Magungunan da ASCO ta amince da su daga 2005 zuwa 2014
Tun da ASCO ta buga rahoton ci gaban ciwon daji na farko a cikin 2005, ta shaida ci gaba mai ƙarfi da ƙayyadaddun ci gaba a fagen ilimin oncology a cikin shekaru 10 da suka gabata.
A cikin shekaru 10 da suka gabata, FDA ta amince da fiye da magungunan 60 anti-tumor (Hoto 1). Tare da zurfafa fahimtar ilimin ilimin ƙwayoyin cuta, masana kimiyya sun ƙirƙiri jerin sabbin magungunan ƙwayoyin cuta, kuma zuwan su ya canza da dubbai. Matsayin dubun dubatan masu fama da ciwon daji waɗanda ke da wahalar magani.
Such new drugs can target specific molecules or molecular clusters necessary for tumo cell growth, survival or spread.
Shekaru goma da suka gabata, Cibiyoyin Lafiya na Ƙasa sun ƙaddamar da aikin TCGA, wanda ya zama farkon kuma mafi girma na irin waɗannan ayyuka. Har zuwa yau, cibiyar sadarwar bincike ta TCGA ta zayyana cikakken taswirar kwayar halitta na nau'ikan ciwon daji guda 10.
A yau, TCGA da sauran manyan ayyuka na jerin ayyuka suna ci gaba da bincika bayanai masu mahimmanci waɗanda zasu taimaka wajen inganta hangen nesa na haƙuri ta hanyar hanyoyi. Yana yiwuwa ga marasa lafiya su zaɓi hanyar magani mafi dacewa. Har ila yau, binciken ya gano sabbin cututtukan da ke haifar da ciwon daji. Wadannan kwayoyin halitta na iya zama makasudin sabbin kwayoyi.
Bayan shekaru masu yawa na ci gaba da ci gaba, filin antibody immunotherapy has finally ushered in the long-awaited major success in recent years. It first occurred in the treatment of advanced melanoma, followed by a series of other cancer types, including lung cancer. Common types have also made progress.
Yawan marasa lafiya waɗanda a baya ba su da ingantattun jiyya sun daɗe suna rayuwa bayan jiyya tare da sabbin hanyoyin kwantar da hankali. Wani bincike na dogon lokaci na baya-bayan nan ya nuna cewa maganin rigakafi na rigakafi har yanzu yana da tasiri akan haɓakar ƙari bayan shekaru da yawa na jiyya.
Wani nau'in immunotherapy ya himmatu don sake tsara ƙwayoyin rigakafi na kansa don kai hari ga ƙwayoyin ƙari. Hakanan yana aiki da kyau ga takamaiman ciwace-ciwacen jini da jerin ƙaƙƙarfan ciwace-ciwace.
Na farko maganin ciwon daji a cikin shekaru goma da suka gabata ma an sake shi (alurar Gardasil na mahaifa). Ana kuma ci gaba da gwaje-gwaje don gano wasu nau'ikan rigakafin cutar daji.
Finally, large-scale screening studies have brought new and important evidence that it can advance screening practices for some common cancers such as lung cancer, breast cancer, and prostate ciwon daji.
Ci gaba da sauri na maganin da aka yi niyya a cikin maganin ciwon daji
A cikin shekaru goma da suka gabata, mun ga ci gaba da sauri a cikin adadin sabbin magungunan warkewa da aka yi niyya da FDA ta amince da su, wanda ya wuce saurin haɓaka sabbin magungunan chemotherapy (Hoto 2).
A cikin wannan lokacin, an amince da sabbin magungunan 40 da aka yi niyya, da yawa daga cikinsu sun canza tsarin jiyya na gargajiya kuma sun inganta hasashen yawancin masu cutar kansa.
Mun fara gabatar da masu hana cutar angiogenesis, waɗanda rukuni ne na magungunan da aka tsara don rage haɓakar ciwace-ciwacen ciwace-ciwacen daji kuma sun zama jiyya mai nasara ga yawancin ci-gaba da cututtukan daji masu ƙarfi.
The first drug approved by the FDA is bevacizumab, which was approved for advanced colorectal cancer in 2004 and has since been used in certain lung, kidney, ovarian, and brain tumors.
