Bisa sabon rahoton da Cibiyar Kula da Cututtuka da Cututtuka ta Amurka (CDC) ta fitar, kusan dukkanin cututtukan daji sun ragu a cikin shekaru ashirin da suka gabata, yayin da cutar kansar mahaifa ta karu. Doctors sun fara ba da hankali ga wannan yanayin kuma suna tunatar da mata su mai da hankali ga mahimman batutuwan wannan cuta.
According to statistics from the American Cancer Society (ACS), more than 90% of uterine cancers occur in the endometrium, called endometrial cancer. Early endometrial cancer has a good prognosis. According to the US Centers for Disease Control and Prevention, the five-year relative survival rate is estimated to be 80% to 90%. Because cutar sankarar mahaifa can usually be diagnosed early, its most typical symptoms are abnormal bleeding before and after menopause, weight loss and pelvic pain. For advanced metastatic patients, treatment options are very limited.
Kwanan nan, FDA ta Amurka ta amince da PD-1 mai hanawa Keytruda (pabolizumab) a hade tare da mai hana tyrosine kinase Lenvima (Levatinib) don magance marasa lafiya da ciwon daji na musamman na endometrial. Yana da kyau a lura cewa waɗannan marasa lafiya ba sa buƙatar babban rashin zaman lafiya na microsatellite (MSI-H) ko nau'in gyare-gyaren rashin daidaituwa (dMMR). Muddin cutar ta ci gaba da samun ci gaba bayan samun farfagandar tsarin tsarin farko kuma ba za a iya samun tiyatar warkewa ko aikin rediyo ba, ana iya karɓar wannan sabuwar hanyar haɗin gwiwa.
Dole ne a ambata cewa wannan ingantaccen yarda an yarda dashi lokaci ɗaya a Amurka, Ostiraliya da Kanada.
Yarda ya dogara ne akan sakamakon binciken marasa lafiya 94 tare da cututtukan daji na endometrial, babu ɗayan su MSI-H ko dMMR. A cikin waɗannan marasa lafiya, yawan adadin amsawa (ORR) ya kasance 38.3%, gami da 10.6% cikakken amsawar amsa (CR) da ƙananan amsa na 27.7%. 69% (n = 25) marasa lafiya suna da tsawon lokacin amsawa (DOR) months 6 watanni.
“Akalla kashi 75% na marasa lafiyar da ke fama da cutar kanjamau ba na MSI-H ko na dMMR ba ne, don haka amincewa da wannan maganin ya kawo sabbin zaɓuɓɓukan magani da bege ga mafi yawan marasa lafiya da ke fama da cutar kanjamau.
A halin yanzu, an gabatar da sauran ci gaban bincike na kansar endometrial a takaice anan:
01avelumab (Bavincia monoclonal antibody) hade da talazoparib (tarazopanib)
Gwajin da Konstantinopoulos ya jagoranta ta yi amfani da avelumab mai hana shigar rigakafi a hade tare da mai hana mai PARP talazoparib. (Masu hana shingen binciken hanya sun share hanyar tsarin garkuwar jiki don kaiwa cutar kansa hari; masu hana PARP sun lalata kwayoyin cutar kansa ta hanyar hana su damar gyara DNA da ta lalace.) ba ya yin aiki a cikin nau'in cuta na “microsatellite barga” (MSS). Gwajin zai bincika ko hada avelumab tare da masu hana PARP ya fi tasiri ga marasa lafiya da cutar ta MSS.
02pembrolizumab (pabolizumab) haɗe tare da mirvetuximab
Gwajin da ke haɗa mai hanawa pembrolizumab tare da mirvetuximab. (Pembrolizumab yana hari da sunadaran gwajin rigakafin rigakafi da ake kira PD-1; mirvetuximab yana ƙara ƙwayoyin rigakafi zuwa ƙwayoyin ƙwayoyi masu niyya ga mahimman sifofi a cikin saurin rarraba ƙwayoyin cutar kansa.) Gwajin, wanda Jennifer Veneris, MD, ya jagoranta, na Aikin Gynecologic Oncology Project, zai bincika tasirin Haɗin Inganci a cikin marasa lafiya da MSS endometrial cancer.
