Zvinoenderana neshumo ichangoburwa kubva kuUS Centers for Disease Control and Prevention (CDC), huwandu hweanenge ese cancers hwakadzikira mukati memakumi maviri emakore apfuura, nepo chiitiko chegomarara rechibereko chakakwira. Vanachiremba vakatanga kutarisisa mamiriro aya uye vakayeuchidza vakadzi kuti vateerere kune dzinoverengeka dzakakosha nyaya dzechirwere ichi.
According to statistics from the American Cancer Society (ACS), more than 90% of uterine cancers occur in the endometrium, called endometrial cancer. Early endometrial cancer has a good prognosis. According to the US Centers for Disease Control and Prevention, the five-year relative survival rate is estimated to be 80% to 90%. Because kenza yechibereko can usually be diagnosed early, its most typical symptoms are abnormal bleeding before and after menopause, weight loss and pelvic pain. For advanced metastatic patients, treatment options are very limited.
Recently, the US FDA approved the PD-1 inhibitor Keytruda (pabolizumab) in combination with the oral tyrosine kinase inhibitor Lenvima (Levatinib) to treat patients with specific advanced endometrial cancer. It is worth noting that these patients do not require high microsatellite instability (MSI-H) or mismatch repair defect (dMMR) types. As long as the disease continues to progress after receiving early systemic therapy and cannot receive curative surgery or radiotherapy, this new combination therapy can be accepted.
Izvo zvinofanirwa kutaurwa kuti iyi mvumo yekukurumidza yakabvumidzwa panguva imwe chete muUnited States, Australia neCanada.
Kubvumidzwa kwakavakirwa pamhedzisiro yeongororo yevarwere makumi mapfumbamwe nemana vane mamota endometrial cancer, hapana mumwe wavo ari MSI-H kana dMMR. Muvarwere ava, chiyero chekupindura chese (ORR) chaive 38.3%, kusanganisira 10.6% yakazara yekupindura (CR) uye chikamu chekupindura chikamu che27.7%. 69% (n = 25) varwere vaive nenguva yekupindura (DOR) ≥ 6 mwedzi.
“Varwere vanosvika makumi manomwe neshanu muzana vane gomarara remudumbu havasi verudzi rweMSI-H kana dMMR, saka kubvumidzwa kwerapi iyi kunounza mikana mitsva yekurapa uye tariro kuvarwere vazhinji vane gomarara remudumbu.
Parizvino, kumwe kutsvagurudza kufambira mberi kwekenza yemendometriari zvakare yakaunzwa muchidimbu apa:
01avelumab (Bavincia monoclonal antibody) yakasanganiswa netalazoparib (tarazopanib)
Muedzo unotungamirwa naKonstantinopoulos wakashandisa immune checkpoint inhibitor avelumab pamwe neIPARP inhibitor talazoparib. (Checkpoint inhibitors inojekesa nzira yekuti immune system irwise cancer; PARP inhibitors inoparadza maseru ekenza nekukanganisa kugona kwavo kugadzirisa DNA yakanganisika.) Mukuyedza kwakapfuura, avelumab yaive Varwere vane gomarara "risina kugadzikana" endometrial inoshanda, asi inonyanya isingashande muchimiro chinozivikanwa che "microsatellite solid" (MSS) yechirwere. Muedzo unozoongorora kuti kusanganisa avelumab neIPARP inhibitors kunonyanya kushanda kuvarwere vane chirwere cheMSS.
02pembrolizumab (pabolizumab) inosanganiswa ne mirvetuximab
A test combining the checkpoint inhibitor pembrolizumab with mirvetuximab. (Pembrolizumab targets an immune checkpoint protein called PD-1; mirvetuximab adds antibodies to drug molecules targeting key structures in rapidly dividing cancer cells.) The trial, led by Jennifer Veneris, MD, of the Gynecologic Oncology Project, will examine the combination Effectiveness in patients with MSS endometrial cancer.
