Mutoro wekenza yechiropa
Liver cancer is a common malignant tumor accounting for more than half of the global liver cancer. The onset of hepatocellular carcinoma (HCC) is hidden, and early symptoms are not obvious. Most people have lost the opportunity for surgery at the time of treatment. Whether it is surgery, interventional therapy or chemotherapy, the treatment effect on liver cancer is still not very satisfactory. The survival rate is still very low.
With the development of science and technology, liver cancer targeted drugs have made great progress, and a variety of targeted drugs and immunotherapy zvinodhaka zvakagamuchirwa, zvichiunza tariro nyowani kupona kwenguva refu kwevarwere vegomarara rechiropa!
Chiropa Kenza Chemotherapy
Chemotherapy kurapwa nemishonga yekuparadza cancer maseru. Systemic chemotherapy inoshandisa inorwisa-kenza zvinodhaka zvinoiswa jekiseni mukati kana nemuromo. Iyi mishonga inopinda muropa uye inosvika munzvimbo dzese dzemuviri, ichiita kurapwa uku kunogona kubatsira kanzira dzakapararira kunhengo dziri kure.
Zvisinei, gomarara rechiropa is resistant to most chemotherapy drugs. The most effective drugs for systemic chemotherapy in liver cancer are doxorubicin (doxorubicin), 5-fluorouracil and cisplatin. But even these drugs will only shrink a small part of the tumarara, and the response usually does not last long. Even with a combination of drugs, in most studies, systemic chemotherapy did not help patients live longer.
Transcatheter hepatic artery infusion chemotherapy due to poor response to systemic chemotherapy, doctors study placing chemotherapy drugs directly into the hepatic artery for treatment. This technique is called transcatheter hepatic artery infusion chemotherapy, and continuous infusion of anticancer drugs is suitable for hepatic artery intubation For the treatment of liver cancer patients who can not be resected or undergo palliative resection, because the blood supply of liver cancer mainly comes from the arteries, this method can make the drug directly act on the tumor tissue, increase the local drug concentration, reduce the systemic response, and achieve the treatment of the tumor and relieve the symptoms And the purpose of prolonging life.
Inofananidzwa ne systemic chemotherapy, transcatheter hepatic artery infusion chemotherapy inoshanda zvakanyanya, asi haina kuwedzera mhedzisiro. Mishonga inonyanya kushandiswa inosanganisira fluorouracil, cisplatin, mitomycin C uye doxorubicin.
Zvinodhaka zvinogamuchirwa kurapwa kwakanangana nekenza yechiropa
Sorafenib (Sorafenib, Dorjemi),
Sorafenib chirwere chakanangwa chine miviri mhedzisiro. Imwe ndeyekudzivirira mitsipa yeropa mitsva inodikanwa kuti isimbe kukura, uye inogona zvakare kunongedza mapuroteni anosimudzira kukura kwemasero ekenza. Izvo zvinangwa zvikuru ndeye VEGFR-1/2/3, RET, FLT3, BRAF zvichingodaro.
Sorafenib inogona kudzivisa zvakananga kupararira kwemasero emarara, uye inogonawo kuita paVEGFR uye PDGFR kudzivisa kuumbwa kwetsinga itsva dzeropa uye kubvisa kudya kunovaka muviri kwemasero emarara, nokudaro kuderedza kukura kwechirwere. Sorafenib inokodzera mutsara wekutanga kurapwa kwekenza yechiropa yepamusoro iyo isingagone kuvhiyiwa kana metastasized.
Sorafenib imishonga yemuromo, kaviri pazuva. Mhedzisiro inowanzoitika yemushonga iyi inosanganisira kuneta kwemichindwe kana soles, kuputika, kurasikirwa nechido, manyoka, kuwedzerwa kweropa, kutsvuka, kurwadziwa, kuzvimba kana blister. Yakakomba mhedzisiro mhedzisiro (zvisingawanzo) inosanganisira matambudziko neropa kuyerera kusvika pamoyo uye kupora kwemudumbu kana ura.
regorafenib (Regofenib, Baivango),
Regefenib inogona kuvhara bundu angiogenesis, uye inogona zvakare kunongedza mapuroteni akati wandei pamusoro pecancer maseru kudzivirira kukura kwemasero ekenza. Iyo yemuromo yakawanda-yakanangwa kinase inhibitor iyo inogona kutadzisa VEGFR-1, 2, 3, TIE-2, BRAF, KIT, RET, PDGFR uye FGFR, uye chimiro chayo chakafanana nesorafenib.
