Culays kansarka beerka ah
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 daawooyinka ayaa la ansixiyay, taasoo rajo cusub u keenaysa badbaadinta muddada dheer ee bukaannada kansarka beerka!
Daaweynta Kiimikada Kansarka Beerka
Chemotherapy ayaa lagu daaweeyaa daawooyinka lagu burburiyo unugyada kansarka. Dawaynta kimikalka ee nidaamsan waxay isticmaashaa dawooyinka kahortagga kansarka ee lagu durayo xididka ama afka. Daawooyinkani waxay galaan dhiigga waxayna gaaraan dhammaan qaybaha jirka, taasoo ka dhigeysa daaweyntan mid waxtar u leh kansarrada ku faafay xubnaha fog.
Si kastaba ha ahaatee, kansarka beerka 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 buro, 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.
Marka la barbardhigo kemotherabi nidaamsan, daaweynta kimikada ee faleebada cagaarshowga transcatheter ayaa waxtar badan leh, laakiin ma kordhinayso waxyeellooyinka soo raaca. Daawooyinka ugu badan ee la isticmaalo waxaa ka mid ah fluorouracil, cisplatin, mitomycin C iyo doxorubicin.
Daawooyinka loo oggolaaday daaweynta bartilmaameedka kansarka beerka
Sorafenib (Sorafenib, Dorjemi),
Sorafenib waa daroogo bartilmaameed ah oo leh laba saameyn. Mid waa in laga hortago xididdada dhiigga ee cusub ee looga baahan yahay koritaanka burooyinka, sidoo kale waxay beegsan kartaa borotiinnada dhiirrigeliya koritaanka unugyada kansarka. Bartilmaameedyada ugu muhiimsan waa VEGFR-1 / 2/3, RET, FLT3, BRAF iyo wixii la mid ah.
Sorafenib can directly inhibit the proliferation of tumor cells, and can also act on VEGFR and PDGFR to inhibit the formation of new blood vessels and cut off the nutritional supply of tumor cells, thereby curbing tumor growth. Sorafenib is suitable for the first-line treatment of advanced liver cancer that cannot be operated or metastasized.
Sorafenib waa dawo afka laga qaato, laba jeer maalintii. Saameynaha ugu caansan ee daawadan waxaa ka mid ah daalka calaacalaha ama cagaha, firiiric, cunto xumo, shuban, dhiig kar, casaan, xanuun, barar ama finan. Dhibaatooyinka halista ah (aan caadi ahayn) waxaa ka mid ah dhibaatooyinka socodka dhiigga ee wadnaha iyo daloolidda caloosha ama mindhicirada.
regorafenib (Regofenib, Baivango),
Regefenib wuxuu xannibayaa burooyinka angiogenesis, sidoo kale wuxuu bartilmaameedsan karaa dhowr borotiin dusha sare ee unugyada kansarka si looga hortago koritaanka unugyada kansarka. Waa kahortaga kinase badan oo afka laga qaato oo xakameyn kara VEGFR-1, 2, 3, TIE-2, BRAF, KIT, RET, PDGFR iyo FGFR, qaab dhismeedkeeduna wuxuu lamid yahay sorafenib.
Bishii Diseembar 12, 2017, Maamulka Cuntada iyo Dawooyinka ee Gobolka (CFDA) ayaa ansixiyay daawada loo yaqaan 'multi-kinase inhibitor regorafenib' ee loogu talagalay bukaanada qaba cudurka 'hepatocellular carcinoma' (HCC) ee horey loogu daaweeyay sorafenib. Qaado hadal ahaan hal mar maalintii 3 usbuuc oo isku xigta, ka dibna naso toddobaad, ka dibna sii wad wareegga xiga.
Dhibaatooyinka guud ee daaweynta kiimikada
Waxyeellooyinka caadiga ah waxaa ka mid ah daal, rabitaanka cuntada oo yaraada, cilladda gacanta iyo cagaha (guduudasho iyo cuncun gacmaha iyo cagaha), dhiig kar, qandho, infekshin, miisaanka oo yaraada, shuban iyo calool xanuun (caloosha). Dhibaatooyinka halista ah (aan caadiga ahayn) waxaa ka mid noqon kara dhaawac beerka oo daran, dhiigbax daran, dhibaatooyinka socodka wadnaha, iyo dalool la'aanta caloosha ama xiidmaha.
lenvatinib (Levatinib, Levira)
Lenvatinib waa daroogo dhowr bartilmaameed ah. Bartilmaameedka ugu muhiimsan ee levatinib waxaa ka mid ah VEGFR1-3, koritaanka cuncunka cuncunka xididdada VEGFR1-4, soosaaraha kobaca fibroblast factor FGFRXNUMX-XNUMX, soo-saaraha soosaaraha soosaarayaasha platelet-ka ah PDGFR-α, cKit, Ret et al. Ku shaqee adigoo ka hortagaya burooyinka inay sameystaan xididdada dhiigga cusub ee u baahan inay koraan.
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 waxaa lagu qaataa afka hal mar maalintii. Saameynaha ugu caansan ee daawadani waa cilladda cirridka lugaha lugaha lugaha, finanka maqaarka, rabitaanka cuntada oo yaraada, shuban, dhiig kar, kalagoys ama muruq xanuun, miisaanka oo yaraada, calool xanuun ama finan. Dhibaatooyinka halista ah (aan caadiga ahayn) waxaa ka mid noqon kara dhibaatooyinka dhiig baxa iyo luminta borotiinka kaadida.
