Gomarara repazamu & chemotherapy
Among the many cancers, breast cancer is probably the most difficult to decide whether to undergo chemotherapy after surgery. Similar to other cancers, the factors that determine breast cancer chemotherapy are (age, tumor size, metastasis of lymph nodes and other organs (so-called TNM, staging), ER, PR, CerbB-2, Ki-67, P53, etc.). If the results of the analysis are obviously sideways, it is easier to make a decision about whether to administer chemotherapy. But in many cases, the result of the analysis is exactly in the middle “gray zone” (I don’t exaggerate, there are many examples of middle zone), which will cause the situation of uncertainty. We often say: Second opinion (listen to the opinions of several doctors), but have you ever thought about it, even if you ask 10 doctors, the answer you get is likely to be: 5 say chemotherapy, 5 say no ( Still two opinions), isn’t it annoying.
Mushure mekunge uine kenza yebonde, it’s important to make a decision about whether to get chemotherapy. If patients who do not need chemotherapy receive unnecessary chemotherapy, it will not only waste time and money, but also endure the various side effects of chemotherapy (nausea, vomiting, hair loss, bone marrow suppression, infection, bleeding, etc.). Patients who originally needed chemotherapy miss the chance of chemotherapy, which increases the risk of recurrence.
Kuitei?
Imwe bvunzo yakakurudzirwa neAmerican ASCO (American Clinical Oncology Association). Inodaidzwa oncotype DX. Bvunzo iyi inoshandisa yakapusa mamorekuru biology nzira yekuongorora izvo zvataurwa pamusoro apa pane chirwere chekenza yemazamu chikamu chehutachiona, uyezve ichipa "Recurrent Score" (RS). Varwere vane yakakwira RS vanoda chemotherapy, uye avo vane yakaderera RS havadi chemotherapy. RS iri pakati inoda kumwe kuongorora (asi vazhinji varwere vane RS munzvimbo yepakati havabatsiri zvakanyanya kubva kuchirimo chemotherapy).
MuUnited States, bvunzo iyi yakajairika pakurapwa kenza yemazamu, nekuti sarudzo yekuti unoda chemotherapy inoenderana zvakadii nemhedzisiro yako yekurapa. Inofungidzirwa kuti mazana maviri nemakumi maviri nemashanu ezviuru emukenza wemazamu anoitika gore rega rega muUnited States, uye makumi mapfumbamwe nemazana mashanu ane makumi matatu nesrogen receptor zvakanaka uye vanoonekwa sevanoda kurapwa chemotherapy. Mari ye chemotherapy pamurwere ingangoita $ 225,000, uye mutengo weimwe oncotype DX bvunzo ndeye $ 94,500. Naizvozvo, kana vese varwere vane mikana yakaderera vasingapi chemotherapy, iyo US ichaponesa mamirioni mazana matatu pagore $ 15,000 mamirioni.
Dr. Joseph Ragaz of the University of British Columbia in Vancouver and colleagues analyzed tumarara samples from 196,967 estrogen receptor-positive breast cancer patients from the database of Genomic Health, the parent company that developed the test, and found that oncotype DX The proportion of patients with positive axillary lymph nodes (59%) with a 10-year recurrence risk score below 18 was greater than that of patients with negative lymph nodes (54%).
These data indicate that oncotype DX testing should be performed on all estrogen receptor-positive breast cancer patients, ethically and economically, regardless of their axillary lymph node status. However, this test can only be applied for testing in hospitals in the United States, Japan and other regions. For details, please visit the Global Oncologist Network.
NCCN inokurudzira kuongororwa kwemajini kwekenza yemazamu: ncotype DX
Ye20th National National Comprehensive Cancer Network (NCCN) Musangano Wegore Negore wakaitwa kubva munaKurume 12 kusvika 14, 2015 muHollywood, Florida, USA. Sekureva kwenhau dzakaburitswa pamusangano, iyo NCCN yakangosaina genome test yekenza yemazamu yekutanga. Yimaitong akataura izvi.