Musi waZvita 12, 2017, iyo State Chikafu neDrug Administration (CFDA) yakabvumidza yemuromo multi-kinase inhibitor regorafenib yevarwere vane hepatocellular carcinoma (HCC) avo vakamborapwa ne sorafenib. Tora muromo nemuromo kamwe pazuva pazuva kwemasvondo matatu akateedzana, wozorora kwevhiki, wobva waenderera kumberi kutenderera.
Zvakajairika mhedzisiro mhedzisiro ye chemotherapy
Zvakajairika mhedzisiro zvinosanganisira kuneta, kurasikirwa nenzara, ruoko uye tsoka tsoka (kutsvuka uye kutsamwa kwemaoko nemakumbo), kuwedzerwa kweropa, kupisa muviri, hutachiona, kuonda, manyoka uye kurwadziwa mudumbu (mudumbu). Matambudziko akakomba (asina kujairika) anogona kusanganisira kukuvara kwechiropa kwakanyanya, kubuda ropa kwakanyanya, matambudziko eropa kuyerera, uye kupera kwemudumbu kana ura.
Lenvatinib (Levatinib, Levira)
Lenvatinib imishonga yakanangwa yakawanda. Zvinangwa zvakakosha zvelevatinib zvinosanganisira vascular endothelial grow factor receptor VEGFR1-3, fibroblast yekukura factor receptor FGFR1-4, platelet-yakatorwa yekukura factor receptor PDGFR-α, cKit, Ret et al. Shanda nekudzivirira mamota kubva pakuumba tsinga dzeropa nyowani dzinoda kukura.
In August this year, Eisai (Eisai) and Merck (MSD) lovastinib were approved by the US FDA for marketing. Leweima was included in the first-line treatment of non-surgical advanced liver cancer by the CSCO liver cancer guideline (2018 version), China’s most authoritative tumor diagnosis and treatment guideline.
Lenvatinib inoitwa nemuromo kamwe chete zuva nezuva. Mhedzisiro yakajairika yemushonga uyu ndeyekutsvuka-tsoka tsoka dzemitsipa, kuputika kweganda, kurasikirwa nechido, manyoka, kukwirisa kweropa, kurwadza kwemajoini kana tsandanyama, kuonda, kurwadziwa mudumbu kana blister. Matambudziko akakomba (zvisingawanzo) anogona kusanganisira matambudziko ekubuda ropa uye kurasikirwa kweprotein mumuti.
Cabozantinib
Cabozantinib (Cabozantinib) idiki-mamorekuru akawanda-akananga inhibitor akagadzirwa naExelixis weUnited States, ayo anogona kunongedza VEGFR, MET, NTRK, RET, AXL uye KIT. Iine zita rinonyatso kuzivikanwa kune vazhinji varwere, "XL184".
Musi waMay 29, 2018, iyo FDA yakabvumidza Carbotinib yechipiri-mutsara kurapwa kwekenza yechiropa yakakwira. Kubvumidzwa kwakavakirwa pachikamu III kiriniki yekuyedza CELESTIAL. Varwere vane advanced hepatocellular carcinoma avo vakafambira mberi mushure mekurapa kwefafafib kwakanyanya kuvandudza hupenyu hwese uchienzaniswa ne placebo. Kufambira mberi-kwemahara kupona uye chinangwa chekupindura mwero chakavandudza zvakanyanya.
Larotinib, yakafara-spectrum anticancer drug
Musi waMbudzi 26, 2018, iyo inozivikanwa anticancer drug larotrectinib (Vitrakvi, Larotinib, LOXO-101) yakazobvumidzwa neFDA kuti irapwe varwere vakuru uye vevana vane mabundu akasimba emunharaunda kana metastatic ane NTRK gene fusion. Zvisinei nerudzi rwegomarara, chero bedzi riri bundu rakasimba rekuongorora majini kune NTRK fusion, iyi yakakura-spectrum yakanangwa mushonga inogona kushandiswa!
In some rare cancers, NTRK fusion often occurs. These include infantile fibrosarcoma, secretory kenza yebonde, etc. These rare cancers usually find NTRK fusion, and these patients may benefit from drugs such as larotrectinib. This targeted drug is not only effective, but also a broad-spectrum anti-cancer drug, effective for many different tumors! This is why this medicine is so eye-catching.
