ezvirwere kuti varwise kenza. Nokuda kwechikonzero ichi, immunotherapy mishonga inowanzova nemigumisiro shomanana kupfuura tsika dzekodhese remishonga.
Ko Opdivo (Nivolumab) Inoshanda Sei?
Opdivo (nivolumab) is immunotherapy drug iyo inorondedzerwa se checkpoint inhibitor.
Checkpoint inhibitors zviri nyore kunzwisisa kana iwe uchifunga nezvekudzivirira muviri kwako semotokari, ne checkpoint inhibitors iri mabheki pamotokari. Masimba edu emagadzirirwo akaitirwa kurwisa mabhakitiriya, mavairusi, uye kunyange masero emukenza mumitumbi yedu. Nhengo dzezvirwere zvedu zvekare dzinotanga kuziva kurwadza kenza. Sezvo muviri wedu uchirwisa mabhakitiriya uye mavairasi munharaunda yedu, yakagadzirirwa kurwisana nemamwe masero akadai sekenza masero.
Izvo zvirwere zvemuviri zvinoshandiswa, asi, zvine cheki uye zviyero. Izvi zvinotarirwa kushandiswa kudzivirira masimba ezvirwere zvemuviri kuitira kuti irege kuisa pasi kana kuti kudarika. Kushandiswa kwezvirwere zvekudzivirira muviri, iko, chaizvoizvo, dambudziko rine zvirwere zvinokonzerwa nehurmumune uye rheumatoid arthritis uye lupus.
I "mabheki" emotokari inononoka kudarika iyo mapuroteni anonzi checkpoint inhibitors. Aya mapuroteni anoona kuti anononoka kupindira mumuviri wezvirwere zvemuviri kuitira kuti usanyanyisa. Imwe yemaprotiniti iyi PD-L1. PD-L1 inosungira PD-1 receptors pamasero eT (masero ari mumuviri wesimba anonyanya kushanda mukurwisa kenza), achivaudza kuti vanyarare.
Makero emukenza anonyengera. Mamwe masero emukenza akawana nzira yekubudisa yakawanda PD-L1. Apo izvi zvinosungira PD-1 receptors pamasero eT , inobvumira masero emukenza kukura asina kuvharwa, sekuita sekuisa maski pamasero ekenza kuitira kuti masimba ezvirwere zvemuviri asazviziva uye avarwise.
Opdivo inoshanda nekusunga nekuvhara kushandiswa kwe PD-1 na PD-L1, zvichida kusunungura mabheki pamotokari (immune system) kuitira kuti inogona kurwisa kenza. Zvose mune zvose, Opdivo inoshanda nekutora mask kubva kune masero ekenza kuitira kuti vasagona kuzovanza kubva mumuviri wezvirwere zvemuviri, uye kuguma kuparadzwa nemuviri wemuviri wake.
Ndeipi uye Sei Opdivo (Nivolumab Inoshandiswa)?
Opdivo inowanzoshandiswa kumutsara we IV (unoperable) kanzira, kanzira isingagoni kurapwa nekuvhiyiwa uye kazhinji inopararira kune dzimwe nhengo dzomuviri (zvinonzi semastatic).
Opdivo inopiwa nejoyo yepravenous pamusoro pechirwere chenguva yeawa. Inowanzopiwa nguva dzose mavhiki maviri.
Chii Chinonzi "Kugadzikana Kupindura" Kunorevei?
Usati wataura nezvezvidzidzo zveNivolumab, zvinobatsira kutsanangura izwi rinoshandiswa nguva dzose apo rinotsanangura mhinduro kune immunotherapy mishonga: izwi rokuti "dura dura".
A "mhinduro yakasimba" inoreva kurarama kwenguva refu kwechiremera kumushonga. Hapana nguva yakatarwa, asi "kugara kwenguva refu" zvinowanzoreva kusingana kwegore rimwe uye dzimwe nguva yakareba.
Kana iwe ukaona zvidzidzo zvekutaura nezve "mhinduro yakasimba," izvi zvinowanzosiyanisa nemhando yemhando yekupindura inotarisirwa kubva ku chemotherapy. Nechitsauko IV mishonga yakasimba, chemotherapy inogona kubudirira asi chiremera chinowanzoramba chichigadzikana chemotherapy pashure penguva shoma yenguva (inowanzotsanangurwa mumwedzi). Nezvinodiwa kurapwa, nguva yekupindura inowanzotora nguva refu, asi kushorwa kazhinji kunowedzera munguva yegore zvichienderana nehuwandu hwemishonga, rudzi rwekenza, nezvimwe zvakawanda.
Kugadzirisa kusingaperi hakurevi "kurapa" asi kunotsanangura mhinduro iyo nenzira dzakawanda chinhu chapedyo chatiine panguva ino-kana inoshanda.
