Braftovi ane Erbitux akazowana mhedzisiro yakanaka kune colorectal cancer

Targeted treatment of colorectal  cancer, BRAF V600E gene mutation targeted therapy of colorectal cancer Braftovi + Erbitux finally achieved positive results

Colorectal kenza yekurapa chinzvimbo

Colorectal cancer is one of the most common malignant tumors in the digestive system. In recent years, its morbidity ranks third in the world in terms of malignant tumors, and its mortality rate ranks second, which seriously threatens people’s lives and health. With the changes in the living habits and dietary structure of our nationals, the incidence of kenza yakajeka has generally shown an upward trend, and has become the second highest incidence of digestive system, and the highest incidence of malignant tumors. According to relevant research statistics, the number of new cases of colorectal cancer in China is expected to exceed 521,000 in 2018, and the number of deaths is as high as 248,000.

Zvidzidzo zvakaratidza kuti vangangoita gumi muzana muzana yevarwere vane metastatic colorectal cancer vanozove neBRAF geni shanduko uye kusarongeka kufungidzira. V15E shanduko ndiyo yakajairika BRAF gene shanduko. Njodzi yekufa kwevarwere vane BRAF V600E shanduko ndeyekutakura mhando yemusango BRAF gene Varwere kaviri.

Faced with such a dangerous BRAF V600E mutation metastatic colorectal cancer, the editor shares a piece of exciting good news learned recently! On April 8, 2020, Pfizer announced that the US FDA has approved Braftovi® (encorafenib, connefenib) and Erbitux® (cetuximab, cetuximab) combination therapy (Braftovi two-drug protocol) is used to treat patients with metastatic colorectal cancer (mCRC) who carry the BRAF V600E mutation. These patients have already received one or two pre-treatments. This approval also makes the Braftovi chechipiri chemushonga mushonga wekutanga wakanangwa kurapa kwakabvumidzwa neFDA kune varwere vane mCRC inotakura BRAF shanduko.

Braftovi kurapa kwakapetwa katatu katatu kunowedzera kupona

Kubva muna Zvita 2019, iyo FDA yakagamuchira iyo Pfizer Braftovi Chechipiri Chirongwa Chirongwa chinowedzerazve chishandiso chitsva chemushonga uye chakapa chinzvimbo chekutanga chekuongorora. Kubvumidzwa uku kunobva pamhedzisiro yeBEACON CRC Phase 3 kiriniki kuyedzwa.

Chidzidzo ichi chakaitwa mune varwere vane advanced BRAF V600E mutant mCRC avo vakambofambira mberi mushure mekugamuchira imwe kana maviri ekurapwa. Kubudirira pamwe nekuchengetedzwa kwechirongwa chekurapa che ritica chakasanganiswa nemishonga (kutonga).

Tafura 1: Chirongwa chemishonga cheboka rega rega

Mhedzisiro huru yekutsvaga

1. Kupona kweMedhia (OS): 9.0 mwedzi muboka retatu rerapi

Mwedzi 8.4 muboka rekurapa mbiri

Kudzora boka ndeye 5.4 mwedzi

2. Kufambira mberi-kusununguka-kupona: 4.3 mwedzi muboka retatu rerapi

Mwedzi 4.2 yezvikamu zviviri zvekurapa

Kudzora boka ndeye 1.5 mwedzi

3. Mwedzi mitanhatu yekupona mwero: 6% mune katatu kurapa boka

65% muboka rekurapa mbiri

Kudzora boka i47%

4. Chinangwa Remission Rate (ORR): 26% muboka retatu rerapi

20% muboka rekurapa mbiri

Kudzora boka i2%

Mufananidzo uri kuruboshwe unofananidza iwo matatu-madhiragi regimen yeRaftovi neOS yeboka rinodzora, uye mufananidzo uri kurudyi unofanidza iwo maviri-madhiragi regimen eRaftovi neOS yeboka rinodzora.

Kazhinji, zvichienzaniswa neErbitux uye irinotecan-ine marapirwo, kushanda kwemaviri-madhiragi uye matatu-madhiragi madhiragi haana kunyanya kusiyana, uye kune mashoma emakiriniki mhedzisiro.

Mukuru weMuongorori Dr. Scott Kopetz vakati: "Semurwere ane yakamborapwa BRAF V600E mutant metastatic colorectal cancer, Braftovi + Erbitux (conefinil + cetuximab) ndiyo yekurapa kwekutanga uye yakanangwa Iyi ndiyo nzira nyowani yekurapa inodiwa zvakanyanya nevarwere vakadaro. "

Braftovi yekubatanidza kurapa misimboti uye zvinoratidza

Braftovi’s active pharmaceutical ingredient binimetinib is an oral small molecule BRAF inhibitor, and Mektovi’s active pharmaceutical ingredient encorafenib is an oral small molecule MEK inhibitor. MEK and BRAF are two key protein kinases in the MAPK signaling pathway (RAS-RAF-MEK-ERK).

Studies have shown that this pathway regulates many key cell activities including cell proliferation, differentiation, survival, and angiogenesis. In many cancers, such as melanoma, colorectal cancer, and thyroid cancer, proteins in this signaling pathway have been shown to be abnormally activated.

In the United States, the Braftovi + Mektovi combination has been approved for unresectable or metastatic melanoma with BRAF V600E or BRAF V600K mutations. Braftovi is not suitable for the treatment of wild-type BRAF melanoma. In Europe, the combination is approved for adults with unresectable or metastatic melanoma with BRAF V600 mutation. In Japan, the combination is approved for BRAF-mutated unresectable melanoma.

The 2019 NCCN Guidelines for Colorectal Cancer adds two new EGFR / BRAF / MEK triple inhibitor combination therapies for patients with advanced BRAF V600E mutation-positive advanced disease, namely:

[1] Dabrafenib + Trametinib + Cetuximab / Panitumumab (Cetuximab / Panitumumab)

[2] Encorafenib (conefinil) + Binimetinib (bimetinib) + Cetuximab / Panitumumab (cetuximab / panitumumab)

Xiaobian ane chekutaura

In the era of targeted therapy, every patient with colorectal cancer should pass MSI detection, mutation analysis of RAS and BRAF, and perform HER2 amplification, NTRK and other gene detection as far as possible. Genetic testing (NGS) will be included in the large The initial examination standard for most patients. Cancer friends who have undergone genetic testing can send the report to the medical department for interpretation to see if there is a relevant treatment option.

Mupepeti anotenda kuti mune ramangwana kuchave nekufambira mberi kwekutsvagisa uye mishonga yakanakisa yegomarara remukati. Chete nyanzvi dzepamusoro dzegomarara kumba nekune dzimwe nyika dzine ruzivo rwakapfuma rwekiriniki. Varwere vegomarara reColorectal vanogona kunyorera chiremera kuburikidza neGlobal Oncologist Network Expert kubvunza, kuwana yakanyanya kuongororwa uye chirongwa chekurapa.