Subsequently, other angiogenesis inhibitor drugs such as axitinib, carbotinib, pazopanib, rigefenib, sorafenib, sunitinib, vandetanib, and abecept were successively Approved for the treatment of advanced kidney cancer, pancreatic cancer, colorectal cancer, thyroid cancer, and ciwon ciki na stromal and sarcomas.
Masu hana EGFR: niyya hanyoyin siginar maɓalli
Tumors da Jini
Wani babban nau'in magungunan da aka yi niyya an tsara shi don tarwatsa mahimman hanyoyin sigina a cikin sel, musamman cibiyar sadarwar siginar da ke sarrafa haɓakar ƙwayoyin cutar kansa. Ɗaya daga cikin waɗannan hanyoyin ana sarrafa shi ta furotin EGFR.
The first EGFR drug was gefitinib, which was approved for the treatment of NSCLC in 2003. Two years later, the FDA approved the second EGFR drug cetuximab for the treatment of advanced maganin ciwon daji, and another similar drug panitumumab was also approved in 2006.
Duk da haka, a cikin 2008, sabon bincike ya nuna cewa masu ciwon daji na launin fata tare da maye gurbin KRAS sun haɓaka juriya ga cetuximab da panitumumab. Wannan binciken yana buƙatar gwaji na yau da kullun na maye gurbi na KRAS don tabbatar da cewa marasa lafiya za su iya amfana daga jiyya biyu na sama, tare da kare sauran marasa lafiya daga mummunan tasirin jiyya mara amfani.
In 2004 and 2005, the FDA approved the EGFR inhibitor erlotinib for the treatment of NSCLC and advanced ciwon cizon sauro. Recently, in 2013, the US FDA approved afatinib for the treatment of advanced NSCLC patients with specific mutations in the EGFR gene. Other EGFR targeted drugs are undergoing clinical trials.
New HER2 therapy brings continuous breakthrough in ciwon nono magani
Kimanin shekaru 15 da suka gabata, masana kimiyya sun gano maganin farko na ƙwayar ƙwayar cuta wanda ke wuce gona da iri na mai karɓar haɓakar haɓakar ɗan adam 2 (HER2). Kimanin kashi 15 zuwa 20% na masu fama da cutar kansar nono suna ɗauke da nakasassun kwayoyin halitta (HER2-positive cancer). Hakazalika da EGFR na iyali ɗaya, HER2 kuma na iya haɓaka haɓakar ƙwayoyin cutar kansa. Tun daga wannan lokacin, an haifi magungunan HER2 guda huɗu, waɗanda duk za su iya inganta rayuwar marasa lafiya da ciwon nono mai cutar HER2.
Maganin HER2 na farko, trastuzumab, idan aka yi amfani da shi tare da chemotherapy zai iya inganta rayuwar mata masu fama da ciwon daji na HER2 mai kyau. A cikin 2006, an amince da trastuzumab ga marasa lafiya da farkon HER2 mai cutar kansar nono don rage haɗarin sake dawowa bayan tiyata.
Kwanan nan, wani bincike mai mahimmanci ya gano cewa sau biyu a kan HER2 ya fi tasiri fiye da trastuzumab monotherapy, wanda ya haifar da amincewar FDA na maganin HER2 na biyu na Pertuzumab a hade tare da trastuzumab a cikin 2012 Monoclonal antibody ana amfani da marasa lafiya tare da ciwon daji na HER2 mai kyau. , sannan kuma an amince da maganin cututtukan farko a cikin 2013.
A cikin wannan shekarar, an kuma yarda da trastuzumab-emtansine (T-DM1) (trastuzumab tare da maganin chemotherapeutic). Wannan haɗin gwiwar ba kawai ya fi tasiri fiye da maganin ƙwayoyi guda ɗaya ba, amma kuma yana ba da damar maganin da za a yi daidai da shi ga kwayoyin cutar kansar nono, ta haka ne ya rage illa ga ƙwayoyin nama masu lafiya. Ga HER2-tabbataccen ciwon nono wanda ya tabarbare bayan jiyya da yawa na baya, wannan shine mafi kyawun tsarin jiyya.
