Gomarara repazamu riri kukura
Gomarara remudumbu rinoramba riri rimwe regomarara rinozivikanwa uye rinouraya pasi rose, kunyanya pakati pevarume vakuru. Kubva paGLOBOCAN 2018 data, gomarara remudumbu ndiro 5th rinowanzozivikanwa neoplasm uye iyo 3rd gomarara rinouraya zvakanyanya, pamwe nekufungidzirwa kufa kwevanhu mazana masere nemakumi manomwe nevatatu muna783,000. Gastric cancer chiitiko uye kufa zvinonyanya kusiyana nedunhu uye zvakanyanya kuvimba nezvikafu uye Helicobacter pylori hutachiona. Ndichiri kufamba mukudzivirira nekurapa H. pylori hutachiona hwadzikira huwandu hwegomarara remudumbu, zvakabatsirawo mukuwedzera kwezviitiko zvecardia gastric cancer, isingawanzoitika tema tumapundu twakakura kanomwe mumakumi emakore apfuura. Kunzwisiswa kuri nani kweiyo etiology uye njodzi zviitiko zvechirwere zvinogona kubatsira kusvika kubvumirano mukusvika H. pylori utachiona. Kugadziriswa kwechikafu, kurega kuputa, uye kurovedza muviri zvine chivimbiso mukudzivirira gomarara remudumbu, nepo kuongororwa kwemajini kuri kugonesa kuongororwa kwekare uye nekudaro kupona kukuru.
Kune mishonga mitsva yegomarara yemudumbu mugore ra2020. Kune huwandu hwakawanda hwecancer yegastric pasi uye kukura kwayo gore rega rega. Chiyero chekuona chevarwere vane gomarara repamberi remudumbu chingangoita 5% -10%. Varwere vazhinji vanowanikwa vari pakati nepakati kana padanho rekutanga nekuti danho rekutanga regomarara remudumbu harisi chiratidzo chiri pachena.
Zvisinei, gomarara remudumbu hachisi chirwere chisingarapike. Nekukurumidza kufambira mberi kwekurapa kwakanangwa uye immunotherapy, varwere vegomarara remudumbu vanoda kuwana kurarama kwenguva refu haichisiri dambudziko. Pamusoro pekuvhiyiwa uye radiotherapy, kurapwa kwezvinodhaka kunosanganisira chemotherapy, kurapa kwakanangwa, uye immunotherapy.
Chemotherapy mishonga yekenza yemudumbu
Chemotherapy inogona kushandiswa kurapa kenza yemudumbu nenzira dzakasiyana:
Mazhinji chemotherapy mishonga inogona kushandiswa kurapa gastric cancer, inosanganisira:
5-FU (fluorouracil) kazhinji inosanganiswa nefomyltetrahydrofolate (folate)
6-Capecitabine (Xeloda®)
Carboplatin
Cisplatin
Docetaxel (Tassodi®)
Epirubicin (Ellence ®)
Irinotecan (Capto®)
Oxaliplatin (Losadine®)
Paclitaxel (Taxol®)
Gastric cancer chemotherapy mishonga inowanzopihwa musanganiswa wemishonga, kusanganisira:
ECF (epirubicin, cisplatin uye 5-FU) inogona kupihwa usati uye mushure mekuvhiyiwa
Docetaxel kana paclitaxel pamwe ne5-FU kana capecitabine, inosanganiswa ne radiotherapy se pre-operative kurapwa
Cisplatin pamwe ne5-FU kana capecitabine, inosanganiswa ne radiotherapy se pre-operative kurapwa
Paclitaxel uye carboplatin inosanganisa radiotherapy se preoperative kurapwa
Gomarara regastric rinotarisana nemishonga
HER2
Vanosvika makumi maviri muzana evarwere vanotaura HER20 protein inosimudzira kukura kwegomarara, uye inhibitors inonangana Her 2 protein inodzivirira epidermal growth factor kubva pakubata Her2 nekuzvibatanidza neHer2, nekudaro ichivharira cancer cell kukura. Inogona kurapwa semushonga mumwe chete, kana musanganiswa neakawanda anti-HER2 yakanangana nemishonga, kana musanganiswa nechemotherapy mishonga.
Trastuzumab (trastuzumab, Herceptin)
Trastuzumab (Herceptin) inorwisa munhu monoclonal antibody iyo inovavarira iyo HER2 protein. Chemotherapy ne trastuzumab inogona kubatsira varwere vane yakakwira HER2-yakanaka gastric kenza vane hupenyu hwakareba kupfuura chemotherapy chete.
Zvashandiswa kugutsikana (trastuzumab-dttb)
Musi wa18 Ndira, 2019, iyo US FDA yakabvumidza Samsung Bioepis 'Ontruzant (trastuzumab-dttb), biosimilar yetrastuzumab (trastuzumab) yekurapa HER2 Positive cancer yemazamu uye HER2 yakanyanyisa gastric cancer.
Zano: Usati washandisa mushonga, ndapota ronga bvunzo kuti uone kutaura kweHER2 protein. Iwe unogona kufonera 400-626-9916 kuti ubvunze nezve genetic test.
VEGFR
Sezvo muviri uchikura nekukura, unoita mitsipa yeropa mitsva kuendesa ropa kumasero ese, maitiro anonzi angiogenesis. Kana mitsipa yeropa mitsva painopa okisijeni uye zvinovaka muviri kumasero ekenza, anobatsira kukura nekupararira kwemasero ekenza.
Angiogenesis inhibitors inobatsira kudzivirira kana kunonoka kukura kana kupararira kwemamota nekudzivirira mamota kubva mukugadzira matsva eropa, zvichikonzera mamota kufa kana kumira kukura nekuti haakwanise kuwana iyo oxygen uye zvinovaka muviri zvavanoda. Inhibitors inoshanda nekuvhara vascular endothelial growth factor (VEGF) receptors mumasero ekenza.
Ramucirumab (Remolucumab, Cyramza®)
Ramucirumab ndeye monoclonal antibody inosunga kune iyo VEGF receptor uye inogona kubatsira kudzora kana kumisa kukura uye kupararira kwegomarara. Muna 2014, mushonga uyu wakabvumidzwa kurapwa kwecancer yegastric uye gastroesophageal junction cancer, asi haisati yave kuwanikwa kuChina.
Gastric kenza immunotherapy
Immunotherapy inovavarira kusimudzira kugona kwechisikirwo kwemajoni emurwere kurwisa gomarara. Immunotherapy haina kunanga zvakananga maseru egomarara mumuviri wemunhu, asi inodzidzisa immune system yemunhu kuziva maseru ekenza uye nekusarudza nekuauraya.
Pembrolizumab (Pembrolizumab, Keytruda)
FDA inobvumira pembrolizumab kune varwere vane gomarara remudumbu repamusoro avo vakagamuchira kurapwa kaviri (kusanganisira chemotherapy) kurapwa kwevarwere vane yakadzokororwa munharaunda yepamusoro kana metastatic gastric kana gastroesophageal junction (GEJ) adenocarcinoma, ane bundu kutaura PD-L2 [Comprehensive Positive Score. (CPS) ≥1], yakatemwa nebvunzo yakatenderwa neFDA. Yakafambiswa mushure memitsara miviri kana kupfuura yechemotherapy inosanganisira fluoropyrimidine uye platinum, kana HER1 / neu yakanangwa kurapa. Pamusoro pezvo, genetic test mhedzisiro yeMSI-H inoshandawo kune varwere vegomarara remudumbu.
