Izvo Zvaunofanira Kuziva Nezve Immunotherapy Kubudirira Mitero yeMelanoma

Zvemukati

• Mhedziso
• Mhando dzekudzivirira
• Checkpoint inhibitors
• Cytokine kurapa
• Oncolytic hutachiona kurapwa
• Kubudirira kwehuwandu hwe immunotherapy
• Ipilimumab (Yervoy)
• Pembrolizumab (Keytruda)
• Nivolumab (Opdivo)
• Nivolumab + ipilimumab (Opdivo + Yervoy)
• Cytokines
• Talimogene laherparepvec (Imlygic)
• Zvimwe zvinokanganisa immunotherapy
• Mutengo we immunotherapy
• Kliniki miedzo
• Mararamiro anochinja
• Outlook

Mhedziso

Kana uine kenza yeganda remelanoma, chiremba wako anogona kukurudzira immunotherapy. Rudzi urwu rwekurapa runogona kubatsira kusimbisa yako immune system mhinduro kupokana nekenza.

Mhando dzinoverengeka dzemununotherapy mishonga iripo yekurapa melanoma. Muzviitiko zvakawanda, iyi mishonga inonyorerwa vanhu vane nhanho yechitatu kana nhanho yechina melanoma. Asi pane dzimwe nguva, chiremba wako anogona kupa immunotherapy kurapa yakaderera mamelanoma.

Verenga pamusoro kuti udzidze zvakawanda nezve iro basa iro immunotherapy inogona kutamba pakurapa kwechirwere ichi.

Mhando dzekudzivirira

Kuti unzwisise kubudirira kwehuwandu hwehutachiona hwehutachiona, zvakakosha kusiyanisa pakati pemhando dzakasiyana dziripo. Kune matatu makuru mapoka eununotherapy anoshandiswa kurapa melanoma:

• checkpoint inhibitors
• cytokine kurapa
• oncolytic hutachiona kurapa

Checkpoint inhibitors

Checkpoint inhibitors mishonga inogona kubatsira immune system yako kuziva uye kuuraya melanoma gomarara reganda maseru.

Chikafu neDrug Administration (FDA) yakabvumidza matatu matatu eanotarisa ekurapa melanoma:

• ipilimumab (Yervoy), iyo inovhara yekutarisa protein CTL4-A
• pembrolizumab (Keytruda), inovhara puroteni yekuongorora PD-1
• nivolumab (Opdivo), iyo zvakare inovhara PD-1

Chiremba wako anogona kupa imwe kana kupfuura cheki inhibitors kana iwe uine danho rechitatu kana nhanho yechina melanoma isingakwanise kubviswa nekuvhiya. Mune zvimwe zviitiko, vanogona kunyorera chekiinhibitors pamwe chete nekuvhiya.

Cytokine kurapa

Kurapa nema cytokines kunogona kubatsira kusimudzira immune yako uye kusimbisa mhinduro yayo kurwisa cancer.

Iyo FDA yakabvumidza matatu marudzi ecytokines ekurapa melanoma:

• interferon alfa-2b (Intron A)
• pegylated interferon alfa-2b (Sylatron)
• interleukin-2 (aldesleukin, Proleukin)

Interferon alfa-2b kana pegylated interferon alfa-2b inowanzo gadzirirwa mushure mekunge melanoma yabviswa nekuvhiyiwa. Izvi zvinozivikanwa sekuwedzera kurapwa. Zvinogona kubatsira kudzikisa mikana yekenza kudzoka.

Proleukin inowanzo shandiswa kurapa nhanho yechitatu kana nhanho yechina melanoma yakapararira.

Oncolytic hutachiona kurapwa

Oncolytic hutachiona hutachiona hwakagadziridzwa kuti hutapure uye uuraye cancer maseru. Zvinogona zvakare kukonzera immune system yako kurwisa cancer maseru mumuviri wako.

Talimogene laherparepvec (Imlygic) hutachiona hwe oncolytic hwakagamuchirwa kurapa melanoma. Iyo inozivikanwawo seT-VEC.

