Ibrutinib, Brentuximab, Blinatumomab ndi Idelalisib
Bungwe la American Society of Hematology (ASH) ndilo bungwe lapamwamba kwambiri padziko lonse lapansi lomwe likukhudzidwa ndi zomwe zimayambitsa ndi chithandizo cha matenda a magazi. Chaka chilichonse, zabwino ndi zowala kwambiri padziko lonse lapansi zimabwera kudzakhala ndi ASH.
Chaka chino, pamakhala zokambirana zatsopano zothandizidwa ndi FDA zokhudzana ndi matenda a hematologic. Iwo unachitikira chifukwa madokotala ankafuna zambiri zokhudza zowonjezera za FDA zatsopano.
Oyankhula amayang'ana mauthenga osiyanasiyana zokhudza mankhwala atsopano, kuphatikizapo ibrutinib (Imbruvica), ndi idelalisib (Zydelig).
Kwa ambiri, msonkhano wa December wa ASH umakhala ngati chiwonetsero cha zonse zomwe zasintha mu hematology ndi oncology. Nazi zinthu zingapo chabe zomwe anthu adakambirana.
Ibrutinib (Imbruvica)
Mapuloteni osiyana kapena ma complexes, monga ma enzyme, amathandiza kugwira ntchito mu selo-njira imene maselo "amamvetsera" ndi kumvetsera zizindikiro za mankhwala. Tyutine Kinase (BTK) ya Bruton (BTK), yomwe imathandiza kwambiri pachithunzi cha B-selo, ndi chitsanzo cha pulojekiti yoteteza selo. Ibrutinib ndi kamolekyu kakang'ono kamene kamateteza BTK ya enzyme.
Mwa kulepheretsa puloteni iyi, ibrutinib imasokoneza njira yowonetsa kuti maselo ena a khansa amadalira. Malingana ndi zovuta mpaka pano, a FDA aika ibrutinib ngati mankhwala opambana, omwe amathandizira kuthetsa malungo otsatirawa:
- Odwala a Lymphocytic leukemia (CLL) amene analandira mankhwala osachepera amodzi
- Odwala a Lymphocytic leukemia (CLL) omwe amachotsa 17p
- Odwala Mantle cell lymphoma (MCL) amene analandira mankhwala osachepera amodzi
Ibrutinib ndi mapiritsi omwe amatengedwa kamodzi pa tsiku ndipo amalekerera bwino. Kugwiritsiridwa ntchito kwa wothandizirayo kumafufuzidwa pakuthandizidwa kwa khansa zina, zonse zokha komanso kuphatikizapo mankhwala osiyanasiyana.
Idelalisib (Zydelig)
Idelalisib ndi FDA -vomerezedwa kwa anthu omwe ali ndi kachilombo kochedwa Lymphocytic leukemia (CLL) , anabwezeretsanso mtundu wa B-cell osati Hodgkin lymphoma (FL), ndipo anabwezeretsanso pang'ono lymphocytic lymphoma (SLL, mtundu wina wosakhala Hodgkin lymphoma).
Chivomerezocho chinachokera pa zomwe anapeza pa mayesero kwa odwala 220 omwe anagwiranso ntchito CLL, kumene mankhwala ochiritsira achilengedwe sanali okonzedweratu. Dipatimentiyi inali yodalirika + rituximab kapena placebo + rituximab. Chigamulochi chinapangitsa kuchepetsa 82 peresenti ya chiopsezo cha khansa ndi idelalisib, kotero iwo anaimitsa msanga, kulola a placebo + rituximab odziwa zonse za idelalisib ndi kuwapatsa mankhwala atsopano. Odwala onse m'gulu la rituximab + placebo adayamba kulandira idelalisib.
Brentuximab vedotin (Adcetris)
Wothandizirayi ndi jekeseni wa kulowetsa m'mimba. Brentuximab vedotin ili ndi njira yosangalatsa yogwirira ntchito. Ndi wothandizidwa ndi injini - imagwirizanitsidwa ndi wothandizira omwe amathandizira kupha maselo a kansa akangomaliza kumene. Cholinga cha puloteni chotchedwa CD30, chomwe chili mu classical Hodgkin lymphoma (HL) komanso mu systemic anaplastiki lalikulu cell lymphoma (SCLCL).
Phunziroli linakambidwa pa ASH ndilo loyambirira mu lymphoma kusonyeza kuti kuwonjezera kwa mankhwala osungirako mankhwala pambuyo pa kusamuka kungathe kusintha kwambiri zotsatira za odwala.
Mu mlanduwo wa AETHERA, pafupifupi 63 peresenti ya odwala omwe ali ndi vuto loopsa la lymphoma omwe adachiritsidwa ndi mankhwalawa adatha kupulumuka kwa miyezi 24 poyerekeza ndi 51 peresenti ya odwala omwe analandira placebo.
Blinatumomab (Blincyto)
Mankhwalawa ndi mankhwala oyambirira a BITE (Bi-specific T Cell Engager) kuti avomerezedwe. Awonetsa zochitika zazikulu mu B-cell acute lymphocytic khansa ya m'magazi (ALL) odwala omwe ali ndi matenda ochepa omwe atsala pang'ono kupatsirana , malinga ndi ofufuza a ASH. Blinatumomab inachotsa maselo a khansa kuchokera kwa 78% mwa odwala 112.
Malingana ndi National Cancer Institute, blinatumomab ndi anti-antibody yomwe imatha kupanga mphamvu ya chitetezo cha mthupi ndikupita kanseri ndi ntchito zapirinoplasitiki.
The FDA inavomereza blinatumomab kuti athetse odwala ali ndi Philadelphia chromosome -negative precursor B-cell acute lymphoblastic leukemia (B-cell ALL), mawonekedwe osadziwika a ONSE.
Yang'anirani Niccola Gokbuget, MD, fotokozani momwe blinatumomab ikugwirira ntchito.
Nkhondo zoyambira ku kukhululukidwa konse
Deta ya nthawi yaitali kuchokera pachiyeso pogwiritsa ntchito chimeric antigen receptor (CAR) T maselo inasonyeza kuti maselowa akugwedezeka kwa nthawi yaitali, akugwira ntchito yawo, ndikuwombera nthawi yaitali. Ambiri mwa asayansi amakhulupirira kuti mtundu uwu wa mankhwalawa ndi mitundu yambiri ya khansa yomwe sichikuvutanso.
Zindikirani pa Zotsatira Zotsatira
Zindikirani, onsewa ali ndi zotsatira zoyipa, zina zomwe zingakhale zovuta, ndipo zina zomwe sizidziwikabe. Monga momwe zilili ndi mankhwala onse, chisankho chochizachi chimakhudzidwa ndi zomwe zimadziwika potsata zowopsa ndi zopindulitsa za mankhwala ndi zifukwa zina za odwala.
Zotsatira
National Cancer Institute. Zokhudza matenda a Blinatumomab. http://www.cancer.gov/drugdictionary?cdrid=487684. Idapezeka mu December 2014.
MedPageToday. http://www.medpagetoday.com/MeetingCoverage/ASHHematology/48998. Idapezeka mu December 2014.