Nadaafad laga soo qaado Cilmi-baarista Kansarka
Sannad kasta Jaamicada Maraykanka ee Hematology (ASH) waxay qabataa shir ay soo bandhigeyso cilmi-baaris cusub oo ku saabsan daawooyinka iyo horumarinta daaweynta kale. Daawooyinka lagu falanqaynayo kulankan waxay ku jiraan dhammaan qaybaha kala duwan ee horumarinta kiliinikada. Si kale haddii loo dhigo, qaar ka mid ah daawooyinka hadda jira, isku dayeen oo runta ah, horey u ansixiyay oo loo isticmaalay, qaar kalena waa daawo cilmi baaris ah, taasoo micnaheedu yahay inaanan wax badan ka ogaan iyaga.
Qaado rituximab, tusaale ahaan. Sannadkii 2016, Rituximab waxaa loo tixgeliyey daawo taariikhi ah oo loo isticmaalay sanado badan si loo daaweeyo noocyada kala duwan ee lymphoma non-Hodgkin. Daawooyinka intooda badani waxay weli hirgelin karaan hirarka mid ka mid ah shirarkan, tusaale ahaan, marka la isticmaalo adeeg cusub.
Daawooyinka qaarkood ee lagaga hadlayo ASH waa marxaladda ugu horeysa ee horumarka-taas oo ah, helitaannada la wadaago waa kuwo horayba u jiray. Badanaa, daraasadahaan waxaa lagu sharaxay "marxalado I-baro". Wajiga I waxaa loola jeedaa tijaabooyinka caafimaadka ee tijaabiya daawada cusub ama daaweyn cusub koox-yar-dad ah-markii ugu horeysay - in la arko haddii ay shaqeyso, si loo helo qiyaas ammaah ah kala duwan, iyo si loo ogaado saameynaha. Marxaladda I tijaabooyinku waxay u eg yihiin miraha: waxaad ugu dambeyntii heli kartaa warshad abaalmarin ah ama midho ah oo aad ku muujin kartid xaflad dawladeed, laakiin sidoo kale waad heli kartaa fashilaad ku ool ah ama warshad aan midho badan qaadin.
Cilmi baarista DLBCL
Lafdhabarta B-cell weyn, ama DLBCL, waa lymfoma dhakhso u koraya.
Waa nooca ugu badan ee lymfoma ee dadka waaweyn, waxayna ka timaaddaa unugyada dhiiga ee B-lymphocytes-cad oo keena soosaarka antibody ee habka difaaca jirka. Dad kala duwan ayaa leh noocyo kala duwan oo DLBCL ah iyo cilmi baarayaashuna waxay baarayaan fursadaha cusub ee loogu talagalay bukaanada leh DLBCL .
Rituximab Plus CHOP ama DA-EPOCH-Rituximab
Daraasada halbeegga ah ee Halbeegga III ayaa diiwaan gashey 524 bukaan oo diiwaangashan (262 cudud kasta oo daaweyn ah) intii u dhaxaysay Maajo 2005 iyo May 2013. Daraasaddan ayaa la barbar dhigtay daaweynta R-CHOP iyo daaweynta DA-EPOCH-R, daaweyn dheeraad ah oo kiimiko ah, oo rajo ka qabta sii-waynta noolaanshaha bukaanka qaba marxaladdan la soo xaqiijiyey marxaladda labaad ama ka sareeya DLBCL.
Ka qaybqaatayaashu waxay ahaayeen ugu yaraan 18 jir iyo HIV-diidmo. Ilaa hadda, guud ahaan, DA-EPOCH-R wuxuu la xiriiray saameeyn badan iyo waxyeelo soo wajahday, mana jirin farqi u dhexeeya kooxaha marka la eego faa'iidooyinka daaweynta ee la darsay. Wali, baarayaashu waxay raadinayaan inay arkaan kooxaha hoose ee gaarka ah ee DLBCL iyo haddii ay tahay ama aan wax faa'iido ah la lahayn DA-EPOCH-R ayaa lagu muujin doonaa kooxaha hoose. Falanqaynta ayaa socota.
Obinutuzumab Plus CHOP ama Rituximab Plus CHOP
Tani waxa ay ahayd daraasad kale oo III ah iyadoo 1,418 kaqeybgalayaashu ay qiimeeyeen waxtarka iyo badbaadada obinutuzumab iyo rituximab iyo CHOP ee bukaanka qaba DLBCL. Ka qaybqaatayaashu waxay ahaayeen 18 sano jir ama ka weyn oo aan hore loogu soo dallacin DLBCL. Guud ahaan, ma jirin farqi u dhexeeya labada kooxood marka la eego faa'iidooyinka badbaadada, munaasabado badan oo ka yimaadana waxaa loo soo gudbiyey bukaanada ku jira obinutuzumab-CHOP marka loo eego kooxda rituximab-CHOP. Guud ahaan, heerarka dhimashada waxay ahaayeen kuwo aad u sarreeya oo ka noqoshada daaweyntuna ay ka badanyihiin labada obinutuzumab -CHOP.
