Mai nauyin ciwon hanta
Liver cancer is a common malignant tumor accounting for more than half of the global liver cancer. The onset of hepatocellular carcinoma (HCC) is hidden, and early symptoms are not obvious. Most people have lost the opportunity for surgery at the time of treatment. Whether it is surgery, interventional therapy or chemotherapy, the treatment effect on liver cancer is still not very satisfactory. The survival rate is still very low.
With the development of science and technology, liver cancer targeted drugs have made great progress, and a variety of targeted drugs and immunotherapy An yarda da magunguna, wanda ke kawo sabon bege ga rayuwar masu ciwon daji na hanta na dogon lokaci!
Ciwon daji na Cancer Chemotherapy
Chemotherapy yana magani tare da kwayoyi don lalata ƙwayoyin kansa. Chemotherapy na yau da kullun yana amfani da magungunan anti-cancer waɗanda ake allurarsu cikin jini ko kuma a baki. Wadannan kwayoyi suna shiga cikin jini kuma suna kaiwa ga dukkan sassan jiki, suna yin wannan maganin yana da amfani ga cututtukan daji da suka bazu zuwa gabobin nesa.
Duk da haka, ciwon daji is resistant to most chemotherapy drugs. The most effective drugs for systemic chemotherapy in liver cancer are doxorubicin (doxorubicin), 5-fluorouracil and cisplatin. But even these drugs will only shrink a small part of the tumo, and the response usually does not last long. Even with a combination of drugs, in most studies, systemic chemotherapy did not help patients live longer.
Transcatheter hepatic artery infusion chemotherapy due to poor response to systemic chemotherapy, doctors study placing chemotherapy drugs directly into the hepatic artery for treatment. This technique is called transcatheter hepatic artery infusion chemotherapy, and continuous infusion of anticancer drugs is suitable for hepatic artery intubation For the treatment of liver cancer patients who can not be resected or undergo palliative resection, because the blood supply of liver cancer mainly comes from the arteries, this method can make the drug directly act on the tumor tissue, increase the local drug concentration, reduce the systemic response, and achieve the treatment of the tumor and relieve the symptoms And the purpose of prolonging life.
Idan aka kwatanta da chemotherapy na tsarin, maganin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta fi tasiri, amma ba ya ƙara illa. Magungunan da aka fi amfani dasu sun hada da fluorouracil, cisplatin, mitomycin C da doxorubicin.
Magunguna da aka amince da su don maganin cutar kansar hanta
Sorafenib (Sorafenib, Dorjemi),
Sorafenib magani ne mai niyya tare da tasiri biyu. Isaya shine hana sabbin hanyoyin jini da ake buƙata don ciwace ciwace ciwace, kuma yana iya ƙaddamar da sunadaran da ke inganta ci gaban ƙwayoyin kansa. Babban maƙasudin sune VEGFR-1 / 2/3, RET, FLT3, BRAF da sauransu.
Sorafenib can directly inhibit the proliferation of tumor cells, and can also act on VEGFR and PDGFR to inhibit the formation of new blood vessels and cut off the nutritional supply of tumor cells, thereby curbing tumor growth. Sorafenib is suitable for the first-line treatment of advanced liver cancer that cannot be operated or metastasized.
Sorafenib magani ne na baka, sau biyu a rana. Abubuwan da aka fi sani da wannan magani sun haɗa da gajiya na tafin hannu ko tafin kafa, kurji, rashi cin abinci, gudawa, hawan jini, ja, zafi, kumburi ko kumfa. M sakamako masu illa (ba nadiri) sun haɗa da matsaloli tare da gudan jini zuwa zuciya da kuma ɓarkewar ciki ko hanji.
regorafenib (Regofenib, Baivango),
Regefenib na iya toshe maganin angiogenesis, kuma zai iya amfani da sunadarai da yawa akan farfajiyar kansar don hana ci gaban ƙwayoyin kansa. Yana da mai hana cin hanci da rashawa da yawa wanda zai iya hana VEGFR-1, 2, 3, TIE-2, BRAF, KIT, RET, PDGFR da FGFR, kuma tsarinta yayi kama da sorafenib.
