Dawooyinka ay ansaxiyeen ASCO 2005 ilaa 2014
Tan iyo markii ASCO ay daabacday warbixinteedii ugu horreysay ee horumarka kansarka ee 2005, waxay aragtay horumar adag oo la go'aamiyay oo ku saabsan cilmiga kansarka 10kii sano ee la soo dhaafay.
10kii sano ee la soo dhaafay, in ka badan 60 dawooyinka ka hortagga burooyinka ayaa waxaa ansixiyay FDA (Jaantuska 1). Iyadoo faham qoto dheer oo ku saabsan bayoolajiga burada, saynisyahannadu waxay soo saareen taxane cusub oo dawooyin ah oo la beegsanayo, iyo imaatinkooda ayaa beddelay kumanaan. Xaaladda tobanaan kun oo bukaan oo kansar ah oo ay adag tahay in la daweeyo.
Such new drugs can target specific molecules or molecular clusters necessary for buro cell growth, survival or spread.
Toban sano ka hor, Machadyada Qaranka ee Caafimaadka ayaa bilaabay mashruuca TCGA, kaasoo noqday kii ugu horreeyay uguna ballaarnaa ee mashaariicdan oo kale ah. Ilaa hadda, shabakadda cilmi baarista ee TCGA waxay soo bandhigtay khariidad dhammaystiran oo kelli ah oo ka kooban 10 nooc oo kansar oo kala duwan.
Maanta, TCGA iyo mashaariicda kale ee isku xigxiga ee wax soo saarka sare waxay sii wadaan inay sahamiyaan macluumaad qiimo leh oo gacan ka geysan doona hagaajinta saadaasha bukaanka iyadoo loo marayo dariiqooyin taxane ah. Waa suurtagal bukaan socodka inay doortaan habka daaweynta ugu habboon. Daraasadu waxay sidoo kale ogaatay cilladaha cusub ee darawalka kansarka. Hiddo-wadahaani waxay noqon karaan bartilmaameedyo daroogo cusub.
Ka dib tobaneeyo sano oo horumar joogto ah, beerta antibody immunotherapy has finally ushered in the long-awaited major success in recent years. It first occurred in the treatment of advanced melanoma, followed by a series of other cancer types, including lung cancer. Common types have also made progress.
Tirada dadka bukaanka ah ee markii hore aan helin daaweyn wax ku ool ah ayaa si aad ah u sii dheeraatay badbaadada ka dib daaweynta cusub ee daaweynta. Daraasad muddo dheer socotey ayaa soo jeedisey in antibody immunotherapy wali saameyn ku leedahay koritaanka burooyinka sanado badan oo daaweyn ah kadib.
Nooc kale oo ka mid ah difaaca jirka ayaa ka go'an inuu dib u habeeyo unugyadiisa difaaca si uu u weeraro unugyada burooyinka. Waxay sidoo kale si fiican ugu qabataa burooyinka dhiigga gaarka ah iyo burooyin adag oo taxane ah.
Midkii kowaad wuxuu u tallaalka kansarka Tobankii sano ee la soo dhaafay ayaa sidoo kale la sii daayay (kaankaarka afka ilmo-galeenka ee Gardasil). Tijaabooyin lagu sahaminayo noocyada kale ee tallaalada kansarka ayaa sidoo kale socda.
Finally, large-scale screening studies have brought new and important evidence that it can advance screening practices for some common cancers such as lung cancer, breast cancer, and kansarka qanjirka 'prostate.
Horumarinta degdegga ah ee daaweynta bartilmaameedka daaweynta kansarka
Tobankii sano ee la soo dhaafay, waxaan aragnay koror joogto ah oo degdeg ah tirada dawooyinka cusub ee la beegsaday ee ay ansixisay FDA, oo aad uga badan xawliga horumarinta dawooyinka kemotherabi ee cusub (Jaantuska 2).
Muddadan, qiyaastii 40 daroogo oo cusub oo la bartilmaameedsaday ayaa la oggolaaday, qaar badan oo ka mid ah ayaa beddelay habka daaweynta dhaqameed waxayna si weyn u wanaajiyeen saadaalinta bukaanno badan oo kansar ah.
Waxaan marka hore soo bandhigeynaa anti-angiogenesis inhibitors, kuwaas oo ah nooc daroogo ah oo loogu talagalay in lagu yareeyo neovascularization-ka burooyinka waxayna noqdeen daaweyn guuleysata oo loogu talagalay kansarro badan oo horumarsan oo dagaal badan.
The first drug approved by the FDA is bevacizumab, which was approved for advanced colorectal cancer in 2004 and has since been used in certain lung, kidney, ovarian, and brain tumors.
