Yanayin kansar nono
Kusan kowane kashi 10-12% na masu fama da cutar kansar nono a duniya suna Indiya, kuma kusan kashi biyu bisa uku na marasa lafiya suna kamuwa da ciwon daji a lokacin ganewar asali. Masana sun yi nazarin cewa ya kamata a sami masu cutar kansar nono 50,000 zuwa 60,000 HER2 masu kyau a Indiya, kuma ƙasa da kashi 20% na marasa lafiyar da aka tabbatar sun sami maganin rigakafin HER2. "Wannan yana nufin cewa fiye da 80% na marasa lafiya ba sa samun magani da aka yi niyya, kuma an rasa mafi kyawun damar jiyya."
According to the data, when receiving targeted therapy based on chemotherapy, the risk of recurrence of HER2-positive ciwon nono patients was reduced by about 40%, the risk of death was reduced by nearly 30%, and the ten-year survival rate was increased by more than 8%. At present, the treatment of breast cancer has entered the era of individualized and precise treatment. However, due to different detection levels and analysis levels, different testing institutions in China will give different test results, which will greatly affect the treatment results of patients.
Nazarin kansar nono
Bisa ga sakamakon “JAMA Oncology” na Jami’ar Washington, ƙwararrun Amurkawa sun yi imani: “Binciken da muka yi ya nuna cewa sakamakon gwajin ƙwayoyin halitta na iya bambanta sosai, ya danganta da gwajin da majiyyaci ya yi.” Masana cibiyar sadarwa ta Oncologist ta Duniya sun yi imanin cewa majiyyata Cibiyar gwajin kwayoyin halitta da aka zaba za su iya tabbatar da daidaiton sakamakon gwajin gwargwadon yiwuwar, daidaiton nazarin magungunan asibiti, da kuma guje wa bambancin sakamakon jiyya.
A 2007, da Ƙasar Amirka ta Cibiyar Nazarin Kwayoyin Kimiyya (ASCO) ya sanar da cewa ya kamata a yi la'akari da gwajin kwayar cutar daji na 21 ga marasa lafiya da farkon ciwon nono waɗanda ke da kyau ga masu karɓar isrogen kuma ba su yada ƙwayoyin lymph ba yayin haɓaka tsarin maganin ciwon nono. Cibiyar Cibiyar Ciwon daji ta ƙasa (NCCN) ta ba da shawarar yin amfani da gwajin kwayar cutar kansar nono 21 a cikin jagororin maganin cutar kansa na 2008.
Breast cancer 21 gene test refers to the detection of the expression levels of 21 different genes in breast cancer tumo tissues, including 16 breast cancer-related genes and 5 reference genes. This test can provide individualized prediction of treatment effects and 10-year risk of recurrence. prediction. By detecting 21 genes and observing their interactions to determine tumor characteristics, the breast cancer recurrence index and the benefit ratio of chemotherapy can be predicted.
Breast cancer 21 gene test is mainly applicable to newly diagnosed breast cancer patients who are in stage I or II, positive for estrogen receptor, negative for lymph node metastasis, and will be treated with tamoxifen. After menopause, patients with aggressive linzoma who are positive for lymph nodes and estrogen receptors can also use the 21 gene test to determine the benefit of chemotherapy.
Daidaitaccen maganin ciwon nono
Ciwon nono ba cuta guda ba ce. Gabaɗaya magana, ciwon nono na iya kasu kashi huɗu: LuminalA, LuminalB, HER2 tabbatacce, da mara kyau sau uku bisa ga alamu daban-daban kamar ER, PR, HER2, da Ki67. Luminal A da Luminal B sune mafi yawan nau'ikan kwayoyin halitta na ciwon nono, suna lissafin fiye da kashi 60 cikin dari na duk ciwon nono, kuma suna da kyakkyawan hangen nesa. Hasashen HER2 tabbatacce da mara kyau sau uku ba shi da kyau. Daga cikin su, HER2-tabbataccen ciwon nono wani nau'in ciwon daji ne mai hatsarin gaske, kuma kusan kashi 20% -30% na masu ciwon nono suna da HER2 mai kyau. Bisa ga genotyping na ciwon nono, nemo madaidaicin magani da magungunan da aka yi niyya.
Magungunan da aka yi niyya don ciwon nono
An ƙaddamar da Trastuzumab (Herceptin) a cikin 1998 kuma yana da tasiri mai kyau akan yawancin HER2 masu cutar kansar nono. Sakamakon gwaje-gwaje na asibiti ya nuna cewa trastuzumab adjuvant far na iya tasiri da kuma rage haɗarin sake dawowa, yana sa ƙarin HER2 marasa lafiya da ciwon daji na farko na nono suna amfana fiye da shekaru 10. Lapatinib (Tykerb) Lapatinib ne na baka, mai jujjuyawar tyrosine kinase mai hanawa wanda ke hana duka ƙwayar cuta mai haɓaka haɓakar haɓakar ƙwayar cuta (EGFR, HER1) da HER2 tyrosine phosphate Effect yana da mahimmanci fiye da magungunan da kawai ke hana ɗaya daga cikin maƙasudi. Wannan magani shine magani na biyu da aka yi niyya ta kwayoyin halitta da aka amince da shi don tallatawa ga kansar nono bayan trastuzumab, musamman don maganin ciwon daji na nono. Bevacizumab (sunan ciniki Avastin) Wani maganin rigakafi na mutum wanda ke toshe ayyukan nazarin halittu na VEGF ta hanyar yin gasa ga masu karɓar VEGF tare da haɓakar haɓakar jijiyar jijiyoyin jini (VEGF), ta haka hana endothelial Mitosis na sel yana rage kumburi neovascularization kuma yana samun tasirin hana ƙari. . Shi ne magani na farko da aka amince da shi don hana ƙwayar cutar angiogenesis. Lenatinib (Neratinib / Noratinib) shine na baka, mai hana HER1,2 da 4. Afatinib Afatinib magani ne na ƙananan ƙwayoyin ƙwayoyin cuta na baka wanda ke da tasirin hanawa mara jurewa akan HER1,2 da 4.
