Izvo Zvaunofanira Kuziva Nezve Genetic Kuedza kweLung Cancer

Zvemukati

• Chii chinonzi genetic mutations?
• Kune mangani marudzi eNSCLC aripo?
• Chii chandinofanira kuziva nezve genetic test?
• Izvi zvinokanganisa sei kurapwa?
• EGFR
• EGFR T790M
• ALK / EML4-ALK
• Mamwe marapirwo

Yisiri-diki kenza yemapapu kenza (NSCLC) izwi rechimiro chinokonzerwa neanopfuura rimwe geni mutation mumapapu. Kuedzwa kweshanduko dzakasiyana idzi kunogona kukanganisa sarudzo nemhedzisiro yekurapa.

Enderera kuverenga kuti udzidze nezvemhando dzakasiyana dzeNSCLC, uye bvunzo nemishonga zviripo.

Chii chinonzi genetic mutations?

Genetic mutations, ingave yakagara nhaka kana yakawanikwa, inoita basa mukukura kwegomarara. Shanduko zhinji dzakabatanidzwa muNSCLC dzakatoonekwa. Izvi zvakabatsira vatsvagiridzi kugadzira mishonga inotarisa zvimwe zveawo maratidziro.

Kuziva kuti ndedzipi shanduko dziri kutyaira kenza yako kunogona kupa chiremba wako zano rekuti gomarara richaita sei. Izvi zvinogona kubatsira kuona kuti ndeipi mishonga ingangoita inoshanda. Inogona zvakare kuona mishonga ine simba isingabatsire pakurapa kwako.

Ichi chikonzero nei kuongororwa kwemajini mushure mekuongororwa kweNSCLC kwakakosha. Inobatsira kugadzirisa kurapwa kwako.

Huwandu hwezvakanangwa kurapwa kweNSCLC zvinoramba zvichikura. Tinogona kutarisira kuona kwakawanda kufambira mberi sevatsvagiri vanowana zvimwe pamusoro pehumwe hutachiona hunokonzera NSCLC kufambira mberi.

Kune mangani marudzi eNSCLC aripo?

Kune maviri epamhando mikuru yekenza yemapapu: diki kenza yemapapu kenza uye isiri-diki kenza yemapapu kenza. Inenge makumi masere kusvika makumi masere neshanu muzana ezvegomarara remapapu ese NSCLC, ayo anogona kupatsanurwa kuita madiki aya

• Adenocarcinoma
  inotanga mumasero madiki anoburitsa mamus. Iyi subtype inowanzo kuwanikwa mu
  zvikamu zvekunze zvepapu. Zvinowanzoitika kazhinji muvakadzi kupfuura muvarume uye
  muvanhu vadiki. Kazhinji kenza inononoka kukura, ichiita kuti iwedzere
  inowanikwa mumatanho ekutanga.
• Squamous
  sero carcinomas tanga mumasero akati sandara anoyerera mukati medzemhepo
  mumapapu ako. Rudzi urwu runogona kutanga padyo nemugwagwa mukuru wepamhepo uri pakati
  yemapapu.
• Yakakura
  sero carcinomas inogona kutanga chero kupi mupapu uye inogona kuve ine hukasha.

Pasina kujairika subtypes anosanganisira adenosquamous carcinoma uye sarcomatoid carcinoma.

Paunenge iwe uchinge waziva kuti ndeupi rudzi weNSCLC wauinayo, nhanho inotevera inowanzo kuve yekutsanangudza chaiwo magene ekuti anogona kubatanidzwa.

Chii chandinofanira kuziva nezve genetic test?

Paunenge uine yako yekutanga biopsy, wako pathologist anga achiongorora kuvapo kwekenza. Iyo imwechete tishu sampuro kubva kune yako biopsy inowanzo shandiswa pakuongorora kwemajini. Genetic bvunzo dzinogona kuongorora mazana ezvisikwa.

Izvi ndizvo zvimwe zvekuchinja kwakanyanya muNSCLC:

• EGFR
  shanduko dzinoitika mune vangangoita gumi muzana yevanhu vane NSCLC. Inenge hafu yevanhu vane NSCLC vasina kumbobvira vaputa
  inowanikwa kuva neiyi geni mutation.
• EGFR T790M
  mutsauko muprotein yeEGFR.
• KRAS
  shanduko dzinobata ingangoita 25 muzana yenguva.
• ALK / EML4-ALK
  shanduko inowanikwa mukati mevashanu muzana yevanhu vane NSCLC. Zvinowanzoitika
  inosanganisira vechidiki uye vasingasvuti, kana vakaputa zvishoma vane adenocarcinoma.