Subsequently, other angiogenesis inhibitor drugs such as axitinib, carbotinib, pazopanib, rigefenib, sorafenib, sunitinib, vandetanib, and abecept were successively Approved for the treatment of advanced kidney cancer, pancreatic cancer, colorectal cancer, thyroid cancer, and burooyinka stromal caloosha iyo mindhicirka and sarcomas.
EGFR inhibitors: bartilmaameedka dariiqyada calaamadaha muhiimka ah
Burooyinka iyo Maraakiibta Dhiiga
Fasal kale oo waaweyn oo daroogada la bartilmaameedsaday ah ayaa loogu talagalay in lagu carqaladeeyo waddooyinka calaamadaha muhiimka ah ee unugyada, gaar ahaan shabakadda calaamadaha tilmaanta koritaanka unugyada kansarka. Mid ka mid ah wadiiqooyinkaas waxaa xukuma borotiinka EGFR.
The first EGFR drug was gefitinib, which was approved for the treatment of NSCLC in 2003. Two years later, the FDA approved the second EGFR drug cetuximab for the treatment of advanced kansarka mindhicirka, and another similar drug panitumumab was also approved in 2006.
Si kastaba ha noqotee, 2008, cilmi baaris cusub ayaa shaaca ka qaaday in bukaanjiifka kansarka mindhicirka ee qaba isbedelka KRAS ay sameeyeen iska caabin cetuximab iyo panitumumab. Raadintaani waxay u baahan tahay baaritaan joogto ah oo ku saabsan is-beddelka hidde-wadaha KRAS si loo hubiyo in bukaanku ka faa'iideysan karo labada daaweyn ee kor ku xusan, iyadoo bukaannada kale laga ilaalinayo saameynta xun ee daaweynta aan waxtarka lahayn.
In 2004 and 2005, the FDA approved the EGFR inhibitor erlotinib for the treatment of NSCLC and advanced kansarka ganaca. Recently, in 2013, the US FDA approved afatinib for the treatment of advanced NSCLC patients with specific mutations in the EGFR gene. Other EGFR targeted drugs are undergoing clinical trials.
New HER2 therapy brings continuous breakthrough in kansarka naasaha daaweynta
Qiyaastii 15 sano ka hor, saynisyahannadu waxay ogaadeen daawaynta ugu horreysa ee unugyada burooyinka taas oo si xad dhaaf ah u muujisa receptor factor factor koritaanka epidermal 2 (HER2). Qiyaastii 15% ilaa 20% bukaannada kansarka naasaha waxay qaadaan cilladaha hidde-sideyaasha ee kore (HER2-positive cancer). Si la mid ah EGFR oo isku qoys ah, HER2 waxay sidoo kale kor u qaadi kartaa koritaanka unugyada kansarka. Tan iyo markaas, afar dawo oo HER2-ku-talagal ah ayaa dhashay, kuwaas oo dhammaantood hagaajin kara badbaadada bukaannada qaba kansarka naasaha ee HER2-positive.
Daawada HER2 ee ugu horreysa, trastuzumab, markii loo isticmaalo isku-darka kiimoteraabiga waxay si weyn u horumarin kartaa badbaadada haweenka qaba kansarka naasaha ee HER2-positive. Sanadkii 2006, trastuzumab ayaa loo ansixiyay bukaanada qaba cudurka HER2 ee kansarka naasaha si loo yareeyo halista soo noqoshada qalliinka kadib.
Dhawaan, daraasad muhiim ah ayaa lagu ogaaday in laba-laabka ka dhanka ah HER2 ay ka waxtar badan tahay daaweynta trastuzumab monotherapy, taas oo horseeday oggolaanshaha FDA ee daawada labaad ee HER2 Pertuzumab oo lagu daray trastuzumab ee 2012 Monoclonal antibody waxaa loo isticmaalaa bukaanada qaba HER2-kansarka naasaha oo sareeya , ka dibna loo ansixiyay daaweynta cudurka hore ee 2013.
Isla sanadkaas, trastuzumab-emtansine (T-DM1) (trastuzumab oo ay weheliso daawo kemotherabi) ayaa sidoo kale la ansixiyay. Daaweyntan isku dhafan ma aha oo kaliya waxtar badan daaweynta hal daroogada, laakiin sidoo kale waxay u oggolaaneysaa daroogada in si sax ah loogu bartilmaameedsado unugyada kansarka naasaha, taas oo hoos u dhigeysa saameynta xun ee unugyada unugyada caafimaadka qaba. Cudurka kansarka naasaha ee HER2 oo xumaaday ka dib daaweynno badan oo hore, tani waa qorshaha daaweynta ugu habboon.
