First immunotherapy has been approved for esophageal cancer treatment. Esophageal cancer is a common malignant tumor. The International Center for Cancer Research of the World Health Organization points out that esophageal cancer has now become the 6th highest incidence cancer in the world. China is also one of the regions with the highest incidence of kansarka hunguriga in the world. Some are squamous cell carcinoma.
Daawaynta ugu muhiimsan ee kansarka hunguriga waxaa ka mid ah qalliin, daawaynta shucaaca, iyo kiimoterabi. Kansarka unugyada squamous cell-ka ayaa si dhexdhexaad ah u nugul daaweynta kiimikaad. Daawooyinka kiimikaad ee dhaqameed iyo daawaynta shucaaca ayaa heer sare ku leh daawaynta kansarka hunguriga ee hunguriga. Si kastaba ha ahaatee, saadaasha bukaanada qaba kansarka hunguriga sare ka dib daaweynta kemotherabi ee safka hore waa mid liidata, fursadaha daawayntana waa xadidan yihiin. Taxane iyo irinotecan ayaa la isticmaalay daawaynta safka koowaad ka dib, laakiin wax faa'iido guud oo badbaado ah laguma arag daraasadda wajiga 3 ee kiimoterabiga.
In recent years, there have been many new attempts in the treatment of esophageal squamous cell carcinoma-molecular targeted drugs and immunotherapy, and great progress has been made.
Recently Merck announced:
The U.S. Food and Drug Administration (FDA) has approved PD-1 buro immunotherapy Keytruda (creta, common name: pembrolizumab, pabolizumab) as a single drug therapy for PD-L1 (combined positive score [CPS] ≥ 10) and treatment of patients with recurrent locally advanced or metastatic esophageal squamous cell carcinoma (ESCC) who have progressed after one or more systemic therapies.”
Daaweynta ugu horreysa ee kansarka hunguriga
Ansixinta waxay ku saleysan tahay natiijooyinka lambarka tijaabada ee loo yaqaan 'KEYNOTE-181' (NCT02564263).
KEYNOTE-181 waa xarumo badan, kala sooc, calaamadeyn furan, tijaabin firfircoon oo firfircoon. 628 bukaan oo qaba kansarka hunguriga maxalliga ah ee soo noqnoqda ama metastatic. Bukaanadan horumarsan waxay horumareen kahor iyo kadib daaweynta nidaamka koowaad.
Bukaannada ayaa si aan kala sooc lahayn loogu qoondeeyey inay helaan Palmumab 200 mg hal mar seddexdii usbuucba, ama daaweynta soo socota ee daaweynta kiimikada: paclitaxel, docetaxel per, or irinotecan.
Natiijooyinka waxay muujiyeen in marka la barbardhigo kooxda kemotherabi, bukaanada burooyinka leh PD-L1 CPS ≥ 10 ay muujiyeen horumarin OS ah bukaanka si aan kala sooc lahayn loogu daaweeyay Keytruda. Heerka jawaabta guud ee pembrolizumab sidoo kale wuu ka sareeyaa kiimoteraabiga. Xogtaani waxay soo jeedineysaa in pembrolizumab ay tahay in loo tixgeliyo heer cusub oo daryeel bukaannada qaba PD-L1 CPS ee 10 ama ka sarreeya daaweynta khadka labaad.
Waxyeellooyinka suurtagalka ah: Pneumonia, ulcerös, cagaarshow, Cudurka endocrine, nephritis iyo kelyaha oo aan shaqeynin, falcelinta maqaarka ee daran, diidmada xubinta taranka ee adag iyo dhibaatooyinka unugyada unugyada unugyada unugyada dhiigga cas (HSCT). Iyadoo ku xiran darnaanta falcelinta xun, pembrolizumab waa in la joojiyaa ama la joojiyaa, iyo daaweynta corticosteroid waa in la bixiyaa marka ay habboon tahay.
Fursadaha kale ee daaweynta kansarka hunguriga
Kiimiko ku daaweynta kansarka hunguriga
Daaweynta kansarka hunguriga, kemotherabi waxaa loo isticmaali karaa waqtiyo kala duwan.