A ranar 12 ga Disamba, 2017, Hukumar Abinci da Magunguna ta Kasa (CFDA) ta amince da regorafenib mai hana yaduwar magunguna da yawa don marasa lafiya da ke fama da cutar sankarar hanta (HCC) wacce a baya aka yi mata magani da sorafenib. Itauke shi da baki sau ɗaya a rana don makonni 3 a jere, sannan hutawa na mako guda, sannan ci gaba zuwa zagaye na gaba.
Sakamakon illa na yau da kullun na chemotherapy
Illolin dake tattare da mutane sun hada da gajiya, rashin cin abinci, ciwon hannu da ƙafa (ja da haushin hannu da ƙafa), hawan jini, zazzabi, kamuwa da cuta, rage nauyi, gudawa da ciwon ciki (ciki). M sakamako mai tsanani (nadiri) na iya haɗawa da cutar hanta mai tsanani, zub da jini mai tsanani, matsalolin kwararar jini, da kuma ɓarkewar ciki ko hanji.
masarautar (Levatinib, Levira)
Lenvatinib magani ne mai niyya da yawa. Babban maƙasudin levatinib ya haɗa da mai karɓar haɓakar ƙarancin jijiyoyin jiki VEGFR1-3, mai karɓar haɓakar haɓakar fibroblast FGFR1-4, mai karɓar sinadarin haɓakar platelet wanda aka samo shi PDGFR-α, cKit, Ret et al. Yi aiki ta hana ciwace-ciwacen kafa sabbin jijiyoyin jini da ke buƙatar girma.
In August this year, Eisai (Eisai) and Merck (MSD) lovastinib were approved by the US FDA for marketing. Leweima was included in the first-line treatment of non-surgical advanced liver cancer by the CSCO liver cancer guideline (2018 version), China’s most authoritative tumor diagnosis and treatment guideline.
Ana gudanar da Lenvatinib a baki sau ɗaya kowace rana. Abubuwan da aka fi sani da wannan magani sune cututtukan red-footed redness, fatar fata, rashin ci, zawo, hawan jini, haɗin gwiwa ko ciwon tsoka, rage nauyi, ciwon ciki ko kumburi. M sakamako masu illa (ba nadiri) na iya haɗawa da matsalolin zub da jini da asarar furotin a cikin fitsari.
Cabozantinib
Cabozantinib (Cabozantinib) wani ɗan ƙaramin kwaya ne mai saurin hana yaduwa wanda Exelixis na Amurka ya kirkira, wanda zai iya ƙaddamar da VEGFR, MET, NTRK, RET, AXL da KIT. Yana da suna mafi sananne ga yawancin marasa lafiya, "XL184".
A ranar 29 ga Mayu, 2018, FDA ta amince da Carbotinib don yin layi na biyu na ci gaba da cutar kansar hanta. Amincewa ya dogara ne akan lokaci na III gwajin gwaji CELESTIAL. Marasa lafiya da ke fama da cutar sanyin hanta wadanda suka sami ci gaba bayan maganin sorafenib sun inganta rayuwa gaba daya idan aka kwatanta da placebo. Ci gaban da ba shi da ci gaba da kuma saurin mayar da martani ya inganta sosai.
Larotinib, mai fa'idar yaduwar cutar kansa
On November 26, 2018, the legendary anticancer drug larotrectinib (Vitrakvi, Larotinib, LOXO-101) was finally approved by the FDA for the treatment of adult and pediatric patients with locally advanced or metastatic solid tumors with NTRK gene fusion . Regardless of the type of cancer, as long as it is a solid tumor positive for genetic testing for NTRK fusion, this broad-spectrum targeted drug can be used!
In some rare cancers, NTRK fusion often occurs. These include infantile fibrosarcoma, secretory ciwon nono, etc. These rare cancers usually find NTRK fusion, and these patients may benefit from drugs such as larotrectinib. This targeted drug is not only effective, but also a broad-spectrum anti-cancer drug, effective for many different tumors! This is why this medicine is so eye-catching.