Daawada afaraad ee HER2, lapatinib, ayaa la ansixiyay 2007. Markii loo isticmaalo isku darka daawooyinka aromatase inhibitor, waxay si wax ku ool ah u daaweyn kartaa HER2-positive iyo receptor receptor-positive / HER2-positive kansarka naasaha metastatic.
Daawooyinka lagu bartilmaameedsado waddooyin badan oo kelli ah: rajo rajo leh
Researchers continue to find that many cancer drugs can block multiple molecular targets or pathways at the same time, which makes them a more effective anti-cancer weapon. For example, vandetanib (approved for the treatment of kansarka tayroodh in 2011) can Block EGFR, VEGFR (protein involved in tumor blood vessel growth) and RET.
Dawada kansarka mindhicirka gefitinib (oo la ansixiyay 2012) ayaa xannibaysa 6 dariiqyada kansarka ee kala duwan: VEGFR1-3, TIE2, PDGFR, FGFR, KIT, iyo RET.
Bartilmaameedyo cusub iyo dawooyin cusub oo lagu daweynayo kansarka
Prospec
ts loogu talagalay horumarinta daroogada cusub ayaa ah mid soo jiidasho leh. Sanadihii 2013 iyo 2014, FDA waxay ansixisay Trametinib iyo Dalafenib, oo ah laba daawo oo loo isticmaali karo daaweynta melanoma gaar ah oo melanoma ee hiddo-wadaha BRAF, oo xukuma dariiqa MEK.
Crizotinib (approved in 2013) can target kansarka sanbabada and childhood cancer with ALK gene mutation. Tisirolimus (approved in 2007) and everolimus (approved in 2012) block the mTOR pathway, which can control the growth of several cancers, including breast cancer, pancreatic cancer, and kidney cancer.
Everolimus waa daroogada ugu horeysa ee wax ku oolka ah ee HER2-kansarka naasaha, noocan ayaa ah kansarka naasaha badankiisa. Everolimus oo ay weheliso daawooyinka aromatase inhibitor ayaa loo ansixiyay hoormoonka qaataha hidaha iyo HER2 diidmada postmenopausal bukaanada kansarka naasaha sare leh.
Nilotinib (oo la ansixiyay 2007) iyo dasatinib (oo la ansixiyay 2010) ayaa bartilmaameedsan kara BCR-ABL, oo ah borotiin gaar ah oo laga helo kaliya noocyada leukemia qaarkood.
Ku soo dhowow xilligii tallaalka difaaca jirka
Saynisyahannadu waxay ogaadeen in habka difaaca jirka uu yahay awood awood leh oo kahortaga kansarka horaantii boqol sano kahor. Laakiin ma ahayn illaa tobankii sano ee la soo dhaafay in tallaalka difaaca jirka uu dhab ahaantii bilaabay inuu beddelo daaweynta kansarka. Horumar ayaa laga sameeyay dhowr jiho oo laga soo qaaday daawooyinka afka laga qaato ilaa daaweynta unugyada ku saleysan ee loogu talagalay bukaan kasta.
Dhiirrigeli habka difaaca jirka si loola dagaallamo kansarka
Unugyada T waxay door muhiim ah ka ciyaaraan la dagaallanka kansarka. 2011, FDA waxay ansixisay ipilimumab inay noqoto daaweyn horumarineed oo loogu talagalay melanoma. Ipilimumab waa dawo difaac ah oo bartilmaameedsata borotiinka CTLA-4 ee unugyada T, kaas oo xakameyn kara saameynta dilka unugyada T.
Tijaabooyinka bukaan socodka, bukaanku waxay la kulmi doonaan burooyin deg deg ah oo muuqda, waxayna wali ka faa'iideysan doonaan waqti dheer kadib markay daaweyntu dhammaato (bukaanada qaar waxay sii socon kartaa dhowr sano).
Tan iyo markaas, qaar ka mid ah waxa loogu yeero daawooyinka xakameynaya isbaarada difaaca ayaa la sameeyay, gaar ahaan daawooyinka qaarkood waxay beegsan karaan dariiqa PD-1 / PD-L1, taas oo ka caawisa burooyinka inay ka baxsadaan nidaamka difaaca.
FDA waxay gudoonsiisay daawooyinka xanibaada PD-1 nivolumab iyo cinwaanada daaweynta horumarineed ee MK-3475. Tijaabooyinkii ugu dambeeyay ee kiliinikada ee melanoma, labaduba waxay muujiyeen waxtar aan horay loo arag (nivolumab sidoo kale si wax ku ool ah ayaa loogu isticmaali karaa kansarka kalyaha iyo daaweynta kansarka sanbabada).
