Luulyo 13 -keeda 2021: Daawo cusub oo loogu talagalay dadka qaba nooc ka mid ah kansarka beerka ee loo yaqaan kansarka hepatocellular carcinoma ayaa diyaar ah oo u muuqda inay ka fiican yihiin daaweynta caadiga ah (HCC). The Maamulka Cuntada iyo Dawooyinka (FDA) waxay ansixisay atezolizumab (Tecentriq) iyo bevacizumab (Avastin) inay yihiin daawaynta safka koowaad ee dadka qaba kansarka beerka ee horumarsan ee aan lagu daweyn karin qaliin.
Patients with liver cancer treated with Atezolizumab with Bevacizumab lived significantly longer than those treated with sorafenib in the IMbrave150 study that resulted to the approval (Nexavar). They were also able to live longer without their cancer progressing. The outcomes of the study were published in the New England Journal of Medicine on May 14th.
Mid ka mid ah khubarada daraasaddan, Richard Finn, MD, oo ka tirsan Jaamacadda California, Los Angeles, ayaa yiri, "Tani waa horumar weyn oo loogu talagalay bukaannada." "Tani waa wax ay takhaatiirta daaweeyay bukaannadan ay codsanayeen muddo dheer, waana tallaabo weyn oo hore loo qaaday."
Atezolizumab waa isbaarada difaaca jirka, taas oo macnaheedu yahay inay ka caawiso habka difaaca inuu helo oo dilo unugyada kansarka. Bevacizumab waa daawo la bar tilmaameedsado oo gaajaysa burooyinka iyadoo joojinaysa koritaanka xididdada dhiigga cusub.
Another targeted therapy, sorafenib, inhibits the formation of blood vessels and cancer cells. Sorafenib was the first medicine approved by the FDA 2007 si loo daweeyo bukaannada HCC qaarkood.
Sida laga soo xigtay Tim Greten, MD, oo ah kuxigeenka madaxa NCI ee Xarunta Cilmi-baarista Kansarka ee Thoracic iyo GI Malignancies Branch, daawaynta kaliya ee HCC ee shatiga la siiyay tan iyo 2007 kama waxtar badna sorafenib.
Tifaftir ahaan, Robin Kelley, MD, oo ka tirsan Xarunta Kansarka ee Qoyska ee UCSF Helen Diller, ayaa sheegay in aysan ahayn oo kaliya isku darka atezolizumab-bevacizumab mid waxtar badan leh, laakiin waxay sidoo kale keentay "natiijooyin bukaan-socod oo aad u wanaagsan oo la soo sheegay," sida awoodaha jireed. .
Sida laga soo xigtay Dr. Greten, habka isku-dhafka ah waxay u badan tahay inuu bedeli doono sorafenib sida daawaynta safka kowaad ee caadiga ah ee dadka qaarkiis ee leh HCC sare.
Ku-darka ka-hortagga isbaarada difaaca
Kansarka beerka is frequently identified after it has progressed outside the liver or become interwoven with several blood arteries, making surgery impossible to treat.
Sorafenib iyo lenvatinib (Lenvima), daawo kale oo hoos u dhigta samaynta xididdada dhiigga, waa ikhtiyaarka keliya ee loogu talagalay dadka qaba kansarka beerka ee aan lagu daweyn karin qalliin (waa mid aan shaqaynayn).
Ka-hortagga isbaarada difaaca ayaa loo sahamiyay inay yihiin daawaynta safka hore ee kansarka beerka ee dhowr daraasadood oo kiliinig ah, laakiin waxaa la ogaaday inay iskood wax u taraan. Saynis yahanadu waxay ogaadeen in xaddi badan oo borotiin ah oo loo yaqaan VEGF laga yaabo inay ka hor istaagaan dawooyinka isbaarada difaaca inay shaqeeyaan baadhitaan dheeraad ah ka dib.
Sida laga soo xigtay Dr. Finn, VEGF waxay kicisaa abuurista xididdada dhiigga cusub waxayna beddeshaa tirada iyo nooca unugyada difaaca ee ku jira iyo agagaarka burooyinka.
Maxaa yeelay, bevacizumab inhibits VEGF, researchers from Genentech and a number of medical institutions compared atezolizumab to bevacizumab in a limited study of patients with liver cancer. They reported in 2019 that the combination was more successful than atezolizumab alone and had manageable adverse effects. The IMbrave150 study is a follow-up to the previous one.
Badbaadada Atezolizumab Plus Bevacizumab
Dawooyinka isku-dhafka ah waxay u keeneen dhowr saameyn taban bukaanno badan. Guud ahaan, in kastoo, bukaanku waxay u muuqdeen inay u dulqaadanayaan labada dawo, sida uu qabo Dr. Greten.
Labada kooxood waxay lahaayeen dhacdooyin isku mid ah oo waxyeelooyin soo raaca ah iyo dhimasho ka timid saameynaha. Si kastaba ha ahaatee, kooxda combo waxay lahaayeen bukaano badan oo la kulmay saameyn xun oo weyn (38 boqolkiiba 31 boqolkiiba).
Dhibaatooyinka soo raaca awgeed, bukaanno yar oo ka tirsan kooxda combo ayaa hakiyay ama wax ka beddelay qiyaasta daawaynta (boqolkiiba 50 iyo 61 boqolkiiba kooxda sorafenib). Kaliya 7% bukaannada kooxda isku dhafka ah ayaa joojiyay qaadashada labada dawo sababo la xiriira saameynaha xun, inkastoo xaqiiqda ah in bukaanno badan oo ka mid ah kooxda isku dhafan ay joojiyeen qaadashada mid ka mid ah daawooyinka (16% vs 10%).
Sababtoo ah saameynta ay ku leedahay halbowlayaasha dhiigga, bevacizumab waxay keeni kartaa dhiig-bax, sida uu qabo Dr. Greten. Waxa uu sheegay in kansarka beerka uu sidoo kale abuuri karo isbeddello kordhiya khatarta dhiig-baxa, sida tirada unugyada platelet oo hooseeya.
"Waxaa jiray dhowr qaybood oo dhiigbax ah oo ku yaal atezolizumab, cududda bevacizumab, laakiin weli aad bay u hooseeyaan boqolkiiba," Dr. Finn ayaa ku daray. Labada kooxoodba, 6% bukaannada ayaa la kulmay dhiig-bax weyn oo ka dhashay daawaynta bevacizumab.
Sida laga soo xigtay Dr. Greten, "waxaa muhiim ah in la doorto bukaanada ku haboon" daaweynta combo. Kahor intaadan bilaabin dawada, bukaanku waxa laga yaabaa inay u baahdaan inay helaan baadhitaano caadi ah si loo hubiyo arrimaha halista dhiigbaxa, ayuu yidhi.
Dr. Kelley ayaa yiri, "Daawaynta beddelka ah waa in loo baaro bukaannada khatarta sare ugu jira dhiig-baxa."
