Anthu opulumuka ku khansa amakhala ndi moyo wochuluka kuposa kale lonse, ndipo izi zikudumphadumpha chifukwa cha mankhwala atsopano. Masiku ano ku Chicago, pamsonkhano wa sayansi wotchedwa ASCO - msonkhano wapachaka wa American Society of Clinical Oncology - akatswiri a khansa akukumana ndi mavuto akuluakulu pa masewero enaake.
Amakhalanso ndi chiyembekezo chenichenicho, ndipo nthawi zina amasangalala.
Deta-break data imasonyeza kuti Gazyva, mankhwala atsopano oletsa khansa , akuthandiza gulu lapadera la anthu omwe akulimbana ndi khansa ya magazi yomwe imadziwika kuti si Hodgkin lymphoma, kapena NHL.
About Lymphoma ya Non-Hodgkin
Pali mitundu iwiri ikuluikulu ya lymphoma: Hodgkin's lymphoma ndi NHL. Pafupifupi 85 peresenti ya mitsempha yonse yomwe imapezeka ndi NHL. Malingana ndi American Cancer Society, anthu pafupifupi 72,000 adzapezeka ndi NHL ku United States mu 2015, ndipo pafupifupi 20,000 adzafa ndi matendawa.
Pa Phunziro
Zosankha zabwino zilipo kale kwa anthu akulimbana ndi mitundu yambiri ya khansa ya magazi . Komabe, monga opulumuka amadziwa, nthawi zina si nkhani yongopambana nkhondo imodzi .
Anthu ambiri amadziwika ndi rituximab (Rituxan), ndipo phindu lokhalapo likugwirizana ndi kugwiritsidwa ntchito kwa mapuloteni oterewa - mapuloteni akuluakulu omwe amawongolera kuti awononge ndi kuwononga maselo a khansa mogwirizana ndi chemotherapy kwambiri kuposa chemotherapy yekha.
Phunziroli linaperekedwa ku ASCO limene linagwiritsa ntchito mankhwala osokoneza bongo omwe amatchedwa obinutuzumab omwe amavomerezedwa ndi FDA pansi pa dzina la malonda Gazyva kuyambira 2013 pofuna kuchiza matenda odwala matenda a m'magazi omwe amaphatikizapo matenda a chlorambucil chemotherapy odwala omwe alibe chithandizo.
"Tinapanga Gazyva kuti tipititse patsogolo mankhwala omwe alipo tsopano ndipo tinkasangalala kuona momwe zinapindulira anthu omwe asiya kutsatira ndondomeko ya chisamaliro," anatero Nancy Valente, MD, Vicezidenti, Global Hematology Development Genentech.
Phunzirolo, lotchedwa kuphunzira GADOLIN, likuwonetsa kuthekera kwa Gazyva mu dongosolo ili. Dr. Valente akuwonetsa kuti ndondomekoyi ndiyomwe ikuyendera kuti avomereze Gazyva mu NHL pogwiritsa ntchito detazi ndipo akuyembekeza kuona zotsatira kuchokera ku maphunziro ena akuluakulu omwe akufanizira mutu wa Gazyva kumodzi mwawo mankhwala.
Odwala
Ophunzira pa phunziroli anali amuna ndi akazi omwe ali ndi khansara - 413 mwa iwo. Onsewa anali ndi NHL yochepa kapena yopanda ulemu yomwe idapitabe ngakhale atalandira chithandizo. Mwachindunji, khansa zawo zinali zotsutsana ndi mankhwala a rituximab - omwe ndi rituximab kapena rituximab kuphatikizapo chemotherapy - zomwe zikutanthauza kuti matenda awo apita mkati kapena mkati mwa miyezi isanu ndi umodzi ya chithandizochi .
Kuchiza
Phunzirani ophunzira omwe ali ndi NHL yosalekeza yopititsa patsogolo anaikidwa m'magulu awiri, kuti athe chithandizo china:
- Gazyva kuphatikizapo bendamustine, yotsatira Gazyva yokha
- Bendamustine chemotherapy yekha
Zotsatira
- Thandizo la Gazyva linachepetsera chiopsezo cha matenda owonjezereka kapena kufa ndi 45 peresenti poyerekeza ndi chemotherapy yekha.
