Ekwindla ka-2015, uDoron Broman oneminyaka engu-44 kwatholakala ukuthi unomdlavuza we-pancreatic - futhi wamangala lapho ethola ukuthi umdlavuza wakhe we-pancreatic wawusumetastasized waba isimila esikhulu esibindini. Ebhekene nesikhathi sokusinda sezinyanga ezimbalwa kuphela, uBroman wanquma ukuchitha isikhathi esilinganiselwe endaweni efanele.
UBroman watholakala enomdlavuza we-metastatic pancreatic eneminyaka engu-44
Ungunjiniyela wezindlu ezinze eMiami futhi ikhaya lakhe liseBoston. Ngemva kokwenza ucwaningo ku-inthanethi, wanquma ukuthola ukwelashwa e-Dana-Farber. 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.
UBroman wayendiza esuka eMiami eya eBoston njalo emasontweni amabili ukuze athole ukwelashwa. Okwamangaza wonke umuntu ukuthi ukonakala kwamanyikwe nesibindi kwaqala ukuncipha ngokushesha.
“Lena yimpendulo ebaluleke kakhulu,” kububula uNg. “Amathumba amaningana acishe anyamalala ngokuphelele ngemva kokwelashwa ngamakhemikhali. Lokhu kusenza sizibuze ukuthi ngabe kukhona yini ukuguqulwa kwamangqamuzana esimilani sakhe okwenza sizwele kakhulu iFOLFIRINOX.”
Izazi ze-Oncologists zaqala ukubheka izinguquko ezingavamile zamangqamuzana noma izinguquko ekufakweni kwekhodi kwe-tumor DNA, ngoba babona isiguli sithuthukisa kakhulu izidakamizwa zomdlavuza, futhi umuthi ngokuvamile unokusabela okulinganiselwe noma akukho nzuzo kwezinye iziguli ezinesifo. 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.
Umdlavuza ka-Broman uphendule kakhulu ekwelashweni okunconywe uKimmie Ng, MD.
UBroman wafika ekwelashweni kuka-Dana-Farber ngemva nje kokuthi uNg nozakwabo besanda kuqala inqubo entsha yocwaningo, evumela iziguli ukuthi zenze ama-biopsies engeziwe ukuze zithole izinto zofuzo ezingelashwa ngomuthi onembayo. Wavuma uBroman. Lonke ukulandelana kwe-exon ye-DNA yakhe yesimila kwembula ukuguqulwa kofuzo lwe-BRCA2. Uma lokhu kuguqulwa kutholwa ngabesifazane, kuzokwandisa kakhulu ingozi yomdlavuza webele nowe-ovary. Kodwa uBroman akazange azuze ifa Ukushintsha kwe-BRCA2 -Kwaba nje ukuthi ngesikhathi esithile empilweni yakhe, amangqamuzana akhe e-pancreatic ayenalokhu kuguqulwa.
Ukuguqulwa kwe-BRCA2 kungaphazamisa ikhono leseli lokulungisa umonakalo we-DNA, okubangela ukuthi iseli lizibhubhise ngokwalo. Amaseli omdlavuza anezinguquko ze-BRCA2 azwela kakhulu emithini ye-chemotherapeutic esekelwe ku-platinum esekelwe emonakalweni we-DNA, okuyingxenye yephrothokholi ye-FOLFIRINOX. Lokhu kungase kuchaze ukuthi kungani umdlavuza kaBroman uhlaselwe ngempumelelo kangaka.
Ngemuva kwemijikelezo ye-13 yokwelashwa nge-FOLFIRINOX, u-Broman uphendule kahle ekwelashweni ngemiphumela emibi efana nokulahlekelwa izinwele nokulimala kwezinzwa, ngakho ithimba lakhe lezokwelapha lanquma ukuyiguqula ibe isidakamizwa esihlosiwe esibizwa ngokuthi i-olaparib ebizwa ngokuthi i-PARP inhibitor (Lynparza) ingavimbela ukulungiswa komonakalo we-DNA. .
"I-Olaparib igunyazelwe umdlavuza we-ovarian ohlobene ne-BRCA-2," kusho uNg. "Kodwa-ke, kumathumba ashintshile [okungelona ifa] i-BRCA2, ayikho idatha yangempela ngendima yawo."
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.
UBroman uthe: “Ngijabule kakhulu”. Ukhuleka zonke izinsuku selokhu ezixilongile. Usanda kuvakashela e-Europe nakwa-Israel lapho azalelwa khona. “Ngenze kangcono kakhulu kunalokho ebengikulindele. Ngizizwa ngikahle, izinwele zami zibuyile, ngiwumqemane, ngihamba amakhilomitha angu-12 ngosuku, ngoMgqibelo nangosuku. Abangane bami bathi abakholwanga.”
Ku-Ng nozakwabo, uthe icala likaBroman "likhomba ukuthi ukunemba kwe-oncology kanye nokwelashwa okuhlosiwe okusekelwe ezicini zamangqamuzana kuzuzisa kakhulu iziguli ezinomdlavuza."
