13 ga Yuli, 2021: Wani sabon magani ga mutanen da ke da irin ciwon hanta da ake kira hepatocellular carcinoma yana samuwa wanda ya bayyana ya fi daidaitaccen magani (HCC). The Abinci da Drug Administration (FDA) ta amince da atezolizumab (Tecentriq) da bevacizumab (Avastin) a matsayin jiyya na farko ga mutanen da ke da ciwon hanta mai ci gaba waɗanda ba za a iya bi da su ta hanyar tiyata ba.
Patients with liver cancer treated with Atezolizumab with Bevacizumab lived significantly longer than those treated with sorafenib in the IMbrave150 study that resulted to the approval (Nexavar). They were also able to live longer without their cancer progressing. The outcomes of the study were published in the New England Journal of Medicine on May 14th.
Daya daga cikin kwararrun binciken, Richard Finn, MD, na Jami'ar California, Los Angeles, ya ce, "Wannan babban ci gaba ne ga marasa lafiya." "Wannan wani abu ne da likitocin da ke kula da waɗannan marasa lafiya suka daɗe suna nema, kuma babban ci gaba ne."
Atezolizumab shine mai hana shinge na rigakafi, wanda ke nufin yana taimakawa tsarin garkuwar jiki ya nemo da kashe ƙwayoyin cutar kansa. Bevacizumab magani ne da aka yi niyya wanda ke fama da yunwa ta hanyar hana ci gaban sabbin jijiyoyin jini.
Another targeted therapy, sorafenib, inhibits the formation of blood vessels and cancer cells. Sorafenib was the first medicine approved by the FDA a 2007 don kula da wasu marasa lafiya na HCC.
A cewar Tim Greten, MD, mataimakin shugaban Cibiyar Nazarin Ciwon daji ta NCI ta Thoracic da GI Malignancies Branch, kawai hanyoyin kwantar da hankali na HCC waɗanda aka ba da lasisi tun 2007 ba su da tasiri fiye da sorafenib.
A cikin edita, Robin Kelley, MD, na UCSF Helen Diller Family Comprehensive Cancer Center, ya bayyana cewa ba wai kawai haɗin atezolizumab-bevacizumab ya fi tasiri ba, amma har ila yau ya haifar da "sakamako mafi kyau da aka bayar da rahoton haƙuri," kamar ƙarfin jiki. .
A cewar Dakta Greten, wataƙila tsarin haɗin gwiwar zai maye gurbin sorafenib a matsayin magani na farko-farko ga wasu mutanen da ke da ci gaban HCC.
Ƙara zuwa masu hana shinge na rigakafi
Ciwon daji is frequently identified after it has progressed outside the liver or become interwoven with several blood arteries, making surgery impossible to treat.
Sorafenib da lenvatinib (Lenvima), wani magani da ke rage jinkirin samuwar jini, su ne kawai zaɓi ga masu ciwon hanta waɗanda ba za a iya jinyar su da tiyata (ba a iya aiki).
An binciko masu hana shingen duba marasa lafiya azaman hanyoyin farko na cutar sankarar hanta a cikin 'yan karatun asibiti, amma an same su da rashin tasiri da kansu. Masana kimiyya sun gano cewa yawan sinadarin gina jiki da ake kira VEGF na iya hana magungunan duba garkuwar jiki yin aiki bayan ƙarin bincike.
A cewar Dakta Finn, VEGF tana jawo kirkirar sabbin jijiyoyin jini kuma tana canza yawa da nau'in sel na garkuwar jiki a ciki da kewaye.
saboda bevacizumab inhibits VEGF, researchers from Genentech and a number of medical institutions compared atezolizumab to bevacizumab in a limited study of patients with liver cancer. They reported in 2019 that the combination was more successful than atezolizumab alone and had manageable adverse effects. The IMbrave150 study is a follow-up to the previous one.
Kariyar Atezolizumab Plus Bevacizumab
Magungunan haɗin gwiwa ya haifar da mummunan sakamako a cikin marasa lafiya da yawa. Gabaɗaya, kodayake, marasa lafiya sun bayyana suna jure magungunan duka, a cewar Dr. Greten.
Ƙungiyoyin biyu sun yi daidai da tasirin sakamako masu illa da mace -mace daga sakamako masu illa. Koyaya, ƙungiyar haɗin gwiwa tana da ƙarin marasa lafiya waɗanda suka sami duk wani mummunan sakamako (38 bisa dari da kashi 31).
Saboda illar da ke tattare da ita, ƙarancin marasa lafiya a cikin ƙungiyar haɗin gwiwa sun dakatar ko canza sashin maganin su (kashi 50 cikin ɗari da kashi 61 cikin ƙungiyar sorafenib). Kashi 7% kawai na marasa lafiya a cikin ƙungiyar haɗin gwiwa sun daina shan magungunan duka biyu saboda illolin da ba su da kyau, duk da cewa ƙarin marasa lafiya a cikin ƙungiyar haɗin gwiwar sun daina shan ɗayan magungunan (16% a kan 10%).
Saboda tasirinsa akan jijiyoyin jini, bevacizumab na iya haifar da zubar jini, a cewar Dr. Greten. Ya bayyana cewa cutar sankarar hanta na iya haifar da canje -canje waɗanda ke ƙara haɗarin zubar jini, kamar ƙaramin adadin platelet.
Dr. Finn ya kara da cewa "Akwai wasu 'yan karin zubar da jini a cikin atezolizumab, bevacizumab hannu, amma har yanzu sun kasance kadan a matsayin kashi," in ji Dokta Finn. A cikin ƙungiyoyin biyu, 6% na marasa lafiya sun sami babban jini a sakamakon jiyya na bevacizumab.
A cewar Dakta Greten, "zai zama da mahimmanci a zaɓi adadin marasa lafiya da suka dace" don maganin haɗin gwiwa. Kafin fara maganin, marasa lafiya na iya buƙatar samun daidaitattun gwaje -gwaje don bincika abubuwan haɗarin zubar jini, in ji shi.
Dokta Kelley ya ce, "Ya kamata a bincika madadin magani ga marasa lafiyar da ke cikin haɗarin zubar jini."