Zvishoma zvakajairika magene ekuchinja anosangana neNSCLC anosanganisira:

• BRAF
• Kuende (KUE)
• MEK
• MET
• RET
• ROS1

Izvi zvinokanganisa sei kurapwa?

Kune akawanda marapirwo akasiyana eNSCLC. Nekuti haisi ese NSCLC akafanana, kurapwa kunofanirwa kutariswa zvakanyatso.

Yakadzama mamorekuru kuyedzwa inogona kukuudza iwe kana bundu rako riine chaiwo magene ekuchinja kana mapuroteni. Marapirwo akanangwa akagadzirirwa kubata chaiwo maficha ebundu.

Aya ndiwo mamwe marapirwo akanangwa eNSCLC:

EGFR

EGFR inhibitors inovhara chiratidzo kubva kuEGFR gene inokurudzira kukura. Izvi zvinosanganisira:

• afatinib (Gilotrif)
• erlotinib (Tarceva)
• gefitinib (Iressa)

Iyi yese mishonga yemumuromo. Kune epamberi NSCLC, iyi mishonga inogona kushandiswa yega kana nekemotherapy. Kana chemotherapy isiri kushanda, iyi mishonga inogona kushandiswa kunyangwe iwe usina EGFR mutation.

Necitumumab (Portrazza) ndeimwe EGFR inhibitor inoshandiswa yepamusoro squamous cell NSCLC. Inopihwa kuburikidza neiyo intravenous (IV) infusion pamwe chete nekemotherapy.

EGFR T790M

EGFR inhibitors inoderedza mamota, asi iyi mishonga inogona kupedzisira yamira kushanda. Kana izvo zvikaitika, chiremba wako anogona kuraira rekuwedzera bundu biopsy kuti aone kana iyo EGFR geni yakagadzira imwe shanduko inonzi T790M.

Muna 2017, iyo US Chikafu neDrug Administration (FDA) kuna osimertinib (Tagrisso). Mushonga uyu unobata epamberi NSCLC inosanganisira iyo T790M mutation. Mushonga uyu wakapihwa mvumo yekukurumidza muna 2015. Mushonga unoratidzwa apo EGFR inhibitors isiri kushanda.

Osimertinib imishonga yemuromo inotorwa kamwe pazuva.

ALK / EML4-ALK

Mishonga inorapa isina kujairika ALK protein inosanganisira:

• alectinib (Alecensa)
• brigatinib (Alunbrig)
• ceritinib (Zykadia)
• crizotinib (Xalkori)

Iyi mishonga yemumuromo inogona kushandiswa panzvimbo yekemotherapy kana mushure mekunge chemotherapy yamira kushanda.

Mamwe marapirwo

Mamwe marapirwo anotarisirwa anosanganisira:

• BRAF: dabrafenib (Tafinlar)
• MEK: trametinib (Mekinist)
• ROS1: crizotinib (Xalkori)

Parizvino, hapana kurapwa kwakatemerwa kwakanangana nekuchinja kweKRAS, asi kutsvagisa kuri kuenderera.

Tumota dzinoda kuumba tsinga dzeropa itsva kuti dzirambe dzichikura. Chiremba wako anogona kupa kurapwa kuti ubvise mutsva weropa kukura mune yakakwira NSCLC, senge:

• bevacizumab (Avastin), iyo inogona kushandiswa ne kana
  pasina chemotherapy
• ramucirumab (Cyramza), iyo inogona kusanganiswa ne
  chemotherapy uye inowanzo kupihwa mushure mekumwe kurapwa kusisiri kushanda

Mimwe mishonga yeNSCLC inogona kusanganisira:

• kuvhiya
• chemotherapy
• radiation
• palliative kurapwa kurerutsa zviratidzo

Zvemakiriniki miedzo inzira yekuyedza kuchengetedzeka uye kushanda kwemayedzo ekurapa ayo asati abvumidzwa kushandiswa. Taura nachiremba wako kana iwe uchida kudzidza zvakawanda nezve kiriniki miedzo yeNSCLC.