Ibrutinib, Brentuximab, Blinatumomab iyo Idelalisib
Jaaliyada Maraykanka ee Hematology (ASH) waa jaaliyadda ugu weyn ee xirfad-yaqaanada ee caalamiga ah ee ku lug leh sababaha iyo daaweynta cudurada dhiiga. Sannad kasta, kan ugu fiican iyo kan ugu qurxan adduunka oo dhan wuxuu yimaadaa ASH.
Sannadkan, waxaa jiray kulan ku saabsan daaweyn cusub oo FDA ah oo la aqoonsan yahay oo loogu talagalay xaaladaha kudhaca shucaaca. Waxaa la qabtay sababtoo ah dadka daaweeya waxay doonayeen macluumaad dheeraad ah oo ku saabsan qaar ka mid ah dhowrista oggolaanshaha FDA.
Afhayeenka ayaa dib u eegay macluumaad badan oo ku saabsan daroogooyinka cusub, oo ay ku jiraan ibrutinib (Imbruvica), iyo idelalisib (Zydelig).
Dad badan, shirkii Diseembar ee ASH waxay u adeegtaa sidii bandhig loogu talagalay horumarka laga sameeyay sanadka soo socda ee kudhaca jimicsiga iyo shimbiraha. Halkan waxa ku yaal dhawr ka mid ah waxyaabaha ay dadku ka hadlaan.
Ibrutinib (Imbruvica)
Protein kala duwan ama isku dhafan, sida enzymes, doorka doorka unugyada unugyada - habka unugyada "dhegeysanaya" kana jawaabaan calaamadaha kimikalka. Bruton's Tyrosine Kinase (BTK), oo ah enzim oo kaalin muhiim ah ka ciyaara horumarinta B-cell, ayaa tusaale u ah sida enzymo oo kale oo xakameynaya calaamadaha gacanta. Ibrutinib waa molecule yare oo ka horjeeda BTK enzim.
By blocking enzyme this, ibrutinib waxa uu farageliyaa marin-wadareedka in unugyada kansarka qaarkood ay ku tiirsan yihiin. Iyada oo ku saleysan guulaha fog, FDA waxay u sharaxday ibrutinib oo ah daweyn degdeg ah, iyada oo door ka qaadashada daaweynta calaamadaha soo socda:
- Bukaannada qaba "lymphocytic leukemia" (CLL) ee qaata ugu yaraan hal daaweyn oo hore
- Cudurrada "lymphocytic leukemia" (CLL) bukaanada leh 17p deletion
- Bukaanka laf-dhabarka mantarka (MCL) bukaanka qaata ugu yaraan hal daaweyn oo hore
Ibrutinib waa kiniin la qaato maalintii hal mar oo si cadaalad ah loo dulqaato. Isticmaalka wakiil waxaa sidoo kale lagu baari karaa daaweynta kansarrada kale, labadaba oo keliya iyo isku dhafka dawooyinka kala duwan.
Idelalisib (Zydelig)
Idelalisib waa FDA-loo ogolaaday dadka qaba lymphocytic leukemia (CLL) , oo dib u soo noqda qanjidhada B-cell un non Hodgkin lymphoma (FL), iyo dib-u-soo-celinta lymphocytic lymphoma (SLL, nooc kale oo ah non-Hodgkin lymphoma).
Oggolaanshaha waxay ku saleysneyd natiijadii tijaabada 220 oo bukaan ah oo leh CLL-ku-noqoshada, oo aan la qorsheynin kiimiko caadiga ah. Cadaadiska wuxuu ahaa idelalisib + rituximab ama placebo + rituximab. Maxkamadeynta ayaa muujisay in 82% hoos u dhaca khatarta ah ee kansarka uur-ku-jirta, sidaas awgeed way joojiyeen horraantoodii, iyada oo la siinayo bukaanka xayawaanka + rituximab si ay u ogaadaan dhammaan waxyaabaha ku saabsan daawada iyo daawada cusub. Dhammaan bukaannada ku jira kooxda rituximab + ee plasebo ayaa markaa bilaabay helitaanka dhakhtarka.
