Nefambiro mberi yenzanga, mipimo yokurarama yavanhu vakawanda yakavandudzika, asi nemhaka yezvikonzero zvebasa kana kuti zvemhuri ivo vakafuratira zvinetso zvavo vamene zvoutano, vachibvumira zvimwe zvirwere kuzvishandisa. Pakati pavo, colorectal cancer muenzaniso wakajairika. Colorectal cancer haiitike kamwe chete. Zvinoenderana nenhamba, nguva inotora mutant sero kuti ikure kuita bundu rakashata inodarika makore makumi matatu paavhareji. Uye nekusaziva, katsika kadiki kemararamiro angave ari kutamba chikamu mucarcinogenesis, uye hazvibviri kudzivirira. Mumakore achangopfuura, gomarara remudumbu rakanyatsotevera gomarara remapapu uye rave rechipiri rine huwandu hwegomarara, iro rinofanirwa kukwezva vanhu.
Precision kurapwa kunounza tariro nyowani kune colorectal cancer varwere
Nekudzika kwetsvakiridzo pamusoro pekushanda kwerapi yakanangwa uye genotyping, mishonga yakanangwa yave sarudzo nyowani yekurapwa kwega uye kurapwa kwakazara kwevarwere vane colorectal cancer. Mutsara wekutanga kurapwa. Kubuda kwemishonga yakanangwa kwakavandudza tarisiro yekurapa kwevarwere vane colorectal cancer, uye kusanganiswa kwayo nechemotherapy mishonga kwakawedzera nguva yekurarama kwevarwere.
Mishonga inowanzoshandiswa pakurapa cancer yegomarara inonyanya kusanganisira mhando mbiri dzemishonga inonangana nepidermal growth factor receptor (EGFR) uye vascular endothelial growth factor (VEGF), yakadai seyaimbova cetuximab uye panib Monoclonal antibodies, iyo yekupedzisira i ramucirumab. , bevacizumab uye regorafenib. Mishonga yakanangwa yakaita seKRAS, BRAF, PIK3CA, MSI uye PD-L1 yakapindawo mumakiriniki ekuyedzwa, uye zvinotendwa kuti mimwe mishonga yakanangwa ichavepo munguva pfupi iri kutevera kubatsira varwere vane colorectal cancer.
Tarisana nemisiyano yemunhu wega wekenza yakajeka kenza yekuedza Gene kwakakosha
Nezve kurapwa kwegomarara remukati, vanhu vanonyanya kunetseka nezve nzira dzipi dzekurapa dziri kushandiswa parizvino? Kurapa kwegomarara remukati kune hukama nebundu nhanho, uye kurapwa kunofanirwa kutevedzera musimboti wekurapwa kwega. Nzira yekuwana sei kurapwa kwega? Mhinduro ndeyokuti, hongu, kuongorora magene. Kuburikidza chete nekuongororwa kwemajini kuti tinzwisise mamorekuru emasero egomarara tinogona kurapa chirwere ichi. Sezvambotaurwa, kune akati wandei akatarwa mishonga atovepo, asi zvinokwana here kungoona chinowirirana chinangwa chemushonga? zvirokwazvo kwete.
Semuenzaniso, kunyange hazvo pasina chakanangwa chinodhaka cheRAS shanduko mukenza yakajeka, zvakakoshawo kuona maRAS magen'a mune akasiyana kenza varwere. Chidzidzo che2008 chakaratidza kuti kune KRAS yemhando-yevarwere varwere, cetuximab monotherapy inogona kuwedzera zvakanyanya OS yevarwere (9.5 mwedzi vs 4.8 mwedzi) zvichienzaniswa nemushonga wakatsigira, asi KRAS mutant varwere Asi vakatadza kubatsirwa nazvo. Izvi zvinoratidza kuti kushandiswa kwecetuximab neEGFR sechinangwa kunodawo kuona shanduko yeKRAS muvarwere, uye kuongororwa kwemajini kwakabata basa risingadzoreke.