Imlygic inowanzo gadzirirwa usati wavhiyiwa. Izvi zvinozivikanwa sekurapwa neoadjuvant.

Kubudirira kwehuwandu hwe immunotherapy

Immunotherapy inogona kubatsira kuwedzera hupenyu mune vamwe vanhu vane nhanho 3 kana nhanho yechina melanoma - kusanganisira vamwe vanhu vane melanoma isingakwanise kubviswa nekuvhiya.

Kana melanoma isingakwanise kuvhiyiwa, zvinozivikanwa semaranoma asingachinjiki.

Ipilimumab (Yervoy)

Mune ongororo yakaburitswa muna 2015, vaongorori vakaunganidza mhedzisiro yezvidzidzo gumi nezviviri zvekare pane yekutarisa inhibitor Yervoy. Vakaona kuti mune vanhu vane unresectable nhanho 3 kana nhanho 4 melanoma, 22 muzana yeavo varwere vakagamuchira Yervoy vaive vapenyu makore matatu gare gare.

Nekudaro, zvimwe zvidzidzo zvakawana yakaderera mitengo yekubudirira mune vanhu vanorapwa neichi chinodhaka.

Apo vaongorori kubva kuEURO-VOYAGE kudzidza vakatarisa mhedzisiro yekurapa muvanhu 1,043 vane advanced melanoma, vakaona kuti 10.9 muzana vakagamuchira Yervoy vakagara kweanenge makore matatu. Zvikamu zvisere muzana zvevanhu vakagashira mushonga uyu vakapona kwemakore mana kana kudarika.

Pembrolizumab (Keytruda)

Tsvagiridzo inoratidza kuti kurapwa naKeytruda chete kunogona kubatsira vamwe vanhu kupfuura kurapwa naJervoy chete.

Mune, masayendisiti akafananidza kurapwa uku kune vanhu vane unresectable nhanho 3 kana nhanho 4 melanoma. Vakaona kuti makumi mashanu neshanu muzana yeavo vakagamuchira Keytruda vakapona kweanenge makore maviri. Mukuenzanisa, makumi mana neshanu muzana yeavo vanorapwa neYervoy vakapona kwemakore maviri kana kudarika.

Vanyori vekumwe kuongorora kuchangobva kuitika vakafungidzira kuti makore mashanu ekupona kwehuwandu hwevanhu vane melanoma yepamusoro avo vaibatwa naKeytruda vaive 34 muzana. Vakaona kuti vanhu vakagashira ichi chinodhaka vairarama wepakati nepakati angangoita makore maviri.

Nivolumab (Opdivo)

Zvidzidzo zvakaona zvakare kuti kurapwa neOpdivo chete kunogona kuwedzera mikana yekurarama kupfuura kurapwa neYervoy chete.

Kana vaongorori vachifananidza kurapwa uku kune vanhu vane unresectable danho rechitatu kana nhanho yechina melanoma, vakaona kuti vanhu vaibatwa neOpdivo voga vakapona pamwero wepakati wepakati pemakore matatu. Vanhu vaibatwa neYervoy voga vakapona pamiyero yepakati yemwedzi ingangoita makumi maviri.

Chidzidzo chimwe chete ichi chakawana kuti makore mana ekupona kwehuwandu hwaive 46 muzana muvanhu vaibatwa neOpdivo voga, zvichienzaniswa ne30 muzana muvanhu vakarapwa neYervoy chete.

Nivolumab + ipilimumab (Opdivo + Yervoy)

Mimwe mhedzisiro inovimbisa yekurapa kune vanhu vane melanoma isingachinjiki yakawanikwa mune varwere vanorapwa pamwe nekubatanidzwa kweOpivovo neYervoy.