Bishii Sebtembar 2014, Mk-3475 (pembrolizumab) waxay noqotay daawadii ugu horreysay ee PD-1 lala beegsado oo ay ansixisay FDA. PD-1 dawada la beegsaday MPDL3280A ayaa sidoo kale muujisay saameyn lid ku ah melanoma horumarsan ee tijaabooyinka kiliinikada.
Daraasadihii ugu dambeeyay waxay soo jeedinayaan in isticmaalka isku dhafan ee daawooyinka isbaarooyinka kala duwan ama isku darka daawooyinka difaaca jirka firfircoon sida interferon, interleukin iyo daawooyinka kale ee isbaarooyinka xakameynaya ay sii wanaajin karaan faa'iidada bukaanka.
Patients and dhibbanayaasha have significantly improved quality of life
Tobankii sano ee la soo dhaafay, cilmi baaris ayaa lagu ogaaday daaweyn taxane ah oo cusub oo hagaajin kara tayada nolosha bukaanka tallaabo kasta oo laga bilaabo ogaanshaha cudurka ilaa noolaanshaha. Intaa waxaa sii dheer, xoojinta isdhexgalka ee daryeelka hore ee daaweynta iyo daaweynta firfircoon waxay caawin doontaa bukaanno badan, gaar ahaan si kor loogu qaado bukaanada horumarsan si ay ugu noolaadaan nolol wanaagsan.
Iska yaree saameynta xun ee la xiriirta kansarka
Istaraatiijiyado cusub oo loogu talagalay xakamaynta saameynta xun ayaa si weyn u wanaajin kara tayada nolosha bukaannada, inta lagu jiro iyo ka dib daaweynta. Tusaale ahaan, laba daraasadood oo madaxbannaan ayaa muujiyey in dawada lidka ku ah diiqadda ee loo yaqaan 'duloxetine' iyo 'antipsychotic olanzapine' ay yihiin daawooyin wax ku ool ah oo looga hortago laba waxyeelo oo caan ah sida kiimoteraabiga durugsan ee neuropathy iyo lallabo
Daraasad kale ayaa heshay daaweyn loogu talagalay astaamaha guud ee aan soo jiidan dareenka ku filan-niyadjab iyo xanuun. Cadeymo badan iyo inbadan ayaa xaqiijinaya waxtarka hababka aan caafimaadka aheyn sida acupuncture iyo yoga si loo wanaajiyo caafimaadka jirka iyo maskaxda ee bukaanada iyo badbaadayaasha. Faa'iidooyinka suurtagalka ah waxaa ka mid ah yareynta daalka iyo xanuunka, hagaajinta tayada nolosha, iyo yareynta isticmaalka daawooyinka.
Isku darida daaweynta kansarka iyo daryeelka hore ee daaweynta
Tijaabo caafimaad oo muhiim ah oo la qaaday sanadkii 2010 ayaa xaqiijisay in isdhexgalka daaweynta xanuunka hore ee daaweynta inta lagu guda jiro daaweynta ay si weyn u wanaajin karto tayada nolosha ayna sii dheereyneyso bukaanada qaba kansarka sanbabada ee horumarsan marka la barbar dhigo daaweynta hal firfircoon. Intaas waxaa sii dheer, bukaanada horey uhelay daryeelkii hore ee daaweynta waxaan loo badin inay helaan daryeel firfircoon oo aad u sareeya sida dib u soo nooleyn dhamaadka nolosha.
Daraasadu waxay kicisay mawjad cusub oo ah daryeel caafimaad oo loogu talagalay bukaannada horumarsan. Daraasadda ayaa sidoo kale lagu xusay talo soo jeedinta tilmaamaha ku-meel-gaarka ah ee ay soo saartay ASCO sanadkii 2012: Bukaan kasta oo qaba kansarka naasaha ama culeyska astaamaha sare waxaa la socon kara daaweyn baalliyo ah ee daaweynta kansarka ee caadiga ah.
Daawooyinka guud ee yareeya halista kansarka
A large number of clinical trials have shown that some commonly used drugs may have important effects on cancer prevention. For example, analysis of data from nearly 50 epidemiological studies shows that oral contraceptives can reduce the risk of ovarian cancer by 20% every 5 years. This reduction effect persists within 30 years of termination of the drug.
Cilmi baaris dheeraad ah ayaa lagu ogaaday in qaadashada aspirin maalin kasta ay yarayn karto halista kansarka mindhicirka. Si kastaba ha ahaatee, dhiigbaxa caloosha iyo khataraha kale awgeed, laguma talinayo in si joogto ah loo isticmaalo aspirin habka ka hortagga kansarka. Tallaabada xigta ee daraasadda ayaa sidoo kale sahamin doonta dawooyinka ka hortagga caabuqa ee ka hortagga kansarka iyo doorka daawaynta.