Amy Cyr weSiteman Cancer Center paYunivhesiti yeWashington, achitaura kumusangano uyu, akataura kuti oncotype DX, iyo yakagadziriswa neGenomic Health, yakahwina rukudzo urwu.
Muedzo uyu une mabasa maviri. Pamusoro pekupa ruzivo rwekufungidzira, kuyedza zvakare kune mhedzisiro yekuitika pakurapwa; inogona kunyatso kufanotaura mhinduro yevarwere ku chemotherapy.
Muchidimbu, Oncotype DX chishandiso chechipiri chekufungidzira uye kufanotaura.
Amy Cyr akati kugona kwake kufanotaura kurapwa kwaizoitwa "chimwe chinhu chakaita kuti zvioneke kusvika pari zvino." Akawedzera kuti mamwe mamorekuru bvunzo yekenza yemazamu, inosanganisira MammaPrint, Prosigna, EndoPredict, uye Cancer Index, haina kuratidza humbowo hwezvose zviri zviviri kugona.
o ncotype DX inokodzera vakadzi vanogamuchira postmenopausal vakadzi vane kenza yemazamu (zvakare inokodzera HER2 negative, pT1, PT2, kana pT3 uye pN0 kana pN1).
Dr Cyr vakati musika wekuyedza uri kuwedzera sezvo vakadzi vazhinji vanoonekwa kuti vane gomarara repazamu rekutanga, chiratidzo chechigadzirwa, nekuvhenekwa mazamu.
Dr. Cyr vakati kuti mamorekuru kutaura profiling "ndeimwe yeakanakisa budiriro" mune zvekurapa oncology, uye kuongororwa kwakawanda kwekenza yemazamu kwakaunza mamwe data.
"Oncotype DX kuyedza chinhu chakakosha kwazvo," akadaro Michael Stone kuGlealey Clinic paUniversity yeColorado kumusangano, uyo unofanotaura nezve njodzi yekudzokororwa kwemuno kana kwemasastatic. "Varwere vangu vazhinji vanofara kuti vangangodaro vasingadi chemotherapy."
Dr. Stone vakatsanangura kuti chemotherapy kazhinji haina kukurudzirwa kune varwere vane yakaderera yekudzokorora mamaki, asi inokurudzirwa kune varwere vane yakanyanya kudzokorora mamaki. Nekudaro, iyo yekudzokorora mamaki inzvimbo yegrey. Akataura kuti anokurudzira chemotherapy kunoenderana nezera remurwere uye hutano. Chemotherapy inowanzo kukurudzirwa kune vadiki, vane hutano postmenopausal varwere vane wepakati kudzokorodza mamaki. Dr Cyr vanobvuma kuti zvinonetsa kuziva kuti vakadzi vane repakati kudzokorodza mamaki vanofanirwa kupihwa chemotherapy.
Cyr akasimbisa kuti kunyangwe oncotype DX inongokodzera chete kune lymph node yakaipa varwere, zvinoita kunge zvinobatsira kune lymph node yakanaka varwere.
Akataura nezve chidzidzo cheTransATAC, icho chakanangana nemadzimai ane gomarara repazamu rekupera kwemwedzi rinobatwa neanastrozole kana tamoxifen (J Clin Oncol. 2010; 28: 1829-1834). Oncotype DX yakashandiswa kuongorora bundu revarwere, uye kudzokororwa kwe lymph node isina kunaka uye lymph node yakanaka varwere vakaverengerwa zvakateerana.
Dr. Cyr vakati "zviyero zvekudzokorora zvinogona kushandiswa kufanofungidzira mhedzisiro yenguva refu mumapoka ese evarwere." Izvo zvakakosha kuti uzive kuti iine yakafanana fungidziro kukosha kwevarwere vane 3 kana mashoma lymph node positives uye 4 kana kupfuura lymph node positives.
