Julayi 13th 2021: Umuthi omusha wabantu abanohlobo lomdlavuza wesibindi obizwa ngokuthi i-hepatocellular carcinoma uyatholakala obonakala ungcono kunokwelashwa okujwayelekile (HCC). I- Ukuphathwa Kwezokudla Nezidakamizwa (i-FDA) igunyaze i-atezolizumab (Tecentriq) kanye ne-bevacizumab (Avastin) njengokwelashwa komugqa wokuqala kubantu abanomdlavuza wesibindi othuthukisiwe abangakwazi ukulashwa ngokuhlinzwa.
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.
Omunye wochwepheshe balolu cwaningo, uRichard Finn, MD, wase-University of California, eLos Angeles, uthe, "Lokhu kusengaphambili kakhulu ezigulini." "Lokhu yinto abezempilo abelapha lezi ziguli abakade beyicela isikhathi eside, futhi kuyisinyathelo esikhulu phambili."
I-Atezolizumab iyi-immune checkpoint inhibitor, okusho ukuthi isiza amasosha omzimba ukuthola nokubulala amangqamuzana omdlavuza. I-Bevacizumab ngumuthi ohlosiwe olambisa izicubu ngokuvimbela ukukhula kwemithambo yegazi emisha.
Another targeted therapy, sorafenib, inhibits the formation of blood vessels and cancer cells. Sorafenib was the first medicine approved by the FDA ngo-2007 ukwelapha iziguli ezithile ze-HCC.
Ngokusho kukaTim Greten, MD, oyisekela lenhloko ye-NCI's Center for Cancer Research's Thoracic and GI Malignancies Branch, ukuphela kwezindlela zokwelashwa ze-HCC ezinikezwe ilayisense kusukela ngo-2007 azisebenzi kune-sorafenib.
Emhlanganweni wokuhlela, uRobin Kelley, MD, we-UCSF uHelen Diller Family Comprehensive Cancer Center, uthe hhayi kuphela ukuthi inhlanganisela ye-atezolizumab – bevacizumab isebenza kangcono kakhulu, kodwa futhi iholele “emiphumeleni ebike kangcono yesiguli,” njengamakhono omzimba .
NgokukaDkt. Greten, uhlobo lwe-combo luzothatha isikhundla se-sorafenib njengokwelashwa okujwayelekile komugqa wokuqala kwabanye abantu abane-HCC esezingeni eliphezulu.
Ukungeza kuma-immune checkpoint inhibitors
Umdlavuza wesibindi is frequently identified after it has progressed outside the liver or become interwoven with several blood arteries, making surgery impossible to treat.
I-Sorafenib ne-lenvatinib (Lenvima), omunye umuthi obambezela ukwakheka kwemithambo yegazi, yiwona kuphela ongawukhetha kubantu abanomdlavuza wesibindi ongelapheka ngokuhlinzwa (okungasebenzi).
Ama-immune checkpoint inhibitors ahlolwe njengezindlela zokwelashwa zokuqala zomdlavuza wesibindi ezifundweni ezimbalwa zemitholampilo, kepha kwatholakala ukuthi azisebenzi zodwa. Ososayensi bathola ukuthi amaprotheni amaningi ngokweqile abizwa nge-VEGF angavimba imishanguzo yokuhlola amasosha omzimba ekusebenzeni ngemuva kophenyo olunzulu.
Ngokusho kukaDkt. Finn, i-VEGF igqugquzela ukwakhiwa kwemithambo yegazi emisha futhi iguqula inani nohlobo lwamaseli omzimba ezifweni nasemathunjini azungezile.
Ngoba 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.
Ukuphepha kwe-Atezolizumab Plus Bevacizumab
Imithi ye-combo idale imiphumela emibi eminingi ezigulini eziningi. Kukonke, nokho, iziguli zabonakala ziyibekezelela yomibili le mithi, ngokusho kukaDkt. Greten.
La maqembu womabili abe nemiphumela elinganayo yemiphumela emibi nokufa kwabantu ngenxa yemiphumela emibi. Kodwa-ke, iqembu le-combo lalineziguli eziningi ezathola imiphumela emibi emikhulu (amaphesenti angama-38 uma kuqhathaniswa namaphesenti angama-31).
Ngenxa yemiphumela engemihle, iziguli ezimbalwa eqenjini le-combo zime kancane noma zaguqula umthamo wokwelashwa kwazo (amaphesenti angama-50 uma kuqhathaniswa namaphesenti angama-61 eqenjini le-sorafenib). Zingu-7% kuphela iziguli eziseqenjini elihlanganisiwe ezayeka ukuthatha yomibili le mithi ngenxa yemiphumela emibi, yize ezinye iziguli eziseqenjini elihlanganisiwe ziyeke ukuthatha esinye sezidakamizwa (i-16% uma iqhathaniswa ne-10%).
Ngenxa yomthelela wayo emithanjeni yegazi, i-bevacizumab ingadala ukopha, ngokusho kukaDkt Greten. Uthe umdlavuza wesibindi ungadala nezinguquko ezandisa ubungozi bokuphuma kwegazi, njengezibalo eziphansi zeplatelet.
"Kwakukhona iziqephu ezimbalwa zokopha engalweni ye-atezolizumab, bevacizumab, kodwa zazisephansi kakhulu njengephesenti," wanezela uDkt. Finn. Kuwo womabili amaqembu, u-6% weziguli zopha kakhulu ngenxa yokwelashwa kwe-bevacizumab.
Ngokusho kukaDkt. Greten, “kuzobaluleke kakhulu ukukhetha iziguli ezifanele” zokwelashwa kwe-combo. Ngaphambi kokuqala imishanguzo, iziguli zingadinga ukuthola izivivinyo ezijwayelekile zokubheka ukuthi kunengozi yokopha, kusho yena.
UDkt Kelley uthe, "Kumele kuphenywe ngezinye izindlela zokwelapha iziguli ezisengozini enkulu yokopha."