Dawaynta kemotherabi ee loo yaqaan 'adjuvant chemotherapy': qalitaanka qalitaanka ka dib markii la qalo. Ujeeddadu waa in la dilo unugyada kansarka ee haray inta lagu guda jiro howsha, maxaa yeelay aad ayey u yar yihiin in lagu arko isha qaawan, sidaa darteed qalliin lagama saari karo. Waxa kale oo suuragal ah in unugyada kansarku ka baxsadaan burooyinka waaweyn oo ay xididdada ku yeeshaan qaybaha kale ee jidhka.
Daaweynta neoadjuvant kemotherabi: kansarrada qaarkood, kemotherabi (badanaa lagu daro daaweynta shucaaca) ayaa la siiyaa qalliinka ka hor si loo isku dayo in loo yareeyo burada loona fududeeyo qalliinka.
Chemotherapy ee kansarka horumarsan: Kansarrada hunguriga ee ku faafay xubnaha kale, sida beerka, kemotherabi ayaa sidoo kale loo isticmaali karaa in lagu caawiyo yareynta burooyinka iyo in laga yareeyo astaamaha. In kasta oo aysan u badnayn in la daaweeyo kansarka, haddana waxay badanaa ka caawin kartaa dadka inay sii cimri dheeraadaan.
Daawooyinka guud ee loo isticmaalo daaweynta kansarka hunguriga
- Carboplatin iyo paclitaxel (waxaa loo isticmaali karaa marka lagu daro shucaaca)
- Cisplatin iyo 5-fluorouracil (5-FU) (badanaa lagu daro daaweynta shucaaca)
- ECF: epirubicin, cisplatin, iyo 5-FU (gaar ahaan burooyinka ku yaal isgoyska gastroesophagus)
- DCF: docetaxel, cisplatin, iyo 5-FU
- Cisplatin iyo capecitabine
- oxaliplatin iyo 5-FU ama capecitabine
- irinotecan
Daaweynta loogu talagalay kansarka hunguriga
Ramucirumab (Cyramza)
Rumizumab is a humanized monoclonal antibody that specifically blocks vascular endothelial growth factor receptor 2 (VEGFR2) and downstream angiogenesis-related pathways. The currently approved indication is monotherapy or in combination with paclitaxel for advanced gastric cancer / gastroesophageal junction adenocarcinoma that progresses during or after chemotherapy with or without fluorouracil or platinum. In addition, it has been approved for the treatment of kansarka sanbabada ee aan yareyn and metastatic colorectal cancer.
Trastuzumab (Trastuzumab, Herceptin)
Trastuzumab, oo ah monoclonal antibody oo ka dhan ah Her2, ayaa ka hortageysa cunsurka koritaanka epidermal ee bini'aadamka inuu ku xirnaado Her2 isagoo isku dhejinaya Her2, taas oo ka hortageysa koritaanka unugyada kansarka. Herceptin wuxuu kaloo kicin karaa unugyada difaaca jirka ee jirka si loo burburiyo unugyada kansarka.
Cudurka qanjidhka 'Esophageal carcinoma', oo ah xubin aad u gaar ah oo ka mid ah burooyinkayaga dheef-shiidka sare, ayaa si toos ah u saameeya cunista. Intaas waxaa sii dheer, kansarka unugyada unugyada 'carcinoma' waa mid aad u faafa oo u nugul halista xannibaadda, daadashada iyo dhiig baxa. Sidaa darteed, geedi socodka daaweynta oo dhan ee kansarka unugyada unugyada, inkasta oo aan adeegsan doonno qaar ka mid ah hababka daaweynta daroogada dhaqameed oo aan tixgelinno qaar ka mid ah iskudayada cusub, waa inaan hirgelinno fikradda maareynta koorsada buuxda inta lagu jiro nidaamka daaweynta. Horumarinta daawada, waxaa jiri doona teknoolojiyad badan oo lagula dagaallamayo kansarka hunguriga, sida proton radiotherapy, unugyada difaaca jirka, iwm. Qof walba waa inuu kalsooni qabaa.
