Metastatic Breast Cancer: Ubwino Wochepa Wachipatala wa Irinotecan ndi Etoposide mu Chithandizo cha Odwala

Mfundo

Khansara ya m'mawere ya metastatic, yomwe imadziwikanso kuti khansa ya m'mawere IV, ndi mtundu wapamwamba wa matenda omwe khansa yafalikira ku ziwalo zina za thupi, monga mafupa, mapapo, chiwindi, kapena ubongo. Ndi ochepa okha pa 6 aliwonse (XNUMX%) mwa amayi omwe amayamba kupezeka ndi mawere a metastatic khansa, ndipo nthawi zambiri zimachitika chifukwa cha kubwereranso pambuyo pa chithandizo choyambirira ndi nthawi ya chikhululukiro.

Pali kusiyana kwakukulu pakati pa khansa ya m'mawere ndi khansa ya m'mawere ya metastatic; khansa ya m'mawere ndi mawu ambulera amitundu yonse ndi magawo a carcinoma omwe amachokera m'mawere. Kumbali inayi, National Cancer Institute (NCI) imaperekanso chidziwitso chokhudza khansa ya m'mawere ya metastatic ndi magawo osiyanasiyana a khansa ya m'mawere, kuphatikiza tanthauzo la khansa ya m'mawere ya metastatic monga gawo IV la matendawa, pomwe maselo a khansa afalikira kumadera ena a thupi. .

Ngakhale kuti khansa ya m'mawere ya metastatic imapezeka kwambiri mwa amayi, imakhudzanso amuna ochepa. Malinga ndi lipoti la American Cancer Society's Cancer Facts and Figures kuchokera mu 2019, zaka 5 zopulumuka za khansa ya m'mawere ya metastatic ndizochepera 30%.
Segar, Jennifer M et al. "Phunziro la Gawo II la Irinotecan ndi Etoposide monga Chithandizo cha Khansa ya M'mawere ya Refractory Metastatic." Dokotala wa oncologist vol. 24,12 (2019): 1512-e1267. doi:10.1634/theoncologist.2019-0516

Kuyesa Kwachipatala (NCT00693719): Irinotecan ndi Etoposide mu Metastatic Breast Cancer

• Panali azimayi 31 omwe adalembetsa nawo mkono umodzi, gawo lachiwiri lazachipatala, azaka zapakati pa 36-84.
• Azimayi 64% anali ndi khansa ya m'mawere ndi HER2 yoyipa.
• Amayiwo adalandira chithandizo chamankhwala osachepera asanu asanafike ndipo anali atagonjetsedwa kale ndi anthracycline, taxane ndi capecitabine.

Malingaliro a Sayansi Phunziro

• Kulingalira kwa mayeserowa kunali kuyesa mankhwala atsopano a chemotherapy omwe onsewa adawonetsa zochitika mu odwala khansa ya m'mawere ndipo kuphatikiza kwake kunatsimikizika molondola.
• Onse awiri a Irinotecan ndi Etoposide ndi achilengedwe, omwe amapangidwa ndi mbewu zomwe zimayambitsa ma enzyme a isoforms a topoisomerase (TOP). Mavitamini apamwamba amafunika kuti DNA isindikizidwe ndi kusindikizidwa, zonsezi ndizofunikira kwambiri pa khansa yomwe ikukula mofulumira. Kulepheretsa kuchitapo kanthu kwa TOP kumayambitsa kusweka kwa DNA, kuwonongeka kwa DNA ndikupangitsa kuti maselo afe.
• Irinotecan ndi TOP1 ndipo Etoposide ndi TOP2 modulator. Chifukwa chophatikizira onse TOP1 ndi TOP2 inhibitors ndikuthandizira kuyambitsa kulipira kwa isoform ina pamene isoforms imaponderezedwa.

Zotsatira Zakuyesa Kwachipatala

• Panali odwala 24 omwe angawunikidwe ngati ali ndi mphamvu yothandizirana ndi Irinotecan ndi Etoposide. 17% adayankha pang'ono ndipo 38% anali ndi matenda okhazikika.
• Odwala onse a 31 adayesedwa kuti ali ndi poizoni ndipo 22 mwa 31 (71%) adakumana ndi zovuta zoyambira 3 ndi 4 zovuta. Chizoloŵezi chodziwika kwambiri chinali neutropenia, komwe kuli ma neutrophils ochepa m'magazi omwe angapangitse kuti atenge matenda.
• Phunziro linathetsedwa koyambirira chifukwa cholemetsa chaukali chinali chachikulu ndipo chimaposa mphamvu yophatikizira.

Zizindikiro za khansa ya m'mawere ya Metastatic

• Kupweteka kwa mafupa kapena kupwetekedwa mtima: Kutha kufalikira ku mafupa, kuchititsa kupweteka kapena kupwetekedwa mtima m'madera okhudzidwa.
• Kutopa: Chithandizo cha khansa ndi khansa chingayambitse kutopa, komwe kungakhale koopsa komanso kosalekeza.
• Kupuma pang'ono: Khansa yofalikira m'mapapo ingayambitse kupuma movutikira.
• Zizindikiro za minyewa: Khansa yomwe yafalikira ku ubongo imatha kuyambitsa zizindikiro za minyewa monga mutu, khunyu, kapena kusintha kwa malingaliro.
• Kutaya chikhumbo cha kudya ndi kuwonda: Kuchiza khansa ndi khansa kungayambitse kutaya chilakolako ndi kuchepa thupi.
• Jaundice kapena kutupa m'mimba pamene khansa yafalikira kuchiwindi.