Cabozantinib
Cabozantinib (Cabozantinib) waa hawo yar-yar oo maaddo badan bartilmaameed u ah oo ay soo saartay shirkadda Exelixis ee Mareykanka, taasoo bartilmaameed ka dhigan kara VEGFR, MET, NTRK, RET, AXL iyo KIT. Waxay leedahay magac si fiican loo yaqaan bukaanka intiisa badan, "XL184".
Bishii Meey 29, 2018, FDA waxay oggolaatay Carbotinib daaweynta khadka labaad ee kansarka beerka ee horumarsan. Ansixinta waxay ku saleysan tahay wajiga III tijaabada caafimaad ee KELIYA. Bukaannada qaba kansarka cagaarshowga ee horumarsan ee horumarka sameeyay ka dib daaweynta sorafenib waxay si aad ah u wanaajiyeen guud ahaan badbaadada marka la barbar dhigo placebo. Heerka badbaadada-bilaash la'aanta iyo heerka jawaabta ujeeddada ayaa sidoo kale si weyn u soo hagaagtay.
Larotinib, waa nooc ballaadhan oo dawada lidka ku ah kansarka ah
On November 26, 2018, the legendary anticancer drug larotrectinib (Vitrakvi, Larotinib, LOXO-101) was finally approved by the FDA for the treatment of adult and pediatric patients with locally advanced or metastatic solid tumors with NTRK gene fusion . Regardless of the type of cancer, as long as it is a solid tumor positive for genetic testing for NTRK fusion, this broad-spectrum targeted drug can be used!
In some rare cancers, NTRK fusion often occurs. These include infantile fibrosarcoma, secretory kansarka naasaha, 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, buro caloosha ku dhacda (GIST), breast cancer, osteosarcoma , Cholangiocarcinoma, primary unknown cancer, congenital mesoderm kidney cancer, appendix and pancreatic cancer.
Intaas waxaa sii dheer, bukaanjiifka kansarka horumarsan ee soo maray baaritaanka hiddo-wadaha kansarka waxaa laga yaabaa inay ogaadaan in burooyinkooda ay leeyihiin isku-darka NTRK, maxaa yeelay isku-darka hidde-wadaha NTRK wuxuu ku dhici karaa unugyada kansarka ee kala duwan, oo ay ku jiraan kansarka beerka.
Kormeerka guud ee hiddo-wadayaasha isugeynta waxay u baahan tahay adeegsiga tikniyoolajiyadda jiilka labaad ee jiilka. Waana in la ogaadaa in isu-beddelka hidde-wadaha NTRK ee hiddo-wadaha kale, halkii uu ka beddeli lahaa dhibic bakhtiyaa-nasiib ah.
Shirkadaha adduunka ugu sarreeya ee baaritaanka hidda-sidaha ee Kerris iyo Foundation Medicine sidoo kale dhowaan wey qurxeen
waxay doorteen aasaaska One CDx ee tijaabada isugeynta NTRK. Bukaannada doonaya inay ogaadaan waxay wici karaan Waaxda Caafimaadka ee Shabakadda Caalamiga ah ee Oncologist si ay ula tashadaan (400-626-9916).
Daawooyinka kansarka beerka ee cilmi baarista
Ro Everolimus
Waa xakameeyaha xulashada ee mTOR. MTOR waa furaha serine-threonine kinase. Everolimus waxay isku dari kartaa borotiinka 'intracellular protein' FKBP12 si loo sameeyo mTORC1 kakooban. Waxay soo saari kartaa ujeedooyin kahortaga burooyinka iyadoo faragalinaysa wareegga unugyada iyo angiogenesis. .
However, the results of the current clinical trials suggest that Everolimus is not effective in the treatment of patients with advanced HCC, and its clinical value as a second-line drug therapy still needs to be further discussed.
EvBevacizumab
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.
PApatinib
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, kansarka sanbabada ee aan yareyn and breast cancer, and has been included in medical insurance.
Aitan (Apatinib) is through highly selective competition for intracellular VEGFR-2 ATP binding site, blocking downstream signal transduction, thereby potently anti-tumor tissue angiogenesis, and ultimately achieve the goal of combating tumors in all directions.
Daawooyinka loo oggol yahay daaweynta cudurka kansarka beerka
Immunotherapy drugs help the body’s immune system attack cancer cells by targeting the PD-1 / PD-L1 cell signaling pathway (PD-1 and PD-L1 are proteins that are present in the body’s immune cells and certain cancer cells). In layman’s terms: By blocking the binding of PD-L1 protein to cancer cells, the camouflage of cancer cells is prevented, and the body’s own immune cells can recognize and eliminate cancer cells.
Pembrolizumab (Pembrolizumab, Keytruda) and Nivolumab (Nivolumab, Opdivo) are drugs targeting PD-1. By blocking PD-1, these drugs can enhance the immune response to cancer cells. This can shrink some tumors or slow their growth. These drugs can be used in patients with liver cancer who have previously undergone treatment with the targeted drug sorafenib (dojime).
Pembrolizumab (Pembrolizumab, Keytruda)