An yarda da maganin HER2 na huɗu, lapatinib, a cikin 2007. Lokacin amfani da shi tare da magungunan aromatase inhibitor, zai iya magance HER2-tabbatacce da kuma mai karɓa na hormonal-positive / HER2-positive metastatic nono cancer.
Magungunan da ke yin niyya ta hanyoyi masu yawa na ƙwayoyin cuta: alƙawura masu albarka
Researchers continue to find that many cancer drugs can block multiple molecular targets or pathways at the same time, which makes them a more effective anti-cancer weapon. For example, vandetanib (approved for the treatment of thyroid ciwon daji in 2011) can Block EGFR, VEGFR (protein involved in tumor blood vessel growth) and RET.
Maganin ciwon daji na colorectal gefitinib (an yarda a cikin 2012) yana toshe hanyoyin kansa guda 6: VEGFR1-3, TIE2, PDGFR, FGFR, KIT, da RET.
Sabbin hari da sabbin magunguna a cikin maganin cutar kansa
The prospec
ts don sababbin ci gaban ƙwayoyi suna da ban sha'awa sosai. A cikin 2013 da 2014, FDA ta amince da Trametinib da Dalafenib, magunguna guda biyu waɗanda za a iya amfani da su don maganin ƙayyadaddun melanoma na kwayoyin halitta na BRAF, wanda ke sarrafa hanyar MEK.
Crizotinib (approved in 2013) can target kwayar cutar huhu and childhood cancer with ALK gene mutation. Tisirolimus (approved in 2007) and everolimus (approved in 2012) block the mTOR pathway, which can control the growth of several cancers, including breast cancer, pancreatic cancer, and kidney cancer.
Everolimus shine magani na farko da aka yi niyya don cutar kansar nono mai cutar HER2, wannan nau'in ya haifar da yawancin ciwon nono. Everolimus hade tare da aromatase inhibitor kwayoyi an yarda da su don ingantaccen mai karɓar maganin hormone da HER2 mara kyau na postmenopausal masu ciwon daji na nono.
Nilotinib (an yarda da shi a cikin 2007) da dasatinib (an yarda a 2010) na iya kaiwa BCR-ABL, takamaiman furotin da aka samu kawai a cikin wasu nau'ikan cutar sankarar bargo.
Barka da zuwa zamanin immunotherapy
Masana kimiyya sun san cewa tsarin garkuwar jiki yana da karfi mai karfi daga cutar kansa tun farkon shekaru dari da suka wuce. Amma sai a cikin shekaru goma da suka gabata da gaske immunotherapy ya fara canza maganin cutar kansa. An sami ci gaba ta hanyoyi da yawa daga magungunan baka zuwa jiyya na tushen tantanin halitta wanda aka keɓance ga kowane majiyyaci.
Ƙarfafa tsarin rigakafi don yaƙar ciwon daji
Kwayoyin T suna taka muhimmiyar rawa wajen yaki da ciwon daji. A cikin 2011, FDA ta amince da ipilimumab a matsayin maganin ci gaba don melanoma. Ipilimumab magani ne na rigakafi wanda ke kaiwa ga furotin CTLA-4 na ƙwayoyin T, wanda zai iya hana tasirin kashe ƙwayoyin T.
A cikin gwaje-gwaje na asibiti, marasa lafiya za su fuskanci saurin ci gaba da ciwon ƙwayar cuta, kuma za su ci gaba da amfana bayan dogon lokaci bayan an gama magani (ga wasu marasa lafiya yana iya wucewa na shekaru da yawa).
Tun daga wannan lokacin, an ƙirƙira wasu magungunan da ake kira masu hana shinge na rigakafi, musamman ma wasu magunguna na iya kaiwa ga hanyar PD-1/PD-L1, wanda ke taimakawa ciwace-ciwace tserewa daga tsarin rigakafi.
FDA ta ba da magungunan PD-1 blocker nivolumab da MK-3475 taken farfadowa na nasara. A cikin gwaje-gwajen farko na asibiti na kwanan nan akan melanoma, duka biyun sun nuna ingantaccen inganci wanda ba a taɓa ganin irinsa ba (ana iya amfani da nivolumab yadda ya kamata a cikin cutar kansar koda da kuma maganin kansar huhu).