03abemaciclib + LY3023414 + maganin hormone
Wani gwajin da Konstantinopoulos ya jagoranta zai gwada haɗakar magungunan abemaciclib + LY3023414 + na maganin hormone. (LY3023414 tana niyya ne akan enzyme din kwayar cutar kanjamau da ake kira PI 3 kinase; abemaciclib yana tsoma baki tare da wani mawuyacin lokaci na sake zagayowar kwayar.) Ta hanyar ƙara abemaciclib da LY70 (za su iya taɓa ɓangarori biyu na wannan hanyar kwayar halitta) don maganin toshewar hormone, masu binciken suna fatan shawo kan matsalar juriya da maganin.
Saukewa: 04AZD1775
A trial led by Joyce Liu, MD, MPH, director of clinical research at the Department of Gynecologic Oncology at Dana-Farber, used AZD1775 for patients with high-grade serous uterine cancer that account for 10-15% of endometrial cancer. Such cancers are aggressive and usually recur after standard treatment. The recently opened trial is based on a study led by Dr. Liu and Ursula Matulonis, director of the Dana-Farber Department of Gynecologic Oncology, showing that AZD1775 is active in a patient model with high-grade serous ciwon daji na ovarian.
05dostarlimab (TSR-042)
Sakamakon gwajin GARNET na Mataki na I / II kwanan nan an buga, kuma jimlar tasiri na PD-1 inhibitor dostarlimab (TSR-042) ga marasa lafiya da suka sake dawowa ko ciwon daji na endometrial yana kusa da 30%.
Bugu da kari, duka rashin daidaiton micro-tauraron dan adam (MSI-H) da ƙungiyoyin micro-satellite kwanciyar hankali (MSS) suna ci gaba.
Dostarlimab (TSR-042) anti-PD-1 monoclonal antibody ne wanda ya haɗu tare wanda TESARO da AnaptysBio suka haɓaka. Yana ɗaure ga mai karɓar PD-1 tare da babban dangantaka, don haka yana hana ɗaurin sa zuwa PD-L1 da PD-L2 ligands.
Sakamakon ya nuna cewa yawan adadin mutanen duka ya kai 29.6%, ingancin tasiri na ƙungiyar masu haƙuri na MSI-H ya kai 48.8%, kuma ingancin tasiri a cikin ƙungiyar MSS ya kasance 20.3%. Marasa lafiya shida (2 MSI-H da 4 MSS) sun sami cikakkiyar gafartawa.
Bayan bin tsakiyar watanni 10, 89% na marasa lafiya sun sami magani> watanni 6, kuma kashi 49% na marasa lafiya sun sami magani na> shekara 1. Bugu da kari, kashi 84% na marasa lafiyar da ke da tasiri a magani har yanzu suna karbar magani.
Finally, in 85% of MSI-H responders, the total tumo burden was reduced by ≥50%, and 69% of patients with MSS had a total tumor burden of ≥50%.
Dostarlimab shine sabon fata don maganin kansar mahaifa.
Masu binciken za su fara kara karatun III a rabi na biyu na 2019. Dostarlimab da chemotherapy za a hade tare da maganin farko na ciwon daji na endometrial, kuma muna sa ran samun sakamako mai ban sha'awa nan da nan!
Kowane gwaji na magance gazawar daidaitaccen magani ko matsalolin da aka samu a cikin sabbin gwajin magunguna da suka gabata. Misali, gwaji guda biyu na farko da nufin shawo kan halin talauci da ake ciki yanzu immunotherapy a cikin marasa lafiya da cutar ta MSS. Na uku yana magance matsalar juriya ga maganin hormone, kuma na huɗu yana ƙaddamar da takamaiman ƙananan ƙananan cututtukan endothelial.
Don ƙarin koyo game da ci gaban bincike na baya-bayan nan da mafi kyawun shirin shan magani don cututtukan endometrial, ƙwararrun masanan kansar a cikin gida da ƙasashen waje ne kawai ke da wadataccen kwarewar asibiti. Kuna iya neman shawarwari tare da masana masu iko na cikin gida da na ƙasa don samun ingantaccen ganewar asali da kuma tsarin kulawa.