- Phunziroli linaimitsidwa oyambirira chifukwa cha phindu lopindula lomwe linagwiritsidwa ntchito mu gulu la Gazyva poyerekeza ndi gulu la bendamustine - ndiko kuti, sikukanakhala zoyenera kuti gulu la bendamustine likhale khungu chifukwa cha zotsatira za gulu la Gazyva.
Panalibe zizindikiro zosayembekezereka zotetezera zomwe zimadziwika ndi Gazyva.
Kodi izi zikutanthauza chiyani?
Munthu yemwe ali ndi NHL wosadziwika nthawi zambiri amapitiliza kubwereranso ndi kukhululukidwa, ndipo zosankha zingakhale zochepa ngati mankhwala a rituximab amasiya kugwira ntchito. Choncho, kuphatikiza kwatsopano komwe kumawoneka kuti kumawathandiza kwambiri odwala omwe akutsutsa ndi uthenga wabwino.
"Anthu ambiri omwe ali ndi vuto la NHL losavomerezeka mobwerezabwereza, ndipo njira zamankhwala zimakhala zochepa kwambiri ndipo mayankho amatha kuchepetsa nthawi iliyonse yomwe matendawa amabwera. Ndimalimbikitsidwa ndi deta ya GADOLIN chifukwa obinutuzumab ndi bendamustine ndizowonjezera. Laurie Sehn, MD, Medical Oncologist ku BC Cancer Agency ndi Professor Associate Professor ku yunivesite ya British Columbia.
Za Gazyva
Phunziro la lymphoma la lero, Gazyva adalimbikitsa nthawi yomwe anthu okhala ndi NHL omwe amatsutsana ndi nkhanza akukhala popanda matenda awo. Genentech ndi Roche, makampani a sayansi ya zakuthambo omwe amapanga mankhwala awa, adzatumiza deta kuchokera ku phunziroli kwa akuluakulu olamulira ku United States, Europe ndi padziko lonse kuti avomereze.
Gazyva ndi anti-monoclonal antibody yokonzedwa kuti igwirizane ndi CD20, mapuloteni omwe amapezeka pa B-maselo okhaokha, omwe amapangidwa ndi rituximab. Gazyva imapha maselo a CD20 molunjika komanso pamodzi ndi chitetezo cha thupi. Gazyva imaganiziridwa kuti imakhala ndi mphamvu yowonjezereka yopangitsa selo yeniyeni kufa ndipo imapangitsa ntchito yaikulu momwe imagwirira ntchito chitetezo cha mthupi kuti chiteteze B-maselo - cytotoxicity ya anti-dependent cell, kapena ADCC - poyerekeza ndi rituximab.
Zotsatira Zotsatira ndi Zoipa Zochitika
Pogwiritsidwa ntchito payekha, zotsatira za Gazyva ndizosawerengeka kwambiri kuposa zotsatira za mankhwala a chemotherapy. Zotsatira zofala kwambiri ndi Gazyva ndizokakanikirana, kuchepa kwa maselo oyera a m'magazi, chiwerengero chochepa cha platelet, chiwerengero chochepa cha maselo ofiira a magazi, malungo, chifuwa, mseru, ndi kutsekula m'mimba.
Gazyva ingayambitse mavuto aakulu kapena owopsya: Kutsegula kwa hepatitis B, kupitilira maulendo amtundu wa multifocal leukoencephalopathy, kapena PML, kukhudza kulowetsedwa, tumor lysis syndrome ndi matenda. Ndiponso, Gazyva ikhoza kuyambitsa kusokonezeka, kuchepa kwa chiwerengero cha maselo oyera a magazi ndi kuchepa mu chiwerengero cha platelet chomwe chingakhale choopsa kapena chowopsya.
Zotsatira
GADOLIN: Zotsatira zapadera kuchokera ku gawo lachitatu la obinutuzumab plus bendamustine poyerekeza ndi bendamustine okha pa odwala okhala ndi rituximab-refractory indolent non-Hodgkin lymphoma. J Clin Oncol 33, 2015 (suppl; pansi LBA8502).
Chithandizo choyembekezeredwa cha chronic lymphocytic khansa ya m'magazi: mwayi wathanzi wa obinutuzumab. Pharmacogenomics ndi Personalized Medicine. 2014; Dec 22; 8: 1-7.