Kusiyana nechemotherapy uye inorapwa-iyo inoshanda chete chero bedzi munhu ari kutora mushonga-kune vamwe vakatora Opdivo, zvinoita sekuti inogona kuramba ichishanda. Nekasaiti kadiki kemukirini yemapapu yemapapu, vamwe vanhu vave nemhinduro dzakasimba kunyange mushure mokurega kurapwa.
Ndeipi Cancers Inogona Kuitwa NaOne Opdivo?
Opdivo (nivolumab) yakagamuchirwa kuitira kurapwa kwevanhu vane mapapu adenocarcinoma (rudzi rwusingaiti duku rwekenza yemapapu emapapu), squamous cell carcinoma yemapapu (imwe mhando yekasi-duku duku yemukenza yemapapu), metastoma yemaranoma, Hodgkin chirwere , mutachiona wemusoro uye wemutsipa, Merkel cell carcinoma, uye renal cell carcinoma (mutsara wepfungwa).
Ndezvipi Zvidzidzo uye Zvimwe Zvimwe Muedzo Zvinotitaurira Nezve Opdivo?
Zvidzidzo zvine, kazhinji, zvakatarisa zvinokonzerwa naOpdivo pane zvimwe zvinokonzera panzvimbo dzekenza yose yakazara:
- Chero-duku kemukirini yemapapu yemapapu - Kubvunzurudzwa kwemasere mapfumbamwe ekubatana nevanhu vane danho rechitatu uye gadziriro yechina yekaseti yemapapu yemapapu yakatora kuti nivolumab (uye atezolitumab uye pembrolizumab) yakavandudza hupenyu huzhinji kupfuura chemotherapy kana yakashandiswa wechipiri mutsara (uyewo pembrolizumab mutsara wekutanga muPDL-1 maitiro akanaka). Mukuwedzera, vanhu vakawana zvishoma zvingava nemigumisiro pa checkpoint inhibitors kupfuura pane chemotherapy. Opdivo inogona kushandiswa pamapapu adenocarcinoma kana squamous cell carcinoma yemapapupa . Opdivo inofanira kushandiswa chete kuvanhu ivavo vasina chekugadzirisa zvirwere zvekuchinja kana kusati vapindure pane zvinorapwa.
- Metastatic melanoma - Opdivo ikozvino yakakurudzirwa mutsara wekutanga (sokutanga kurapwa) kwemastanoma ye melanoma .
- Chikoro cheHodgkin lymphoma - Opdivo inogona kushandiswa kuvanhu vane classical Hodgkin lymphoma vasingashanduki mushure mekudzivirira sero cell transplant uye kushandiswa kwechirwere chinotarisirwa.
- Chirwere chesero musoro nemukenza wemutsipa (metastatic kana zvakare).
- Renal cell carcinoma - Opdivo inogamuchirwa mutsara wechipiri (mushure mokunge anti-angiogenesis inhibitor therapy) yepamusoro renal cell carcinoma , iyo yakanyanya kufanana nekenza yempfungwa.
- Urothelial carcinoma - Opdivo inogamuchirwa kune vanhu vane chirwere ichi chirwere chekemhavha asiri kuwedzera mune chemotherapy.
- Merkel cell carcinoma
Ndeipi Iyo Immunotherapy Inoshanda Zvakanakisisa?
Tsvakurudzo yeOpdivo nedzimwe zvirwere zvekudzivirira muviri zvinenge zvichiri vaduku, asi nemukenza wekumapapu zvishoma, zvinoratidzika kuti vanhu vakatsvaga munguva yakapfuura vanowanzopindura kune zvinodhaka kupfuura avo vasina kumbobvira vasvuta. Izvi zvinonzwisisika paunofunga pamusoro pemagetsi. Matumbo ane mapapiro mukati mevanhu vanoputa vane "kuwedzera mutered load." Mune mamwe mazwi, masero emukenza ane zvakawanda zvekuchinja kwezvinhu zvinowanika mukenza masero anowanikwa mukushanda kwesero kuva kenza. (Izvi hazvirevi nehutano uye izvi zvinochinja hazviperi mumhuri). Maseji ane zviitiko zvakawanda zvinowanzooneka sechinhu chisina kujairika (zvisingasviki semasero akajairika) kuzvirwere zvekudzivirira muviri, kuita zvirongwa zvinoshandisa maitiro ezvirwere zvezvirwere zvezvirwere kana maitiro ayo zvingave akabudirira.
Zvimwe Zvimwe Zviito ZveWopdivo (Nivolumab)
Kufanana nehupi hupi hwehupano hwekenza, kune huwandu uye zvinogona kuve nemigumisiro kune kurapa naOpdivo.