Si kastaba ha noqotee, baarayaashu waxay qorsheynayaan inay eegaan kooxaha hoose ee DLBCL inay isku dayaan oo ay helaan wax faa'iido leh ama halis ah oo aan ka muuqan kooxda oo dhan.
Lenalidomide ee bukaanka qaba DLBCL
Dadka aan u qalmin laf-dhabarka laf-dhabarka ama dib-u-soo-ceshad ka dib markay dhashadu ku yar tahay ayaa laga yaabaa in ay yar tahay daaweynta, sidaa daraadeed hal koox oo cilmi-baaris ah ayaa eegay isticmaalka daawo si loo sii wado sii-noolaanta bukaankan.
Waxay ogaadeen in wakiilka lenalidomide uu yahay musharax u qalma sababta oo ah waa daroogo afka ah, firfircoon oo ka soo horjeeda DLBCL kaas oo la qaadan karo sanado badan oo leh astaamo la aqbali karo.
Daraasadan ayaa muujisay in bukaanno waaweyn oo leh noocyo kala duwan oo ah DLBCL ay ka faa'iideysteen daaweynta lenalidomide oo lagu hagaajinayo badbaadada. Daaweynta dayactirka waxaa loola jeedaa daaweynta kansarka leh daawo, badanaa ka dib wareega hore ee daaweynta.
Cilmi baarista Lymphoma
Lymphoma lymphoma waa nooca ugu caansan ee maqaarka-taas oo ah, lymphoma-gaabis-sii kordhaya. In kasta oo obinutuzumab aysan u muuqan in ay bixiyaan wax faa'iido leh oo weli ku jira daraasaadka DLBCL ee kor ku xusan, taasi ma ahayn kiiska obinutuzumab ee lymphoma follicle.
Daaweynta Obinutuzumab-Tababarka Ku Xeel-dheeraaday Xilliga Ka-Horreysta-Bilaashka ah ee Bukaan-jiifka Iyadoo Horay Looga Hortagay Lymphoma Lymphoma
Diiwaanka GALLIUM wuxuu ahaa marxaladda caalamiga ah ee 3aad iyadoo la barbardhigayo waxtarka iyo badbaadada rituximab ama obinutuzumab oo leh daaweynta kiimikada iyadoo la raacayo dayactirka daaweynta koowaad ee lymphoma non-Hodgkin lymphoma.
Bukaannada qaba lymfoma-ka ee hore loo daaweyn, daaweynta kemotherabi-ka ee kemotherabi-ku-salaysan iyo daaweynta dayactirka waxay keentay in horumar la taaban karo oo ku salaysan daaweynta iyada oo aan cudurku hagaagin - 34 boqolkiiba hoos u dhaca khatarta uureysiga ee ku salaysan daaweynta rituximab. Obinutuzumab waxay leedahay marxalado badan oo ka mid ah dhacdooyinka waxyeellada leh sida ficil-celinta faleebo-ficil-celinta, dhiig-yaraanta hooseeya, iyo infekshannada. Cilmi baadhayaashu waxay soo gabagabeeyeen taageerada xogta ikhtiyaarka ikhtiyaarka ah ee obinutuzumab noqdaan heerka cusub ee daryeelka ee bukaannada aan hore loo daaweynin leh lymphoma.
Cilmi baarista Hodgkin Lymphoma
Waxaa jira shan nooc oo waaweyn oo ah Hodgkin Lymphoma (HL) in qof la ogaado. Nooca Hodgkin Lymphoma waa ereygii hore ee loo isticmaalo in lagu tilmaamo koox ka kooban afar nooc oo caadi ah kuwaas oo ka kooban wax ka badan 95% dhammaan xaaladaha HL ee dalalka horumaray.
Calaamadeynta Calaamadinta Immune ee Loogu Talagalay Nooca Hodgkin Lymphoma
Lymphoma heerka caadiga ah wuxuu u muuqday in uu leeyahay isbeddelada hidde-keena taas oo u keeni lahayd daaweyn cusub oo la yiraahdo koontaroolka difaaca jirka , oo ku salaysan daraasado hore. Sidaas darteed, koox cilmi-baaris ah oo ASH eegtay 210 bukaanno oo loo daweeyay cudurka jaban ama dib-u-soo-noqoshada HL si loo arko sida loo baaro horjoogaha horjoogaha ee pembrolizumab.
Qaar ka mid ah unugyada kansarka ayaa soo saara xaddi badan oo ah PD-L1, taasina waa wax ka caawisa inay ka baxsadaan weerarka difaaca. Pembrolizumab ayaa kaa caawin karta joojinta taas. PD-1 xannibaadda oo ay la socdaan dawooyinka lagu magacaabo pembrolizumab ayaa ka shaqeeyey kooxo bukaano ah oo leh qoryo caadi ah oo si aad ah loogu daaweyn jiray daweyno kale. Pembrolizumab waxay leedahay xaddiga sare ee xitaa cudur ku jira adkaysiga kiimikada. Natiijooyinka dheeraadka ah, oo ay ku jiraan inta laga gaadhayo jawaabta la sugayey ayaa laga filayey kulanka.
