Braftovi sareng Erbitux tungtungna ngahontal hasil anu positif pikeun kanker kolorektal

Perawatan sasaran kanker kolorektal, mutasi gen BRAF V600E sasaran terapi kanker kolorektal Braftovi + Erbitux tungtungna ngahontal hasil anu positif

Status pangobatan kanker koloréktal

Colorectal cancer is one of the most common malignant tumors in the digestive system. In recent years, its morbidity ranks third in the world in terms of malignant tumors, and its mortality rate ranks second, which seriously threatens people’s lives and health. With the changes in the living habits and dietary structure of our nationals, the incidence of kangker colorectal has generally shown an upward trend, and has become the second highest incidence of digestive system, and the highest incidence of malignant tumors. According to relevant research statistics, the number of new cases of colorectal cancer in China is expected to exceed 521,000 in 2018, and the number of deaths is as high as 248,000.

Panilitian parantos nunjukkeun yén sakitar 15% pasien kalayan kanker kolorektal metastatik bakal ngagaduhan mutasi gén BRAF sareng ramalan goréng. Mutasi V600E mangrupikeun mutasi gén BRAF anu paling umum. Résiko maotna pasién anu mutasi BRAF V600E nyaéta nyandak pasién gén BRAF jenis liar dua kali.

Faced with such a dangerous BRAF V600E mutation metastatic colorectal cancer, the editor shares a piece of exciting good news learned recently! On April 8, 2020, Pfizer announced that the US FDA has approved Braftovi® (encorafenib, connefenib) and Erbitux® (cetuximab, cetuximab) combination therapy (Braftovi two-drug protocol) is used to treat patients with metastatic colorectal cancer (mCRC) who carry the BRAF V600E mutation. These patients have already received one or two pre-treatments. This approval also makes the Braftovi regimen ubar kadua terapi sasaran kahiji disatujuan ku FDA pikeun penderita mCRC mawa mutasi BRAF.

Terapi dobel sareng triple sacara signifikan manjangkeun salamet

Salaku awal Désémber 2019, FDA nampi aplikasi ubar anyar suplemén Pfizer Braftovi Kadua sareng nampi kualifikasi tinjauan prioritas. Persetujuan ieu dumasar kana hasil uji klinis BEACON CRC Phase 3.

Panilitian dilumangsungkeun dina pasien anu maju BRAF V600E mutan mCRC anu sateuacanna parantos maju saatos nampi hiji atanapi dua terapi. Khasiat sareng kaamanan rencana pangobatan ritica digabungkeun sareng pangobatan (kontrol).

Tabél 1: Rencana pangobatan unggal kelompok

Hasil panilitian utama

1. Median survival (OS): 9.0 bulan dina kelompok terapi triple

8.4 bulan dina grup terapi ganda

Grup kontrol nyaéta 5.4 bulan

2. Kalangsungan bébas tina kamajuan: 4.3 bulan dina kelompok terapi triple

4.2 bulan pikeun kelompok terapi dobel

Grup kontrol nyaéta 1.5 bulan

3. Tingkat salamet 6 bulan: 71% dina kelompok terapi triple

65% dina grup terapi ganda

Grup kontrol nyaéta 47%

4. Laju Remisi Objektif (ORR): 26% dina kelompok terapi triple

20% dina grup terapi ganda

Grup kontrol nyaéta 2%

Gambar di kénca ngabandingkeun rézim tilu-ubar tina raftovi sareng OS kelompok kontrol, sareng gambar di belah katuhu ngabandingkeun rézim dua-ubar tina raftovi sareng OS tina kelompok kontrol

Sacara umum, dibandingkeun sareng régim pangobatan anu ngandung Erbitux sareng irinotecan, hasiat tina rézim dua ubar sareng rézim tilu ubar henteu jauh béda, sareng aya efek samping klinis anu langkung saeutik.

Pokok Investigator Dr. Scott Kopetz nyarios: "Salaku pasién anu diubaran Kanker kolorektal mutter BRAF V600E mutahir, Braftovi + Erbitux (konefinil + cetuximab) mangrupikeun terapi anu munggaran sareng anu ditargetkeun Ieu mangrupikeun pilihan pangobatan anyar anu peryogi pisan ku pasién sapertos kitu. "

Prinsip terapi gabungan Braftovi sareng indikasi

Braftovi’s active pharmaceutical ingredient binimetinib is an oral small molecule BRAF inhibitor, and Mektovi’s active pharmaceutical ingredient encorafenib is an oral small molecule MEK inhibitor. MEK and BRAF are two key protein kinases in the MAPK signaling pathway (RAS-RAF-MEK-ERK).

Studies have shown that this pathway regulates many key cell activities including cell proliferation, differentiation, survival, and angiogenesis. In many cancers, such as melanoma, colorectal cancer, and thyroid cancer, proteins in this signaling pathway have been shown to be abnormally activated.

Di Amérika Serikat, kombinasi Braftovi + Mektovi geus disatujuan pikeun melanoma unresectable atanapi métastatik kalawan mutasi BRAF V600E atanapi BRAF V600K. Braftovi henteu cocog pikeun pengobatan melanoma BRAF tipe liar. Di Éropa, kombinasi ieu disatujuan pikeun déwasa sareng melanoma unresectable atanapi métastatik sareng mutasi BRAF V600. Di Jepang, kombinasi ieu disatujuan pikeun BRAF-mutated unresectable melanoma.

Pedoman NCCN 2019 pikeun Kanker Kolorektal nambihan dua terapi kombinasi triple inhibitor EGFR / BRAF / MEK anyar pikeun penderita panyakit maju mutasi-positip BRAF V600E maju, nyaéta:

[1] Dabrafenib + Trametinib + Cetuximab / Panitumumab (Cetuximab / Panitumumab)

[2] Encorafenib (conefinil) + Binimetinib (bimetinib) + Cetuximab / Panitumumab (cetuximab / panitumumab)

Xiaobian aya anu nyarios

Dina jaman terapi anu dituju, unggal pasien kanker kolorektal kedah lulus deteksi MSI, analisa mutasi RAS sareng BRAF, sareng ngalaksanakeun amplifikasi HER2, NTRK sareng deteksi gen sanésna sajauh mungkin. Tés genetik (NGS) bakal dilebetkeun kana standar pamariksaan awal anu ageung pikeun kalolobaan pasien. Babaturan kanker anu parantos ngalaman tés genetik tiasa ngirim laporan ka departemen médis pikeun interpretasi pikeun ningali naha aya pilihan perawatan anu relevan.

Éditor percaya yén ka hareupna bakal aya kamajuan panalungtikan anu langkung énggal sareng pangobatan anu pangsaéna pikeun kanker kolorektal. Ngan para ahli kanker top di bumi sareng di luar negeri anu gaduh pangalaman klinis anu beunghar. Pasién kanker kolorektal tiasa ngalamar otoritas ngaliwatan konsultasi Ahli Jaringan Oncologist Global, kéngingkeun diagnosis sareng rencana perawatan anu pangsaéna.