Genetic kuyedza kunoenderana neyechipiri-chizvarwa kuteedzana hakugone kuzadzikisa zvido zvevarwere
Kana zvasvika pakuongororwa kwemajini, chinhu chekutanga icho munhu wese anofunga nezvacho chizvarwa chechipiri chinoteedzana kuti chione shanduko yeDNA. Kuburikidza nekuongorora kwemajini, tsvaga chiratidzo chakanangwa nemishonga yekuchinja marongero ekutungamira kurapwa kwevarwere. Asi vangani varwere vegomarara vanogona kunyatso kubatsirwa kubva kune yechipiri-chizvarwa kuteedzana? Zvinoenderana nehuwandu, zvishoma pasi pegumi muzana yevarwere vanogona kuona shanduko tarisiro, uye kunyangwe vashoma varwere vanogona kuramba vachishandisa zvakanangwa zvinodhaka uye kubatsirwa. Vazhinji varwere vachiri kuvimba pakurapwa kwemakemikari ekurapa kuti vawedzere hupenyu hwavo. Iko kune chaiko sarudzo dzesarudzo yemakemikari ekurapa. Panzvimbo pekutevedzera zvakapofomara iwo marongero, United States ine tekinoroji isingangogone chete kutungamira kurapwa kwakanangwa asi zvakare kutungamira varwere kukemotherapy Kusarudzwa chaiko, kuburikidza nekuyedza, kunogona kugonesa 10% yevarwere kuti vagamuchire nhungamiro yekurapwa uye vabatsirwe nayo.
Caris yakawanda-chikuva mamorekuru kuongororwa ndiyo yekutanga sarudzo yevarwere
Pamusoro pekutungamira mishonga yakanangwa, inogona zvakare kutungamira kusarudzwa kwemakemikari ekurapa. Ichi ndicho chikamu chikuru chevazhinji-chikuva mamorekuru profiling ongororo yeUnited States Keris, uye zvakare inzvimbo inokwanisa kubatsira varwere zvakanyanya. Kerais yakawanda-chikuva mamorekuru kuongororwa, kwemarudzi ese evarwere vegomarara, inonyatsoongorora mamorekuru ehupenyu mamota kubva kuDNA, RNA uye mapuroteni mazinga, inogona kupa anopfuura makumi matanhatu emakumi matanhatu FDA-anotenderwa mikana yekusarudza zvinodhaka, uye apedza 60 tumota mepu ongororo. , 127,000% yevarwere vegomarara vanogona kubatsirwa kukiriniki.
Zvinoenderana nedhata repamutemo reKeruisi, hombe yakasimba bundu kudzidza kunyoresa varwere mazana masere negumi nemasere, mushure mekutungamirwa neKeruisi yakawanda-chikuva mamorekuru kuongororwa, kurarama kwenguva refu kwevarwere nemazuva makumi mana nemaviri. Ivhareji nhamba yemishonga inoshandiswa nevarwere pasi pekurairwa yaive 1180, uye huwandu hwemishonga inoshandiswa nevarwere vasina hutungamiriri hwaive 422. Mimwe mishonga yaireva kuti varwere vangangoda kutambura mamwe mhedzisiro uye kurasikirwa zvisina kufanira kwehupfumi. Izvo izvo varwere vasingafungire ndezvekuti pamusoro pekutungamira kusarudzwa kwemishonga yakanangwa, Keruisi inogona zvakare kuongorora kuti ndeapi makemikari ekurapa akakodzera varwere. Vanhu vazhinji vanoziva kuti yakanangwa kurapwa kunoenderana nekuchinja kwemajini kusarudza yakanangwa mishonga Kurapa kwakaringana, asi kutaura zvazviri, kusarudzwa kwemakemikari ekurapa anodawo hutungamiriri, uye haugone kuteedzerwa zvinoenderana nemazano ekurapa. Keris mizhinji-chikuva mamorekuru ongororo iyi yakazara yakazara nzwisisika yekuongorora tekinoroji, ichipa varwere vane chaiyo uye yakakodzera nzira dzekurapa.
Magomarara akanyanya kubatsirwa eKeruis molecular analysis ikenza yemapapu, colorectal cancer uye mazamu. Varwere vanogona kubatsirwa neKeruis molecular analysis mumamiriro ezvinhu anotevera, akadai sekurapa kwekenza yemetastatic nemishonga yemishonga: yakadai sekenza yeruvara, kenza yemapapu, kenza yemazamu, uye kenza ye ovarian; kenza isingawanzowanikwi ine nzira shoma dzekurapa: senge sarcoma, glia Stromal tumors, metastatic carcinoma yeisingazivikanwe yekutanga kutarisa; anenge asina maitiro ekusarudza emamota akaipa: senge melanoma, pancreatic cancer.
Colorectal kenza varwere vanofanirwa kukoshesa uyu mukana. Kubudikidza neyakawanda-chikuva mamorekuru kuongororwa kweKeruis, ivo vanokwanisa kunzwisisa kuwana hunhu hwemepu yekenza. Kunyangwe kana pasina chinangwa chekuchinja, Keruisi anogona kunongedzera kuti ndeapi madhiragi anobatsira kukiriniki uye asingakwanise kubatsirwa nemakemikari mishonga Kubatsira varwere kuti vadzivise mhedzisiro.