In the experiment, these patient tumor types included 10 different soft tissue sarcomas, salivary adenocarcinoma, infantile fibrosarcoma, thyroid cancer, lung cancer, melanoma, colorectal cancer, gastrointestinal stromal bundu (GIST), breast cancer, osteosarcoma , Cholangiocarcinoma, primary unknown cancer, congenital mesoderm kidney cancer, appendix and pancreatic cancer.
Uye zvakare, varwere vekenza vepamberi avo vakaitwa cancer cancer genome vanogona kuwana kuti mapundu avo ane NTRK fusion, nekuti NTRK gene fusion inogona kuitika mune dzakasiyana cancer cancer, kusanganisira chiropa gomarara.
Kuongorora kwakawanda kwemajini ekubatanidza kunoda kushandiswa kwechipiri-chizvarwa chemagetsi ekuyedza tekinoroji. Uye zvinofanirwa kucherechedzwa kuti shanduko yeNTRK gene kusanganiswa nemamwe magene, pane kungochinja poindi.
Makambani epamusoro epasi ekuyedza magene Kerris uye Foundation Medicine zvakare achangobuda
oped Foundation Imwe CDx yeNTRK fusion kuyedzwa. Varwere vanoda kuziva vanogona kufonera Medical Dhipatimendi reGlobal Oncologist Network kuti vabvunze (400-626-9916).
Chirwere chekenza chiropa mukutsvaga
① Everolimus
Iyo inosarudza inhibitor ye mTOR. MTOR yakakosha serine-threonine kinase. Everolimus inogona kusanganisa nepracacellular protein FKBP12 kuti igadzire inhibitory yakaoma mTORC1. Inogona kuburitsa anti-bundu zvinangwa nekukanganisa maseru kutenderera uye angiogenesis. .
Nekudaro, mhedzisiro yemakiriniki ekuyedzwa kwazvino inoratidza kuti Everolimus haishande mukurapa kwevarwere vane HCC yepamusoro, uye kukosha kwayo kwekiriniki seyechipiri-mutsara mushonga wemishonga ichiri kuda kukurukurwa zvakare.
②Bevacizumab
It is the first anti-angiogenic drug approved by the FDA for clinical use. It is a recombinant human IgG-1 monoclonal antibody against VEGF. It can prevent VEGF from binding to VEGFR by binding to VEGF and inhibit the proliferation and activation of vascular endothelial cells. , Thereby exerting anti-angiogenesis and anti-tumor effects. Current research shows that bevacizumab alone or combined chemotherapy or other targeted drugs are effective in the treatment of liver cancer.
AtinApatinib
Apatinib is the world’s first small molecule anti-angiogenesis targeted drug that has been proven to be safe and effective in advanced gastric cancer. It is also a single drug that significantly prolongs survival after standard chemotherapy for advanced gastric cancer fails. It is also a self-developed anti-cancer targeted drug in China, which has achieved certain effects in liver cancer, gastric cancer, isina-diki kenza yemapapu kenza and breast cancer, and has been included in medical insurance.
Aitan (Apatinib) iri kuburikidza nemakwikwi akasarudzika eiyo intracellular VEGFR-2 ATP inosunga saiti, ichivharira kudzika kwechiratidzo transduction, nekudaro zvine simba anti-tumor tishu angiogenesis, uye pakupedzisira kuzadzisa chinangwa chekurwisa bundu munzira dzese.
Zvinodhaka zvinogamuchirwa nekenza yechiropa immunotherapy
Immunotherapy mishonga inobatsira immune system kurwisa cancer maseru nekunanga PD-1 / PD-L1 cell signing nzira (PD-1 uye PD-L1 mapuroteni aripo mumasero emuviri ekudzivirira uye mamwe maseru egomarara). Mukutaura kwe layman: Nekuvhara kusungwa kwePD-L1 protein kumasero egomarara, kuvharika kwemasero egomarara kunodzivirirwa, uye masero emuviri ekudzivirira anogona kuziva nekubvisa maseru egomarara.
Pembrolizumab (Pembrolizumab, Keytruda) uye Nivolumab (Nivolumab, Opdivo) mishonga inonangana nePD-1. Nekuvhara PD-1, mishonga iyi inogona kukwidziridza mhinduro yekudzivirira kumasero egomarara. Izvi zvinogona kuderedza mamwe mapundu kana kuderedza kukura kwawo. Mishonga iyi inogona kushandiswa kune varwere vane kenza yechiropa vakamborapwa nemushonga wakanangwa sorafenib (dojime).
Pembrolizumab (Pembrolizumab, Keytruda)