Brentuximab vedotin (Adcetris)
Wakaalkan waa cirbadeynta faleebo xidid. Brentuximab vedotin waxay leedahay ficil ficil ah oo ficil ah. Waa antibody injineer ah - waxaa lagu daraa wakiil caawiya dilida unugyada kansarka marka ay gaaraan bartilmaameedkooda. Waxaa loogu talagalay borotiin la yiraahdo CD30, taas oo ku jirta Hodgkin lymphoma (HL) iyo nidaam ahaan anaplastic lymphoma (sALCL).
Daraasadan ka hadlaysay ASH waxay ahayd markii ugu horeysay ee lymfoma si ay u muujiso in lagu daro daroogo dayactir ah ka dib markii tallaalka loo bedelay natiijada bukaanka.
Diiwangalinta AETHERA, qiyaastii 63% bukaannada qalliinka ah ee halista ah ee lagu daaweeyay daroogada ayaa heley 24 bilood oo bilaash ah oo aan noolaan karin iyadoo la barbar dhigayo 51% bukaannada qaata kiniinada.
Blinatomomab (Blincyto)
Daawadani waa tan ugu horeysa ee daawada BEE (T-ga gaar ah ee T Cell) si loo oggolaado. Waxay muujisay waxqabad muhiim ah oo ka mid ah bukaan-socodka lymphocytic leukemia (ALL) bukaanka oo leh cudur aan haysanin ka dib daaweynta induction , sida ay qabaan cilmi-baadhayaasha ASH. Blinatumomab waxay nadiifisay unugyada kansarka haraaga ah 78% ee bukaanka la daweeyey 112.
Sida laga soo xigtay Machadka Kansarka Qaranka, blinatumomab waa antibio injineernimo leh oo suurtogal ah in labada kiciyo habka difaaca jirka oo la raaco kansarka leh hawlaha antineoplastic.
Qalabka FDA ee loo yaqaan 'FDA' ayaa ogolaaday bukaanada qaba Philadelphia chromosome- hormarin B-unugyada lymphoblastic lymphoblastic (B-cell ALL), oo ah nooc aan caadi aheyn oo dhan.
Eeg Niccola Gokbuget, MD, sharax sida blinatomomab u shaqeyso.
Gawaarida Hogaaminaya All Remission
Xogta muddada dheer ee tijaabada ah ee la isticmaalayo qalliinka antigen-ga (CAR) T-yada ayaa muujiyay unugyadaas dib-u-dhiska ah ee wakhti-wakhti ah, iyagoo qabanaya shaqadooda, taasoo horseed u ah inay si dhibco ah u dheeraato. Qaar badan oo ka mid ah bulshada cilmi-baarista waxay ku rajo weyntahay nooca daaweynta noocyada kala duwan ee kansarka noocyo kala duwan oo kansar ah oo si kale u adag in la qaato.
Ogsoonow saameynta daaweynta
Xasuusta, dhammaan wakiilladaasi waxay leeyihiin waxyeelo, qaar ka mid ah oo laga yaabo inay halis yihiin, qaar ka mid ahna laga yaabo in aan weli la aqoon. Sida daawooyinka oo idil, go'aanka daaweynta waxaa saameyn ku yeelan kara waxa la yaqaan ee ku saabsan khatarta iyo khidmadaha daaweynta iyo xaaladaha qofka bukaanka ah.
Ilaha
Machadka Kansarka Qaranka. Macluumaadka bukaanka Blinatumomab. http://www.cancer.gov/drugdictionary?cdrid=487684. Lasoo gooyey December 2014.
MedPageToday. http://www.medpagetoday.com/MeetingCoverage/ASHHematology/48998. Lasoo gooyey December 2014.