A cikin Satumba 2014, Mk-3475 (pembrolizumab) ya zama na farko da aka yi niyya na PD-1 da FDA ta amince. PD-1 da aka yi niyya magani MPDL3280A kuma ya nuna tasiri akan ci gaban melanoma a cikin gwaji na asibiti.
Binciken da aka yi kwanan nan ya ba da shawarar cewa haɗuwa da magunguna daban-daban masu hanawa ko haɗakar da magungunan rigakafi kamar su interferon, interleukin da sauran magunguna masu hana wuraren bincike na iya ƙara haɓaka fa'idar mara lafiya.
Patients and tsira have significantly improved quality of life
A cikin shekaru goma da suka gabata, bincike ya gano jerin sabbin jiyya waɗanda zasu iya inganta rayuwar marasa lafiya a kowane mataki daga ganewar asali zuwa rayuwa. Bugu da ƙari, ƙaddamar da haɗin gwiwar kulawar gaggawa na farko da magani mai aiki zai taimaka wa marasa lafiya da yawa, musamman don inganta marasa lafiya masu ci gaba don rayuwa mafi kyau.
Rage illolin da ke da alaƙa da kansa
Sabbin dabarun da ke da nufin sarrafa abubuwan da ba su da kyau na iya inganta rayuwar marasa lafiya sosai, duka a lokacin da kuma bayan jiyya. Alal misali, binciken biyu masu zaman kansu sun nuna cewa duloxetine antidepressant da olanzapine antipsychotic kwayoyi ne masu tasiri don hana cututtuka guda biyu na yau da kullum irin su chemotherapy peripheral neuropathy da tashin zuciya.
Wani binciken kuma ya sami magani don bayyanar cututtuka na yau da kullum wanda bai jawo hankalin hankali ba - damuwa da zafi. Shaidu da yawa sun tabbatar da tasirin hanyoyin da ba na likita ba kamar acupuncture da yoga don inganta lafiyar jiki da tunani na marasa lafiya da masu tsira. Abubuwan da za a iya amfani da su sun haɗa da rage gajiya da zafi, inganta yanayin rayuwa, da rage amfani da magunguna.
Haɗa maganin ciwon daji tare da kulawar gaggawa ta farko
Wani mahimmin gwaji na asibiti a cikin 2010 ya tabbatar da cewa haɗakar da maganin jin zafi na farko a lokacin jiyya na iya inganta yanayin rayuwa sosai da kuma tsawaita rayuwar marasa lafiya da ciwon huhu na huhu idan aka kwatanta da magani guda ɗaya. Bugu da ƙari, marasa lafiya waɗanda suka sami kulawar gaggawa na farko ba su da wuya su sami kulawa mai mahimmanci kamar farfadowa a ƙarshen rayuwa.
Binciken ya haifar da sabon yanayin kula da marasa lafiya na ci gaba. Har ila yau, binciken ya ambaci shawarwarin jagororin wucin gadi da ASCO ta bayar a cikin 2012: Duk wani majiyyaci da ciwon daji na metastatic ko babban nauyin bayyanar cututtuka na iya kasancewa tare da maganin kwantar da hankali a farkon maganin ciwon daji.
Magunguna na yau da kullun waɗanda ke rage haɗarin cutar kansa
A large number of clinical trials have shown that some commonly used drugs may have important effects on cancer prevention. For example, analysis of data from nearly 50 epidemiological studies shows that oral contraceptives can reduce the risk of ovarian cancer by 20% every 5 years. This reduction effect persists within 30 years of termination of the drug.
Wani bincike da aka yi ya gano cewa shan aspirin a kullum na iya rage barazanar kamuwa da ciwon sankara. Koyaya, saboda zubar jini na ciki da sauran haɗari, ba a ba da shawarar yin amfani da aspirin akai-akai azaman hanyar rigakafin cutar kansa ba. Mataki na gaba na binciken kuma zai bincika magungunan hana kumburi a rigakafin cutar kansa da kuma rawar da magani ke bayarwa.