Nzira dzinowanzoitika (izvo zvinowanikwa mu10 muzana kana kupfuura vanhu) dzinosanganisira:
- Kushanda kweganda
- Itching (pruritis)
- Yakawanda potassium yepamusoro ( hyperkalemia ) uye pasi yakanyanya sodium (hyponatremia)
- Dzakaipa zvechiropa chekuita mabasa akadai seAlt uye alkaline phosphatase
- Kukosora
- Kupfupika kwemhepo
- Kuneta
- Low white white cell count
- Kusuruvara kwematumbo kunyanya nemukenza wemapapu
Zviito zvisiri izvo zvinowanzoonekwa asi zvakakomba zvinogona kusanganisira:
- Chinenge chinhu chipi zvacho chinoguma nechinguva "itis" - kureva kuputika; zvakadai seplitis, pneumonitis, hepatitis, nephritis, pancreatitis, nezvimwewo
- Maziso ejeri akadai sokuveitis uye maziso akaoma
- Matambudziko eDokocrine anokonzera chirwere chetachiona, marrenti adrenal, uye pituitary gland
Manyevero Pave pa Opdivo (Nivolumab)
Vanhu vanotora Opdivo vanofanira kuongororwa nokuda kwezviratidzo zvekuvhiringidza, uye kana zviripo, mishonga inogona kudiwa kuti iitwe kana kumira. Izvi zvinosanganisira zvinhu zvakadai sepneumonitis, encephalitis, nephritis, uye colitis. Mushonga unogona kukonzera chirwere chechirwere cheshuga, uye shuga yeropa inofanira kuongororwa.
Kutadza kusina kukwana kana kukanganisa kunogona kuitika, uye vanhu vanofanira kuziva nezvekugona kwechiitiko ichi pamwe chete nezviratidzo zvinogona kuitika.
Huru dzakawanda dzakasangana nemashure zvakadai seStevens-Johnson syndrome dzinogona kuitika, uye iwe unofanira kutaura nachiremba wako pamusoro pemhando ipi neipi yaunoshandisa.
Kakawanda, zvisinei, kupindira kwakaipisisa kunobatsira kuvhara mishonga hazvisi zvisizvo, zvichiitika zvishoma pane 1 muzana yenguva. Iva nechokwadi chekutaura newe oncologist pamusoro pezvimwe zviratidzo zvinogona kuitika uye paunofanira kudana.
Shoko Rinobva
Opdivo (nivolumab) mishonga mitsva iyo inorondedzerwa sechimiro chekudzivirira muviri. Kune avo vane mishonga iyi iri kubudirira, dzimwe nguva takaona mhinduro dzemakumbo akaoma zvakanyanya asina kumbofungidzirwa makore mashomanana apfuura. Izvozvo zvakati, hazvibatsire munhu wese, uye isu tisati tine nzira yakanaka yekuziva kuti ndiani achapindura zvakanakisisa pakurapwa.
Migumisiro inowanzoonekwa, kunyanya zviratidzo zvakadai sekumhanya, kuchenesa, uye utachiona husingaiti. Kukanganisa kwakakomba kunogona kuitika dzimwe nguva zvakare. Muzhinji, zvisinei, Opdivo inobvumirwa zviri nani kudarika tsika dzemaitiro chemotherapy.
Pakava nekufadzwa kwakanyanya kubva munharaunda yezvokurapa kwezvikonzero zvishomanana. Opdivo inogona kushandiswa kurapa kunyange zvakanyanya zvakanyanya tumor tumor. Mukuwedzera, inogona kushanda mumhando dzakasiyana-siyana dzekenza. Zvichida kushandiswa kwatsva kwechirwere kuchagamuchirwa munguva yemberi iri pedyo, uye mimwe miedzo yekliniki iri kuenderera mberi ichiongorora kukosha kwaOpdivo pane zvakasiyana-siyana zvekenza marudzi, ose ari oga, uye pamwe chete nezvimwe zvirwere zvekudzivirira zvirwere.
> Sources:
> Abdel-Rahman, O., > Oweira >, H., Petrausch, U. et al. Zvirwere Zvisingazivikanwi Nezvirwere Zvisingaoneki Muhutano Hwakasimba Muzvirwere Zvinotarisana neImune Immune Checkpoint Inhibitors: Ongororo Yakarongeka. Ongororo Inyanzvi yeAnticancer Therapy . 2017. 17 (4): 387-394.
> Ellis, P., Vella, E., uye Y. Ung. Immune Checkpoint Inhibitors kune Vashandi Vanokurudzira Vasingazivikanwi-Cell Lung Cancer: Ongororo Yokugadzirisa. Clinical Lung Cancer . 2017 Feb 16. (Epub mberi kwekudhinda).
> Posto >, M., uye J. Wolchok. Toxicities Associated With Checkpoint Inhibitor Immunotherapy. UpToDate . Updated 05/31/17.
> Wang, X., Bao, Z., Zhang, X. et al. Kubudirira uye kuchengeteka kweP-PD / 1-PD-L1 Inhibitor muKushandiswa Kwemakumbo Akakomba: Kuongorora Kunogadzirisa uye Meta-Kuongorora. Oncotarget . 2017 May 31. (Epub mberi kwechinyorwa).