In the experiment, these patient tumor types included 10 different soft tissue sarcomas, salivary adenocarcinoma, infantile fibrosarcoma, thyroid cancer, lung cancer, melanoma, colorectal cancer, ciwon ciki na stromal (GIST), breast cancer, osteosarcoma , Cholangiocarcinoma, primary unknown cancer, congenital mesoderm kidney cancer, appendix and pancreatic cancer.
Bugu da kari, wadanda suka kamu da cutar kansa wadanda suka yi gwajin kwayar cutar kanjamau na iya gano cewa kumburinsu na da NTRK haɗuwa, saboda haɗakar kwayar cutar ta NTRK na iya faruwa a cikin ƙwayoyin cutar kansa daban-daban, gami da ciwon hanta.
Binciken gaba ɗaya na ƙwayoyin halittar haɗi yana buƙatar amfani da fasahar gwajin ƙarnin ƙarni na biyu. Kuma dole ne a lura cewa maye gurbi na NTRK ya haɗu da wasu kwayoyin halittu, maimakon maye gurbin ma'anar yanayi.
Har ila yau, manyan kamfanonin gwajin kwayoyin halittu na duniya Kerris da Medicine Foundation sun yi farin jini kwanan nan
oped Foundation One CDx don gwajin haɗakar NTRK. Marasa lafiya da ke son sani za su iya kiran Sashen Kiwon Lafiya na Onungiyar Sadarwar Oncologist ta Duniya don shawara (400-626-9916).
Magungunan ciwon daji na hanta a cikin bincike
Everolimus
Yana da mai hana zaɓin zaɓi na mTOR. MTOR shine babbar serine-threonine kinase. Everolimus na iya haɗuwa tare da furotin cikin cikin FKBP12 don ƙirƙirar hadadden ƙwayar mTORC1. Zai iya haifar da dalilai na hana ƙari ta hanyar kutsa kai tsaye tare da sake zagayowar ƙwayoyin halitta da angiogenesis. .
However, the results of the current clinical trials suggest that Everolimus is not effective in the treatment of patients with advanced HCC, and its clinical value as a second-line drug therapy still needs to be further discussed.
EvBeacacumumab
It is the first anti-angiogenic drug approved by the FDA for clinical use. It is a recombinant human IgG-1 monoclonal antibody against VEGF. It can prevent VEGF from binding to VEGFR by binding to VEGF and inhibit the proliferation and activation of vascular endothelial cells. , Thereby exerting anti-angiogenesis and anti-tumor effects. Current research shows that bevacizumab alone or combined chemotherapy or other targeted drugs are effective in the treatment of liver cancer.
PApatinib
Apatinib is the world’s first small molecule anti-angiogenesis targeted drug that has been proven to be safe and effective in advanced gastric cancer. It is also a single drug that significantly prolongs survival after standard chemotherapy for advanced gastric cancer fails. It is also a self-developed anti-cancer targeted drug in China, which has achieved certain effects in liver cancer, gastric cancer, cututtukan daji na kansa marasa kansar and breast cancer, and has been included in medical insurance.
Aitan (Apatinib) is through highly selective competition for intracellular VEGFR-2 ATP binding site, blocking downstream signal transduction, thereby potently anti-tumor tissue angiogenesis, and ultimately achieve the goal of combating tumors in all directions.
Magunguna da aka yarda da su don rigakafin cutar kansar hanta
Immunotherapy drugs help the body’s immune system attack cancer cells by targeting the PD-1 / PD-L1 cell signaling pathway (PD-1 and PD-L1 are proteins that are present in the body’s immune cells and certain cancer cells). In layman’s terms: By blocking the binding of PD-L1 protein to cancer cells, the camouflage of cancer cells is prevented, and the body’s own immune cells can recognize and eliminate cancer cells.
Pembrolizumab (Pembrolizumab, Keytruda) and Nivolumab (Nivolumab, Opdivo) are drugs targeting PD-1. By blocking PD-1, these drugs can enhance the immune response to cancer cells. This can shrink some tumors or slow their growth. These drugs can be used in patients with liver cancer who have previously undergone treatment with the targeted drug sorafenib (dojime).
Pembrolizumab (Pembrolizumab, Keytruda)