Cilmi-baaris ku saabsan Leukemia
Daaweynta Taageerada ee Bukaanjiifka leh AML - Eltrombopag
Bukaannada ayaa daaweynaya kiimiko badan oo la yiraahdo 'leukemia leukemia' (AML) , mararka qaarkood qaliinka tirakoobka ayaa hoos u dhaca ka dib daweynta kiimikada, taasina waxay keeni kartaa khataro badan oo dhiigbax ah, baahida loo qabo in badan oo dhiiga la isku qaadsiiyo, iyo bukaanku waxay horumarin karaan ficil-celinta difaaca taramadaha, kuwaas oo dhammaantood u adeega inay hor istaagaan horumarka.
Sannadka 2016 koox ayaa sheegtay inay isticmaasho altrombopag, dawo ujooga jirka si ay u sameeyaan tarootiin badan, dadka waayeelka ah ee daaweynayay AML.
Natiijooyinka ayaa ahaa hordhac-tani waa wajiga I ee daraasada sahlan-laakiin waxay u muuqdeen inay guulo ka soo hooyeen in dadku ay si degdeg ah uga soo kabtaan chemo si aysan u baahnayn in la siiyo wareejin badan oo tubaako. Waxaa jiray arrin walaac ah in wakiil sida eltrombopag ay dedejin karto horumarka leetemia, marka lagu daro faa'iidooyinka faa'iido leh ee caawinta taramadaha ay soo kabsadaan, si kastaba ha ahaatee, illaa hadda daraasaddan ma jirto wax caddayn ah in halistu ay tahay mid dhab ah.
Lafdhabarta ama Neefsashada Lymphoblastic Lymphoblastic (ALL)
Ma jiro nidaam caadi ah oo loogu talagalay ALL relay. Inotuzumab ozogamicin waa daaweyn degdeg ah oo FDA loogu talagalay daaweynta bukaanka qaba cudurka lymphoblastic ee laf-dhabarka (ALL). Hal tijaabo oo kiliinik ah, inotuzumab ozogamicin waxay soo saartey horumarin weyn oo ka timaadda kiimikada caadiga ah ee bukaanka oo leh DHAMMAAN inay nadiif noqoto, ama aysan ka jawaabin, daaweynta kale.
Inotuzumab ozogamicin waa unugyada daawada ee antibody-ka ee ka samaysan antibiyo ku xiran wakiil oo dila unugyada kansarka. Marka daroogadu ay ku xiran tahay summad loogu yeero CD22 oo ku saabsan unugyada kansarka, waxay ku dhex jirtaa unugyada halkaasoo ay sabab u tahay DNA-da in ay jebiso, taasoo keenta dhimashada unugyada.
Maxay Cilmi-baaristu adiga kuu leedahay
Inkasta oo shirarka badanaa la sameeyo si loo siiyo dhakhaatiirta caafimaadka cilmi-baaristii ugu dambeysay, macluumaadka badanaa waa xiiseyneysaa kuwa lagu sheegay shuruudaha, iyo sidoo kale kuwa ay jecel yihiin. Markaad booqanayso dhakhtarkaaga weydii wixii ku cusub ee ku dhexjirta goobta aqoonta waxay kaa caawin kartaa inaad dareento wax badan inaad ilaaliso caafimaadkaaga.
> Ilo:
> 469 Wajiga III Daraasada Habdhaqanka ee R-CHOP Versus DA-EPOCH-R iyo Falanqaynta Molecula ee Lymphoma Leh Boog Leh Leh: CALGB / Alliance 50303
> 474 Lalalidomide Dayactir Muhiim ah oo Hagaajineysa Tirada Nabadgalyada Tirada Bukaan-jiifka Iskuday Boogada Leh-B-Cell Lymphoma (RDLBCL) Yaan U Kuma Qalan Karno Qalitaanka Qalitaanka Qalooca Mobilka (ASCT): Natiijooyinka Ugu Dambeeya ee Maxkamadda 2aad
> 470 Obinutuzumab ama Rituximab Plus CHOP ee Bukaanjiifka hore ee aan la daweynin Kala-hadhmo Leh-B-Cell Lymphoma: Natiijooyinka Ugu Dambeeya ee Furan, Falanqaynta Wajiga 3aad (GOYA)
> 1107 Pembrolizumab ee Lafdhabarka / Hoos u Dhiska Hodgkin Lymphoma: Falanqaynta Ugu Horreeya ee Wajiga 2aad ee Keynote-087 Study
> 447 Tababarka Keli ah, Tababarka 2aad ee Daraasadda Eltrombopag si loo Hagaajiyo Tirada Booska Tirada Soo-kabashada ee Bukaannada Waayeelka leh Cudurka Dib-u-Dhaca ee Maqaar-la'aanta Muraayadda Dhiig-baxa
> 6 Soo-saarista iyo Dib-u-dhiska Obinutuzumab-ku-saleysan oo sii dheeraaday sii-dheellitirnaan la'aan-bilaash ah (PFS) ee bukaan-jiifka leh Lymphoma hore loo sii daaweyn: Natiijooyinka Aasaasiga ah ee Wareega 3aad GALLIUM Study