Matapirwo matsva ekurapa anonzi zvakakosha kurapwa ari kuwanikwa nemukenza wemapapu. Kusiyana nemaitiro emakemikrasira , izvi zvipembenene zvinoda mapuroteni pamagetsi ekenza kana kuti masero masero ose akave akabatwa nechirwere mukuedza kwawo kukura. Nokuda kwechikonzero ichocho, vanowanzova nemigumisiro shoma iyo yakawanda yemishonga inoshandiswa nekenza.
Pari zvino, izvi zvinoshandiswa kunyanya kumutsara wechitatu uye 4 mutsa wemapapu usina kumbobvuma kune dzimwe mishonga . Zvimwe zvezvinyorwa zvinowanzodiwa zvinosanganisira:
Tarceva (erlotinib)
Musoro wemasero emapapu emapapu akafukidzwa neprotheni inonzi epidermal growth factor receptor (EGFR) , iyo inobatsira masero kugovana. Tarceva inoshanda nekurega kubvumira EGFR kuti iudze majekiseni emukenza kuti akure. Kunyange zvazvo inogona kuva inoshanda mumarudzi akawanda evarwere, yakaratidzwa kuva yakanyanya kushanda kune avo vasina kumbosvuta kana kuvakadzi vaduku. Kupiwa sepiritsi yezuva nezuva, zvinowanzovhiringidza zvinokonzera ganda rakafanana nemakona, uye chirwere. Kunyange zvazvo kuputika kweganda kunogona kuva nhamo yezvokuzora, avo vanokura nekukurumidza ne erlotinib vanogona kunge vari kupindura kurapwa.
Xylori (crizotinib)
Pakati pe3 kusvika ku5% yevanhu vane kenza isiri duku yemapapu ine mutende inozivikanwa seA ALK-EML4 rearrangement gene.
Kune vanhu vane mutauro uyu, crizotinib yemishonga inowanikwa kuwedzera kukura-kusina kusununguka. Sezvakaita erlotinib, crizotinib inowanzova nemigumisiro shomanana kupfuura tsika dzekodheseti uye inogona kutorwa semuromo wemishonga. Saizvozvowo, kuchinja uku kana zvichida kuwanika kune vanhu vasina kumboputa.
Kunyange zvazvo crizotinib inowedzera kufambira mberi-kusununguka kusina, kumira kunoramba kuripo munguva. Zvinofadza kuti mishonga mitsva yakawanikwa mumakiriniki ekuedza kunogona kushanda apo kupikisa crizotinib inokura, uye inotarisirwa kuti nenguva, mukana weAl-positive wemapapu unogona kurapwa sechirwere chisingaperi, chakadai seshuga.
Dzidza zvakawanda pamusoro peAlk-positive pamuviri wemapapu munyaya ino
Kubva muna 2014, crizotinib yakabvumidzwawo nevanhu vane ROS1 mutations . Kufanana neavo vane mutenuko we ALK, crizotinib inowedzera kusununguka-kusina kusununguka.
Mamwe mishonga iye zvino iri kuongororwa mumakiriniki ekuedzwa kwevanhu vakave vasingagamuchirwi nemishonga yeEGFR mutations uye mutsauko we ALK, uye zvimwe "zvinotaridzirwa" zvinodzidzwa.
Genetic Testing (Molecular Profiling) Kwemapupa Emarumbo
Iko zvino yava kunzwa kuti munhu wose ane mapapu adenocarcinoma (uye vamwe vanhu vane chirwere chepammune chepammapu , kunyanya avo vasina kumbobvira vasvuta) vanofanira kuongororwa kuchinja kwemashoko uye izvo zvingaita kuti mishonga yavo iite zvinoenderana nemishonga inotanga kudiwa. Pasinei neizvi, vanhu vazhinji vanogona kuva vakanaka nokuda kwekuchinja kwezvinhu izvi uye nekuda kwekutsvaga kwemishonga iyi, havagoni kubatsirwa.
Dzidza zvakawanda pamusoro pekunyorwa kwema molecular yemukenza wemapapu munyaya ino
> Sources:
> America Cancer Society. Targeted Therapies. 08/13/15.
> National Cancer Institute. Non-Small Cell Lung Cancer (PDQ). Kurapa Option Overview. Updated 05/12/15.