First immunotherapy has been approved for esophageal cancer treatment. Esophageal cancer is a common malignant tumor. The International Center for Cancer Research of the World Health Organization points out that esophageal cancer has now become the 6th highest incidence cancer in the world. China is also one of the regions with the highest incidence of kenza yegurokuro in the world. Some are squamous cell carcinoma.
The main treatments for esophageal cancer include surgery, radiotherapy, and chemotherapy. Squamous cell carcinoma is moderately sensitive to chemotherapy. Traditional chemotherapeutic drugs and radiation therapy have a high status in the treatment of esophageal squamous cell carcinoma. However, the prognosis of patients with advanced esophageal cancer after first-line chemotherapy is poor, and treatment options are limited. Taxane and irinotecan have been used after first-line treatment, but no overall survival benefit was seen in the Phase 3 study of chemotherapy.
In recent years, there have been many new attempts in the treatment of esophageal squamous cell carcinoma-molecular targeted drugs and immunotherapy, and great progress has been made.
Recently Merck announced:
The U.S. Food and Drug Administration (FDA) has approved PD-1 tumarara immunotherapy Keytruda (creta, common name: pembrolizumab, pabolizumab) as a single drug therapy for PD-L1 (combined positive score [CPS] ≥ 10) and treatment of patients with recurrent locally advanced or metastatic esophageal squamous cell carcinoma (ESCC) who have progressed after one or more systemic therapies.”
Yekutanga immunotherapy yekenza yesophageal
Kubvumidzwa kwakavakirwa pamhedzisiro yekodhi yekuyedza-yakanzi KEYNOTE-181 (NCT02564263).
KEYNOTE-181 ndeye multicenter, yakasarudzika, yakavhurika-label, inoshanda inodzorwa kutongwa. 628 varwere vane dzokororo yemunzvimbo yepamusoro kana metastatic esophageal cancer yakaverengerwa. Ava varwere vemberi vakapfuurira mberi uye mushure mekutanga-mutsara systemic kurapwa.
Varwere vaiwanzopihwa kupihwa palmumab 200 mg kamwe chete pavhiki nhatu, kana anotevera chemotherapy intravenous regimen: paclitaxel, docetaxel per, kana irinotecan.
Mhedzisiro yacho yakaratidza kuti ichienzaniswa neboka remakemikari, varwere vane mamota ane PD-L1 CPS-10 yakaratidza kuvandudzwa muOS mune varwere vaiitwa zvisina mutsigo neChitruda. Iyo yakazara yekupindura mwero wepembrolizumab iri zvakare yakakwira kupfuura chemotherapy. Iyi data inoratidza kuti pembrolizumab inofanirwa kutariswa seyakajairwa kurapwa kune varwere vane PD-L1 CPS yegumi kana yepamusoro pakurapa kwechipiri-mutsara.
Zvinogona kuitika mhedzisiro: Pneumonia, colitis, hepatitis, endocrine disease, nephritis and renal dysfunction, severe skin reactions, solid organ transplant rejection and complications of allogeneic hematopoietic stem cell transplantation (HSCT). Depending on the severity of the adverse reaction, pembrolizumab should be discontinued or discontinued, and corticosteroid therapy should be given when appropriate.
Dzimwe nzira dzokurapa kenza yesophageal
Chemotherapy mukenza yesophageal
Nekurapa kenza yesophageal, chemotherapy inogona kushandiswa panguva dzakasiyana.
Adjuvant chemotherapy: chemotherapy mushure mekuvhiyiwa. Chinangwa ndechekuuraya chero masero ekenza anogona kusara panguva yekuita, nekuti madiki kwazvo kuti aonekwe neziso rakashama, saka haakwanise kubviswa kuvhiya. Izvo zvakare zvinokwanisika kuti maseru ekenza atize kubva mumamota makuru uye anotora midzi mune mamwe mativi emuviri.
Neoadjuvant chemotherapy: Kune mamwe magomarara, chemotherapy (inowanzo sanganiswa ne radiation radiation) inopihwa pamberi pekuvhiyiwa kuyedza kudzikisa bundu uye kuita kuti kuvhiya kuve nyore kujekesa.
Chemotherapy yekenza yepamberi: Kune kenza yesophageal yakapararira kune dzimwe nhengo, senge chiropa, chemotherapy inogona zvakare kushandiswa kubatsira kudzora mamota uye kubvisa zviratidzo. Kunyangwe zvisingaite kurapa kenza, inogona kubatsira vanhu kurarama kwenguva yakareba.
Zvinowanzoitika zvinodhaka zvinoshandiswa pakurapa kenza yesophageal
- Carboplatin uye paclitaxel (inogona kushandiswa musanganiswa ne radiotherapy)
- Cisplatin uye 5-fluorouracil (5-FU) (kazhinji inosanganiswa ne radiation radiation)
- ECF: epirubicin, cisplatin, uye 5-FU (kunyanya tumarara panosangana gastroesophagus)
- DCF: docetaxel, cisplatin, uye 5-FU
- Cisplatin uye capecitabine
- oxaliplatin uye 5-FU kana capecitabine
- irinotecan
Inotarisirwa kurapwa mukenza yesophageal
Ramucirumab (Cyramza)
Rumizumab is a humanized monoclonal antibody that specifically blocks vascular endothelial growth factor receptor 2 (VEGFR2) and downstream angiogenesis-related pathways. The currently approved indication is monotherapy or in combination with paclitaxel for advanced gastric cancer / gastroesophageal junction adenocarcinoma that progresses during or after chemotherapy with or without fluorouracil or platinum. In addition, it has been approved for the treatment of isina-diki kenza yemapapu kenza and metastatic colorectal cancer.
Trastuzumab (Trastuzumab, Herceptin)
Trastuzumab, anti-monoclonal antibody inopesana naHer2, inodzivirira epidermal yekukura kwechinhu kubva pakubatanidza kuna Her2 nekuzvinamatira kuna Her2, nekudaro ichivharira kukura kwemasero ekenza. Herceptin inogona zvakare kukurudzira iyo yemuviri Maseru emuviri kuparadza gomarara maseru.
Esophageal squamous cell carcinoma, senhengo yakasarudzika mumatumbu edu epamusoro ekugaya, inokanganisa kudya. Uye zvakare, squamous cell carcinoma inonyanya kuvhiringidza uye inowanzova panjodzi yekudzivirirwa, kubuda uye kubuda ropa. Naizvozvo, mune yekurapa kwese squamous cell carcinoma, kunyangwe isu tichizoshandisa dzimwe nzira dzechivanhu dzekurapa zvinodhaka uye tichifunga kumwe kuyedza kutsva, isu tinofanirwa kushandisa pfungwa yeiyo yakazara-kosi manejimendi panguva yekurapa kwese. Nekufambira mberi kwemishonga, pachave nehunyanzvi hwakawanda hwekurwisa gomarara rekusophage, senge proton radiotherapy, cellular immunotherapy, nezvimwe. Munhu wese anofanira kuva nechivimbo.
