2015 yilning kuzida 44 yoshli Doron Bromanga oshqozon osti bezi saratoni tashxisi qo'yildi va uning oshqozon osti bezi saratoni jigarda katta o'simtaga metastaz berganini bilib hayron bo'ldi. Bir necha oylik omon qolish davriga duch kelgan Broman cheklangan vaqtni kerakli joyda o'tkazishga qaror qildi.
Broman 44 yoshida metastatik oshqozon osti bezi saratoniga chalingan
U Mayamida joylashgan ko'chmas mulk ishlab chiqaruvchisi va uning uyi Bostonda. Internetda tadqiqot olib borgach, u Dana-Farberda davolanishga qaror qildi. His doctor Kimmie Ng, MD, MPH, director of clinical research at the Gastrointestinal Cancer Treatment Center, recommends the FOLFIRINOX regimen, which is the strongest combination chemotherapy for pancreatic cancer. Pancreatic cancer is the most infamous treatment.
Broman davolanish uchun har ikki haftada Mayamidan Bostonga uchib ketdi. Hammaning ajablantiradigan joyi shundaki, uning oshqozon osti bezi va jigaridagi maligniteleriya tez kamayib bora boshladi.
“This is the most significant response,” Ng sighed. “Several tumors almost completely disappeared after chemotherapy. This makes us wonder if there is a molecular mutation in his shish that makes it particularly sensitive to FOLFIRINOX.
Onkologlar o'smaning DNKlarini kodlashda g'ayrioddiy molekulyar o'zgarishlar yoki mutatsiyalarni izlay boshladilar, chunki ular bemorni saratonga qarshi dori-darmonlarni sezilarli darajada yaxshilaganini ko'rishdi va preparat odatda o'rtacha javobga ega yoki boshqa kasallikka chalingan bemorlarga foyda keltirmaydi. These types of patients are called “special responders.” In the era of precision medicine, sequencing DNA from cancers of special responders may identify rare mutations, making patients ‘tumors extremely sensitive to specific drugs.
Bromanning saraton kasalligi tibbiyot fanlari doktori Kimmi Ng tomonidan tavsiya etilgan davolanishga juda katta ta'sir ko'rsatdi.
Broman happened to arrive at Dana-Farber treatment just after Ng and her colleagues just started a new research protocol, allowing patients to perform additional biopsies to obtain genetic material that can be treated with precision medicine. Broman agreed. The entire exon sequence of his tumor DNA revealed mutations in the BRCA2 gene. When this mutation is inherited by women, it will greatly increase the risk of breast and ovaryan saraton. But Broman did not inherit the BRCA2 mutatsiyasi - bu shunchaki uning hayotining bir qismida uning bezi hujayralarida tasodifiy ravishda bu mutatsiya bo'lgan.
BRCA2 mutations can interfere with a cell’s ability to repair DNA damage, causing the cell to destroy itself. Cancer cells with BRCA2 mutations are particularly sensitive to platinum-based chemotherapeutic drugs based on DNA damage, which is part of the FOLFIRINOX protocol. This may explain why Broman ‘s cancer has been hit so successfully.
FOLFIRINOX bilan davolanishning 13 tsiklidan so'ng, Broman sochlarning to'kilishi va asabning shikastlanishi kabi nojo'ya ta'sirlar bilan davolanishga yaxshi ta'sir ko'rsatdi, shuning uchun uning tibbiy guruhi uni PARP inhibitori (Lynparza) deb nomlangan olaparib nomli dori vositasiga aylantirishga qaror qildi. .
"Olaparib irsiy BRCA-2 mutatsiyasiga bog'liq tuxumdon saratoni uchun tasdiqlangan", dedi Ng. "Biroq, somatik [nasliy bo'lmagan] BRCA2-mutatsiyaga uchragan o'smalarda uning roli to'g'risida aniq ma'lumotlar yo'q."
Therefore, Broman stopped FOLFIRINOX and now takes 12 olabally daily. He said that there will be no side effects. Six months after his new protocol, MRI and CT scans showed no cancer recurrence, and pancreatic cancer blood biomarker levels remained within normal limits. Ng said his plan is to keep him taking olabally indefinitely, as long as it keeps the cancer under control and has few side effects.
Broman: "Men haqiqatan ham baxtliman", dedi. O'ziga tashxis qo'yganidan beri u har kuni ibodat qildi. U yaqinda o'zi tug'ilgan Evropa va Isroilga sayohat qildi. “Men kutganimdan ancha yaxshi ishladim. Men o'zimni yaxshi his qilyapman, sochlarim qaytib, sog'lom, kuniga 12 mil yuraman, shanba va bir kun. Do'stlarim bunga ishonolmasliklarini aytishdi ”.
For Ng and her colleagues, she said that Broman ‘s case “points out that precision oncology and targeted therapy based on its molecular characteristics benefit cancer patients greatly.”
