Maxaa Cusub ee Cusub ee Daaweynta Kansarka Qanjidhka |

Daaweyn loogu talagalay kaansarka daawada u adkaysta ee kaansarka leh

Waxyaabo badan ayaa isbeddelay daaweynta kansarka qanjirka 'prostate' sanadihii la soo dhaafay. Tani waxay si gaar ah u tahay runta daaweynta kansarka qanjirka 'prostate-resistant-resistant prostate' (mCRPC). Kani waa kansarka qanjirka 'prostate' kaas oo ku fashilmay daaweyn asaasi ah (qalliin, shucaac iwm.) Waxaana uu sii waday inuu joojiyo daaweynta hoormoonka (xannibaadda iyo xakamaynta).

Tani waxay sidoo kale khuseysaa bukaanada ay la kulmaan cudur halis ah oo ay ku dhacaan daaweynta hormoonnada. Ka hor inta aan la bilaabin isticmaalka kemotherabi ee bukaankan, celceliska nolosha ayaa qiyaastii ahayd 8 bilood. Chemotherapy ayaa fiicnayd tan, laakiin ma aha daaweyn.

Laga bilaabo 2010 dhowr daaweyn oo cusub ayaa loo heli karaa bukaanada qaba mCRPC. Waxyaabaha soo socda ayaa ah sharaxaad kooban oo ku saabsan daaweynta cusub.

1. Abi-virone Acetate (Zytiga) - Zytiga wuxuu horjoogsanayaa soo saarida tijaabada baaritaanka testosterone iyo hoos u dhigidda heerarka testosterone. Badanaa waxaa la siiyaa jimicsi. Zytiga waxaa markii hore lagu tilmaamey bukaanno ku dhacay jimicsi (chemotherapy), laakiin daraasadihii dhawaa waxay muujiyeen faa'iidada bukaan-socodka pre-chemo. Mid ka mid ah daraasaddan ayaa muujisay in korodhka sii wacyigelinta cudurrada shucaacu (RPFS) ay ka badnayd 16 bilood Abiraterone iyo prednisone group ilaa 8 bilood kooxda gacanta ku haya.
2. Enzalutamide (Xtandi) - Si rasmi ah loo yaqaan MDV3100 daawadani waa jiilka labaad ee xayawaanka iyo xayawaanka. Wuxuu ka shaqeeyaa dibadda iyo gudaha gudaha unugga. Waxaa markii hore lagu tilmaamey bukaansocodka daaweynta ka dib ee mCRPC laakiin baadhitaanadu waxay muujiyeen faa'iidada bukaan-socodka ka hor-chemo. Daraasada PREVail waxay muujisay in celcelis ahaan, enzalutamide dib u dhigtay baahida loo qabo daaweynta kiimiko ilaa 17 bilood (28 iyo 11). Waxa kale oo ay muujisay in isticmaalka daroogada ay dib u dhigtay koritaanka shucaaca 81%.

1. Radium 223 Dichloride (Xofigo) - Inkastoo tani ay tahay cirbad, dhab ahaantii waa nooca shucaaca ee loo yaqaan alpha radiation. Daaweynta waxaa loogu talagalay in lagu barto unugyada kansarka qanjirka 'prostate' ee lafaha. Lafaha qaba kansarka qanjirka 'prostate' ayaa doorbidaya inuu xoqdo Xofigo. Radium ka dibna sii daaya shucaaca alpha, taas oo ah mid aad u gaaban. Fikradda waa in la dilo unugyada kansarka firfircoon oo leh dhaawac yar oo lafaha caadiga ah. Tani waa inay ahaato mid la beegsado marka loo eego strontium-89, oo hore loo adeegsaday. Daraasaduhu waxay muujiyeen in korodhka noolaanshaha bukaanada qaba mCRPC iyo metastasis lafo.

1. Sipuleucel-T (Provenge) - Sipuleucel-T waa tallaal cudurka kansarka loogu talagalay kansarka qanjirka 'prostate'. Waxaa loogu talagalay asmada ama astaamaha calaamadaha astaamaha leh ee mCRPC. Waxaa shakhsi ahaan loogu talagalay bukaanka kasta wuxuuna u baahan yahay dhiig. Dhiiggu wuxuu ku shaqeeyaa shaybaarka kadibna dib loo soo celiyo toddobaadka dambe. Daaweynta waxaa la siiyaa 3 jeer muddo bil ah. Waa tallaabada koowaad ee daweynta kansarka ee loo yaqaan 'FDA' (oo ka soo horjeeda tallaal ka hortag ah). Badbaadinta guud waxaa lagu kordhay isticmaalka Baadhitaanka Calaamadaha lagu yaqaan 'symptomatic or minimalally symptomatic patients' ee mCRPC.

Su'aalaha lagu rajeynayo in la caddeeyo mustaqbalku waa sida ugu wanaagsan ee loo kala qaado daaweyntan cusub? Marka bukaanku ku dhaco hormoonnada, waa in daawada la isticmaalo marka hore ama waa in chemo la bilaabo? Daaweeyntu waxay bixisaa qiimaha ugu fiican? Daawooyinkani ma loo isticmaali karaa kali ama isku dhafan? Inkasta oo ay jiraan su'aalo badan oo ku-meel-gaadhka ah ee ku-xigeenka cusub ee loo yaqaan 'armamentarium' ayaa dhab ahaantii ka faa'iideysan doona bukaanno badan.

_Ilaha

_{Rathkopf DE, Smith MR, De Bono JS, iyo al. Cusbooneysiinta falanqaynta ku-meel-gaadhka ah (IA) ee COU-AA-302, daraasaddan aan kala-sooc lahayn ee III ee daraasada abiraterone acetate (AA) ee bukaanada (pts) oo leh kansar-celis-celis-celinta qanjirka 'prostate' (mCRPC) iyada oo aan lahayn kiimiko hore. J Clin Oncol. 2013; 31 (ku dar 6, abstr 5).}

_{Beer TM. al. Enzalutamide ee ragga qaba daaweynta kansarka qanjirka 'prostate' (mCRPC): Natiijooyinka jaangooyada 3aad ee PREVAIL. J Clin Oncol 32, 2014 (ku dar 4: abstr LBA1 ^).}

_{Parker C et al. Alpha Emitter Radium-223 iyo Badbaadinta Kansarka Prostate ee Metastatic. N Engl J Med. 2013; 369: 213.}

_{Longo DL (Julaay 2010). "Daaweyn cusub oo loogu talagalay kaansarka difaaca jidhka ee difaaca". N. Engl. J. Med. 363 (5): 479-81.}