Chikunguru 13th 2021: Mushonga mutsva wevanhu vane rudzi rwegomarara rechiropa unonzi hepatocellular carcinoma unowanikwa unoratidzika kunge uri nani pane kurapa kwakajairwa (HCC). The Zvokudya uye Drug Administration (FDA) yakatenderwa atezolizumab (Tecentriq) uye bevacizumab (Avastin) semutsetse wekutanga kurapwa kune vanhu vane gomarara rechiropa repamusoro vasingakwanise kurapwa.
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.
Imwe yenyanzvi dzeongororo iyi, Richard Finn, MD, weUniversity of California, Los Angeles, akati, "Ichi chiitiko chikuru chevarwere." "Ichi chinhu icho varapi vanorapa varwere ava vanga vachikumbira kwenguva yakareba, uye iri danho rakakura kuenda kumberi."
Atezolizumab is immune checkpoint inhibitor, zvinoreva kuti inobatsira immune system kuwana uye kuuraya cancer maseru. Bevacizumab imishonga yakanangwa iyo inofa nenzara mamota nekudzivirira kukura kwemidzi mitsva yeropa.
Another targeted therapy, sorafenib, inhibits the formation of blood vessels and cancer cells. Sorafenib was the first medicine approved by the FDA muna 2007 kurapa vamwe varwere veHCC.
Sekureva kwaTim Greten, MD, mutevedzeri wemukuru weNCI's Center for Cancer Research's Thoracic uye GI Malignancies Branch, chete marapirwo eHCC akapihwa marezenisi kubvira 2007 haashandi kupfuura sorafenib.
Mune mupepeti, Robin Kelley, MD, weUCSF Helen Diller Family Comprehensive Cancer Center, akataura kuti kwete chete mubatanidzwa weatezolizumab – bevacizumab wainyanya kushanda, asi wakazogumawo "nezvakanaka zvirinani zvataurwa nemurwere-zvakataurwa," senge masimba emuviri. .
Sekureva kwaDr. Greten, iyo combo regimen inogona kutsiva sorafenib seyakajairwa kurapwa-mutsara wekutanga kune vamwe vanhu vane HCC yepamusoro.
Kuwedzera kune immune checkpoint inhibitors
Chirwere cheropa is frequently identified after it has progressed outside the liver or become interwoven with several blood arteries, making surgery impossible to treat.
Sorafenib uye lenvatinib (Lenvima), mumwe mushonga unononoka kuumbwa kwetsinga yeropa, ndiyo yega sarudzo kune vanhu vane kenza yechiropa vasingakwanisi kurapwa nekuvhiyiwa (haisi kushanda).
Immune checkpoint inhibitors yakaongororwa senzira yekutanga yekurapa kenza yechiropa mune mashoma emakiriniki ezvidzidzo, asi zvakawanikwa zvisina basa pachavo. Masayendisiti akawana kuti kuwanda kweprotein inonzi VEGF inogona kutadzisa mishonga yekudzivirira immune kubva mukushanda mushure mekuferefeta.
Sekureva kwaDr.Finn, VEGF inokonzeresa kugadzirwa kwemitsipa yeropa mitsva uye inochinja huwandu uye mhando yemaseru emuviri mumashure uye mumatumbu.
nekuti 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.
Kuchengetedzwa kweAtezolizumab Plus Bevacizumab
Iyo combo mishonga yakakonzera akati wandei mhedzisiro muvarwere vazhinji. Pakazara, zvakadaro, varwere vakaita kunge vanoshivirira ese ari maviri mishonga, sekureva kwa Dr. Greten.
Iwo mapoka maviri aive akaenzana zviitiko zvemhedzisiro uye kufa kubva kumhedzisiro. Nekudaro, iro combo boka rakange riine varwere vazhinji vakasangana nemimwe mibairo mikuru (38 muzana maringe ne31 muzana).
Nekuda kwemhedzisiro, vashoma varwere muboka re combo vakambomira kana kuchinjisa iwo madosi erapi yavo (50 muzana maringe ne 61 muzana muboka reSorafenib). Chete 7% yevarwere vari muboka reboka ndivo vakamira kutora mishonga yese nekuda kwemhedzisiro, kunyangwe hazvo varwere vazhinji muboka rekubatanidza vakamira kutora mumwe wemishonga (16% maringe ne10%).
Nekuda kwekukanganisa kwayo tsinga dzeropa, bevacizumab inogona kukonzera kubuda ropa, sekureva kwaDr Greten. Akataura kuti gomarara rechiropa rinogona zvakare kugadzira shanduko dzinowedzera mukana wekubuda ropa, senge yakaderera maplatelet kuverenga.
"Paiva nezvikamu zvishomanana zvekubuda ropa mu atezolizumab, bevacizumab ruoko, asi ivo vakanga vachiri kuderera zvakanyanya sezana," Dr. Finn akawedzera. Mumapoka ose ari maviri, 6% yevarwere vakaona kubuda kukuru kweropa nekuda kwekurapa bevacizumab.
Sekureva kwaDr. Greten, "zvichave zvakakosha kusarudza huwandu hwevarwere" hwekurapa combo. Asati atanga mushonga, varwere vangangoda kuwana bvunzo dzakajairika kuti vatarise kubuda ropa njodzi, akadaro.
Dr. Kelley akati, "Imwe nzira yekurapa inofanirwa kuongororwa kune varwere vari panjodzi huru yekubuda ropa."
