First immunotherapy has been approved for esophageal cancer treatment. Esophageal cancer is a common malignant tumor. The International Center for Cancer Research of the World Health Organization points out that esophageal cancer has now become the 6th highest incidence cancer in the world. China is also one of the regions with the highest incidence of cututtukan hanji in the world. Some are squamous cell carcinoma.
The main treatments for esophageal cancer include surgery, radiotherapy, and chemotherapy. Squamous cell carcinoma is moderately sensitive to chemotherapy. Traditional chemotherapeutic drugs and radiation therapy have a high status in the treatment of esophageal squamous cell carcinoma. However, the prognosis of patients with advanced esophageal cancer after first-line chemotherapy is poor, and treatment options are limited. Taxane and irinotecan have been used after first-line treatment, but no overall survival benefit was seen in the Phase 3 study of chemotherapy.
In recent years, there have been many new attempts in the treatment of esophageal squamous cell carcinoma-molecular targeted drugs and immunotherapy, and great progress has been made.
Recently Merck announced:
The U.S. Food and Drug Administration (FDA) has approved PD-1 tumo immunotherapy Keytruda (creta, common name: pembrolizumab, pabolizumab) as a single drug therapy for PD-L1 (combined positive score [CPS] ≥ 10) and treatment of patients with recurrent locally advanced or metastatic esophageal squamous cell carcinoma (ESCC) who have progressed after one or more systemic therapies.”
Immunotherapy na farko don ciwon daji na esophageal
Amincewar ta dogara ne akan sakamakon lambar gwaji mai suna KEYNOTE-181 (NCT02564263).
KEYNOTE-181 na tsakiya ne, bazuwar, buɗaɗɗen lakabin, gwajin sarrafawa mai aiki. An haɗa marasa lafiya 628 tare da ci gaba na gida ko kuma ciwon daji na ƙashin ƙugu. Waɗannan marasa lafiya na ci gaba sun ci gaba kafin da kuma bayan jiyya na tsarin layi na farko.
An ba marasa lafiya bazuwar don karɓar palmumab 200 MG sau ɗaya a kowane mako uku, ko tsarin tsarin jijiya na chemotherapy mai zuwa: paclitaxel, docetaxel per, ko irinotecan.
Sakamakon ya nuna cewa idan aka kwatanta da ƙungiyar chemotherapy, marasa lafiya tare da ciwace-ciwacen ƙwayoyi tare da PD-L1 CPS ≥ 10 sun nuna ci gaba a cikin OS a cikin marasa lafiya waɗanda aka ba da izini tare da Keytruda. Gabaɗayan ƙimar amsawar pembrolizumab shima ya fi chemotherapy. Wadannan bayanan sun nuna cewa pembrolizumab ya kamata a yi la'akari da sabon tsarin kulawa a marasa lafiya tare da PD-L1 CPS na 10 ko mafi girma a cikin jiyya na biyu.
Matsaloli masu yuwuwa: ciwon huhu, colitis, hepatitis, endocrine disease, nephritis and renal dysfunction, severe skin reactions, solid organ transplant rejection and complications of allogeneic hematopoietic stem cell transplantation (HSCT). Depending on the severity of the adverse reaction, pembrolizumab should be discontinued or discontinued, and corticosteroid therapy should be given when appropriate.
Sauran zaɓuɓɓukan magani don ciwon daji na esophageal
Chemotherapy a cikin ciwon daji na esophageal
Don maganin ciwon daji na esophageal, ana iya amfani da chemotherapy a lokuta daban-daban.
Adjuvant chemotherapy: chemotherapy bayan tiyata. Manufar ita ce a kashe duk wani kwayar cutar daji da za a iya barin yayin aikin, saboda sun yi kankanta da ido tsirara, don haka ba za a iya cire su ta hanyar tiyata ba. Hakanan yana yiwuwa kwayoyin cutar kansa su kubuta daga manyan ciwace-ciwacen daji kuma su sami tushe a wasu sassan jiki.
Neoadjuvant chemotherapy: Ga wasu cututtukan daji, ana ba da chemotherapy (yawanci haɗe da maganin radiation) kafin a yi aikin tiyata don ƙoƙarin rage ƙwayar ƙwayar cuta kuma a sauƙaƙe aikin tiyata.
Chemotherapy don ciwon daji mai tasowa: Ga ciwon daji na esophageal wanda ya yadu zuwa wasu gabobin, kamar hanta, ana iya amfani da chemotherapy don taimakawa wajen rage ciwace-ciwacen ƙwayoyi da kuma rage alamun. Ko da yake yana da wuya ya warkar da ciwon daji, sau da yawa yana iya taimakawa mutane su rayu tsawon lokaci.
Magunguna na yau da kullum da ake amfani da su a maganin ciwon daji na esophageal
- Carboplatin da paclitaxel (ana iya amfani da su a hade tare da radiotherapy)
- Cisplatin da 5-fluorouracil (5-FU) (yawanci hade da radiation far)
- ECF: epirubicin, cisplatin, da 5-FU (musamman ciwace-ciwacen daji a mahaɗin gastroesophagus)
- DCF: docetaxel, cisplatin, da 5-FU
- Cisplatin da capecitabine
- oxaliplatin da 5-FU ko capecitabine
- Irinotecan
Maganin da aka yi niyya a cikin ciwon daji na esophageal
Ramucirumab (Cyramza)
Rumizumab is a humanized monoclonal antibody that specifically blocks vascular endothelial growth factor receptor 2 (VEGFR2) and downstream angiogenesis-related pathways. The currently approved indication is monotherapy or in combination with paclitaxel for advanced gastric cancer / gastroesophageal junction adenocarcinoma that progresses during or after chemotherapy with or without fluorouracil or platinum. In addition, it has been approved for the treatment of cututtukan daji na kansa marasa kansar and metastatic colorectal cancer.
Trastuzumab (Trastuzumab, Herceptin)
Trastuzumab, antibody monoclonal a kan Her2, yana hana haɓakar haɓakar ɗan adam daga haɗuwa da Her2 ta hanyar haɗa kanta zuwa Her2, don haka toshe ci gaban ƙwayoyin cutar kansa. Har ila yau, Herceptin na iya tada ƙwayoyin rigakafi na jiki don lalata ƙwayoyin cutar kansa.
Esophageal squamous cell carcinoma, a matsayin wata kwayar halitta ta musamman a cikin ciwace-ciwacen mu na hanji, kai tsaye yana shafar ci. Bugu da kari, squemous tantanin halitta yana da matukar amfani kuma yana da haɗarin haɗarin toshe, ruwa da zub da jini. Sabili da haka, a cikin dukkanin tsarin maganin ciwon daji na squamous cell carcinoma, ko da yake za mu yi amfani da wasu hanyoyin maganin miyagun ƙwayoyi na gargajiya da kuma yin la'akari da wasu sababbin yunƙurin, dole ne mu aiwatar da manufar gudanar da cikakken tsari a duk lokacin aikin jiyya. Tare da ci gaban magani, za a sami ƙarin fasahohin yaƙi da cutar kansar hanji, kamar su proton radiotherapy, cellular immunotherapy, da dai sauransu. Dole ne kowa ya kasance da kwarin gwiwa.