Nthawi yokhala ndi moyo wa munthu yemwe ali ndi khansa ya m'mawere imatha kusiyanasiyana kutengera zinthu zingapo monga malo ndi kufalikira kwa chotupacho.

Malinga ndi kafukufuku, kupulumuka kwa zaka 5 ndi muyeso wa anthu angati omwe ali ndi mtundu uwu khansa akadali ndi moyo zaka zisanu zapitazi khansayo itapezeka. Imafotokozedwa ngati peresenti, kutanthauza kuti chiwerengero cha anthu mwa 5 omwe ali ndi moyo pambuyo pa zaka 100. Malinga ndi American Cancer Society, zaka 5 za moyo kwa amayi omwe ali ndi khansa ya m'mawere ya metastatic ndi 5%, pamene zaka 29 zopulumuka kwa amuna ndi 5%. Ndikofunika kuzindikira kuti izi ndi ziwerengero wamba ndipo milandu ingasiyane.

Chithandizo cha Khansa ya M'mawere ya Metastatic

Chithandizocho ndizovuta koma kuphatikiza kwa chemotherapy ndi mankhwala enaake a chemo kuli ndi zabwino zina pakuwongolera khansa. Sichingagwiritsidwe ntchito mozama komanso kwanthawi yayitali chifukwa cha kuopsa kwake komanso momwe moyo umakhudzira wodwalayo. Chithandizo cha immunotherapy ndi njira ina yomwe ingaganizidwe kwa odwala omwe ali ndi khansa ya m'mawere ya metastatic; njira yochizirayi ingathandize chitetezo cha mthupi kuzindikira ndikuukira maselo a khansa.

Kuwunika kusintha kwa chotupa cha metastatic kungathandizenso kuzindikira kuphatikizika kwa njira zochiritsira zomwe zimayang'aniridwa kwambiri ndi zotsatira zochepa. Kuopsa kogwiritsa ntchito kuphatikiza kwa topoisomerase inhibitors Irinotecan ndi Etoposide kunaposa phindu ndipo sikungagwiritsidwe ntchito pochiza mawere a metastatic. khansa.  

Popeza khansa ya m'mawere ya metastatic iliyonse imakhala yosiyana ndi mitundu yakeyake ya ma genomic, njira zochizira zimasinthidwa malinga ndi akatswiri a oncologists. Pali ntchito yoti ichitidwe kupeza njira zochiritsira zabwino komanso zotetezeka. Chaka chilichonse, pa 13th October, tsiku lodziwitsa anthu za khansa ya m'mawere ya metastatic limakondwerera kuti lipereke chithandizo kwa omwe akhudzidwa ndi matendawa komanso kupeza ndalama zothandizira kafukufuku kuti apange njira zowonjezera zothandizira.

Chakudya chomwe mumadya komanso chomwe chimakupatsani thanzi ndi chisankho chomwe mumapanga. Lingaliro lanu liyenera kuphatikizapo kulingalira za kusintha kwa majini a khansa, khansa, chithandizo chamankhwala chopitilira muyeso, zovuta zilizonse, zidziwitso za moyo, kulemera, kutalika ndi zizolowezi.

Kukonzekera kwa khansa kuchokera ku addon sikudalira pakusaka kwa intaneti. Zimakusankhirani zomwe mungasankhe malinga ndi sayansi yamayendedwe omwe asayansi athu ndi akatswiri a mapulogalamu. Mosasamala kanthu kuti mumasamala kumvetsetsa zomwe zimayambira zamagulu am'thupi kapena ayi - pakukonzekera zakudya za khansa kumvetsetsa kumafunikira.

Yambirani TSOPANO ndikukonzekera zakudya zanu poyankha mafunso okhudzana ndi khansa, kusintha kwa majini, mankhwala opitilira muyeso ndi zowonjezera, chifuwa chilichonse, zizolowezi, moyo, gulu la zaka komanso jenda.

Odwala khansa nthawi zambiri amakhala ndi zovuta zosiyanasiyana chemotherapy mavuto zomwe zimakhudza moyo wawo ndikuyang'ana njira zina zochiritsira khansa. Kutenga chakudya choyenera ndi zowonjezera zowonjezera kutengera zomwe asayansi amalingalira (kupewa kuyerekezera ndi kusankha mwachisawawa) ndiye njira yabwino kwambiri yachilengedwe ya khansa ndi zovuta zina zokhudzana ndi chithandizo.

Zothandizira:

• Cancer.net (2022). Khansa ya M'mawere - Metastatic: Statistics.
• National Cancer Institute. (ndi). Khansa ya M'mawere.
• American Cancer Society. (2021). Metastatic Breast Cancer.
• National Cancer Institute. (2021). Metastatic Breast Cancer.
• Cancer.net. (2022). Khansa ya M'mawere - Metastatic: Statistics.

• Ndi Zakudya Ziti Zomwe Zimalimbikitsidwa ndi Colorectal Adenocarcinoma?
• Ndi Zakudya Ziti Zomwe Zimalimbikitsidwa pa Esophageal Squamous Cell Carcinoma?
• Ndi Zakudya Ziti Zomwe Zimalimbikitsidwa pa Gastric Neuroendocrine Chotupa?
• Kodi ndizotheka kugwiritsa ntchito Soy Isoflavone Genistein limodzi ndi Chemotherapy ya Metastatic Colorectal Cancer?
• Chakudya Chamtundu Wokha / Chakudya cha Khansa ya M'mawere ya Metastatic