Ukuhlolwa kofuzo lomdlavuza
Imihlahlandlela yokuhlolwa kofuzo lomdlavuza eqondiswe ekwelashweni njengobuchwepheshe obuyisisekelo bokwelashwa okunembayo komdlavuza. Sonke isiguli somdlavuza kufanele sizihlolele isakhi sofuzo somdlavuza, sibheke izidakamizwa eziqondiswe ngempumelelo kanye nezivivinyo zokwelashwa zokwelashwa. I-Global Oncologist Network, ngokubambisana ne-ejensi yokuhlola izakhi zofuzo yase-US kanye ne-ejensi yasekhaya yokuhlola izakhi zofuzo, inikeza iziguli ukuhlolwa kofuzo okunembile komdlavuza kanye nezinsizakalo zokubonisana nochwepheshe ukusiza iziguli zenze uhlelo lokwelapha olunembe kakhulu.
I-FDA isanda kugunyaza i-Iressa njengokwelashwa kwe-ejenti eyodwa yomdlavuza we-metastatic non-small cell lung cancer (NSCLC) positive ekuguqulweni kwe-epidermal growth factor receptor (EGFR) okuqinisekiswe ikhithi yokuxilonga engumngane egunyazwe yi-FDA.
I-Iressa umuthi wokuqala oqondiswe kumamolekyuli wokwelapha umdlavuza wamaphaphu eChina. Yethulwa ngokusemthethweni e-China ngemvume ye-State Food and Drug Administration ngo-2005, kwavula inkathi entsha yokwelashwa kweziguli ezinomdlavuza wamaphaphu ongewona omncane. I-Iressa iletha izindlela zokwelapha ezithuthukisiwe ezigulini ezinomdlavuza wamaphaphu e-China ukuze zithuthukise izinga lempilo yazo futhi inomkhuba wokwandisa isikhathi sokuphila kwazo. Ngonyaka wesi-6 wokufakwa kuhlu kwe-Iressa, u-Iressa uphinde wagunyazwa njengokwelashwa kokuqala komdlavuza wamaphaphu wamangqamuzana amancane.
Umdlavuza wamaphaphu ungumdlavuza ohamba phambili phakathi kwamazinga okufa okuhlobene nesimila eChina. Umdlavuza wamaphaphu ongewona omncane (NSCLC) ubala cishe ama-85% azo zonke izigameko zomdlavuza wamaphaphu.
Njengamanje, ukwelapha umdlavuza wamaphaphu ngokuyinhloko kusawukuhlinzwa, ukwelapha ngemisebe, nokwelashwa kwezidakamizwa. Ukwelashwa ngezidakamizwa komdlavuza wamaphaphu kuhlanganisa ukwelashwa ngamakhemikhali kanye nokwelashwa kwezidakamizwa okuhloswe nge-molecularly (okuvamile kuma-EGFR-TKIs).
Ukwelashwa komdlavuza wamaphaphu, ikakhulukazi umdlavuza wamaphaphu ongewona omncane, kukhuthaza imodeli yokwelashwa yomuntu ngamunye. Kususelwa esimeni sokukhuluma sofuzo somshayeli seziguli ezinomdlavuza wamaphaphu, okungukuthi, ukwelashwa komuntu ngamunye okusekelwe ekutheni iziguli ezinomdlavuza wamaphaphu zinezakhi zofuzo zomshayeli. Phakathi kwazo, i-epidermal growth factor receptor (EGFR) ingeye-tyrosine kinase receptor, futhi indlela yayo yokudlulisa isignali ilawula ukukhula kwamaseli, ukwanda nokuhlukaniswa. Ngomdlavuza, kutholakala ukuthi izinguquko ezihlukahlukene zivame ukwenzeka esifundeni se-EGFR tyrosine kinase. Lezi zinguquko zihlobene eduze nokusebenza kwe-tyrosine kinase inhibitors. Ukuguqulwa kwe-EGFR kuwumshayeli womdlavuza obalulekile. Ukuguqulwa kwe-EGFR kuyisibikezelo esinamandla sokuthi iziguli ezinomdlavuza ziyazwela yini ku-TKI. Ngakho-ke, ukutholwa kokuguqulwa kofuzo kwe-EGFR kunganikeza isisekelo sokwelashwa okuhlosiwe kwe-tumor. Izinga lokuguqulwa kwe-EGFR leziguli ezinomdlavuza wamaphaphu e-China lingama-30% -40%.
Amasayithi okuguqulwa kofuzo e-EGFR anquma ukuthi iziguli ezingezona ezincane ezinomdlavuza wamaphaphu zingasebenzisa i-Iressa, i-Tarceva nezinye izidakamizwa ezihlosiwe. Ukuguqulwa kwe-Iressa / Trokai kuma-exons 18, 19, 20, kanye no-21, ikakhulukazi ukususwa kwe-exon 19 noma ukuguqulwa kwe-exon 21, kunomthelela obalulekile. Kunconywa ukuthi iziguli ezinomdlavuza wamaphaphu ongewona omncane zihlolwe izakhi zofuzo ngaphambi kokusebenzisa izidakamizwa eziqondiwe njenge-Iressa / Troca.