03abemaciclib + LY3023414 + hormone therapy
Imwe muyedzo inotungamirwa naKonstantinopoulos ichaedza musanganiswa wezvinotarisirwa zvinodhaka abemaciclib + LY3023414 + hormone therapy. (LY3023414 inokonzeresa enzyme yesero yekenza inonzi PI 3 kinase; abemaciclib inopindirana nechikamu chakakomba chesero kutenderera.) 70% kusvika 90% yemakenza endometrial anodyiswa neestrogen uye anotanga kupindura kuhormoni inodzivirira kurapwa, asi pakupedzisira inodzokazve. Nekuwedzera abemaciclib uye LY3023414 (vanogona kubata zvikamu zviviri zveiyo imwechete mamorekuru nzira) yehormone ichivharira kurapwa, vaongorori vanotarisira kukunda dambudziko rekurwisa zvinodhaka.
04AZD1775
A trial led by Joyce Liu, MD, MPH, director of clinical research at the Department of Gynecologic Oncology at Dana-Farber, used AZD1775 for patients with high-grade serous uterine cancer that account for 10-15% of endometrial cancer. Such cancers are aggressive and usually recur after standard treatment. The recently opened trial is based on a study led by Dr. Liu and Ursula Matulonis, director of the Dana-Farber Department of Gynecologic Oncology, showing that AZD1775 is active in a patient model with high-grade serous ovarian kenza.
05dostarlimab (TSR-042)
Mhedzisiro yemuyedzo wePhase I / II GARNET ichangobva kuburitswa, uye huwandu hunoshanda hwePD-1 inhibitor dostarlimab (TSR-042) kune varwere vane kenza yekudzokazve kana yepamusoro endometrial iri pedyo ne30%.
Uye zvakare, ese ari maviri micro-satellite kusagadzikana (MSI-H) uye micro-satellite kugadzikana (MSS) mapoka anoramba aripo.
Dostarlimab (TSR-042) inorwisa anti-PD-1 monoclonal antibody yakabatana neTESARO neAnaptysBio. Iyo inosunga kune iyo PD-1 receptor nehukama hwakakwira, nokudaro ichivharira kusunga kwayo kune PD-L1 uye PD-L2 ligands.
Mhedzisiro yacho yakaratidza kuti mwero unoshanda wehuwandu hwevanhu hwese hwaive 29.6%, chiyero chinoshanda cheboka revarwere veMSI-H chaive 48.8%, uye chiyero chinoshanda muboka reMSS chaive 20.3%. Varwere vatanhatu (2 MSI-H uye 4 MSS) vakaregererwa zvakakwana.
Mushure mekuteedzana kwepakati pemwedzi gumi, 10% yevarwere vakagamuchira kurapwa> mwedzi mitanhatu, uye 89% yevarwere vakagamuchira kurapwa kwe> 6 gore. Uye zvakare, 49% yevarwere vanobudirira pakurapa vachiri kuwana kurapwa.
Finally, in 85% of MSI-H responders, the total tumarara burden was reduced by ≥50%, and 69% of patients with MSS had a total tumor burden of ≥50%.
Dostarlimab ndiyo tariro nyowani yekurapwa kwekenza yemendometri.
The researchers will start further III studies in the second half of 2019. Dostarlimab and chemotherapy will be combined with first-line treatment of endometrial cancer, and we look forward to obtaining promising results soon!
Chiyedzo chega chega chinogadzirisa kusakwana kwekurapa kwakajairwa kana matambudziko anowanikwa mukuedza kwezvinodhaka kwapfuura. Semuenzaniso, miedzo miviri yekutanga ine chinangwa chekukunda mamiriro ehurombo aripo immunotherapy muvarwere vane MSS chirwere. Yechitatu inogadzirisa dambudziko rekupokana nehomoni therapy, uye yechina inotarisa chaiwo subtypes endothelial cancer.
Kuti udzidze zvakawanda nezve yazvino fambiro mberi yekutsvagisa uye chirongwa chakanakisa chemushonga checancer ye endometrial, chete ivo vepamusoro gomarara nyanzvi kumba nekune dzimwe nyika vane hupfumi hwekiriniki ruzivo. Iwe unogona kunyorera kubvunzana neanotevera epamba uye epasi rose ane hunyanzvi nyanzvi kuti uwane yakanyanya kuongororwa chirwere uye chirongwa chekurapa.