Muchidzidzo chidiki chakaburitswa muRondedzero yeClinical Oncology, masayendisiti akataura makore matatu ekupona kwehuwandu hwe63 muzana pakati pevarwere makumi mapfumbamwe nemapfumbamwe vakabatwa nemusanganiswa wemishonga iyi. Vese varwere vaive nhanho 3 kana nhanho 4 melanoma iyo yaisakwanisa kubviswa nekuvhiya.

Kunyangwe vaongorori vakabatanidza kusanganiswa kwemishonga nemitero yekuvandudza kupona, vakaonawo kuti inokonzeresa mhedzisiro dzakakomba kupfuura chero mishonga yega.

Zvidzidzo zvakakura pane iyi yekubatanidza kurapa inodiwa.

Cytokines

Kune vanhu vazhinji vane melanoma, izvo zvinogona kubatsira pakurapwa necytokine therapy inoita kunge idiki pane iyo yekutora checkpoint inhibitors. Zvisinei, vamwe varwere vasingapinduri zvakanaka kune mamwe marapirwo vanogona kubatsirwa necytokine therapy.

Muna 2010, vaongorori vakaburitsa ongororo yezvidzidzo pa interferon alfa-2b mukurapa nhanho yechipiri kana nhanho 3 melanoma. Vanyori vakaona kuti varwere vakagamuchira mwero wakanyanya weiyo interferon alfa-2b mushure mekuvhiyiwa vaive nemitero iri nani zvishoma yekurarama kwezvirwere, zvichienzaniswa neavo vasina kugamuchira kurapwa uku. Vakawana zvakare kuti varwere vakagamuchira interferon alfa-2b mushure mekuvhiyiwa vaive nemitowo iri nani yepashure yekupona.

Imwe yekutsvagisa pamusoro pegylated interferon alfa-2b yakawana kuti mune kumwe kuongorora, vanhu vane nhanho 2 kana nhanho 3 melanoma vakagamuchira mushonga uyu mushure mekuvhiyiwa vaive nemitengo yepamusoro yekurarama isingadzokororwazve. Zvisinei, vanyori vakawana uchapupu hushoma hwekuvandudzwa kwehuwandu hwehupenyu hwehuwandu.

Zvinoenderana neimwe ongororo, ongororo dzakawana kuti melanoma inova isingaonekwe mushure mekurapwa nemiyero mizhinji ye interleukin-2 mu4 kusvika 9 muzana yevanhu vane melanoma isingachinjiki. Mune imwe 7 kusvika ku13 muzana yevanhu, madosi epamusoro e interleukin-2 akaratidzirwa kudzora matunduru asingagadzirisike emelanoma.

Talimogene laherparepvec (Imlygic)

Tsvagiridzo yakaunzwa kumusangano we2019 European Society yeMedical Oncology musangano unoratidza kuti kupa Imlygic usati wabvisa melanoma nenzira yekurapa kunogona kubatsira vamwe varwere kurarama kwenguva yakareba.

Ichi chidzidzo chakawana kuti pakati pevanhu vane advanced stage melanoma avo vakarapwa nekuvhiyiwa voga, 77.4 muzana vakapona kweanenge makore maviri. Pakati peavo vakarapwa pamwe nekubatanidzwa kwekuvhiya uye Imlygic, 88.9 muzana vakapona kweanenge makore maviri.

Kumwe kutsvagurudza kunodiwa pane zvingangoitika marapirwo aya.

Zvimwe zvinokanganisa immunotherapy

Immunotherapy inogona kukonzeresa mhedzisiro, iyo inosiyana zvichienderana nerumwe rudzi uye dhizaini yemununotherapy yaunogashira.

Semuenzaniso, zvinogona kuitika mhedzisiro zvinosanganisira:

• kuneta
• kupindwa nechando
• chills
• kusvotwa
• kurutsa
• manyoka
• kuputika kweganda

Izvi ndezvimwe zvengangove mhedzisiro mhedzisiro iyo immunotherapy inogona kukonzera. Kuti udzidze zvakawanda nezve zvingangoitika mhedzisiro yemamwe immunotherapy kurapwa, taura nachiremba wako.

Iyo mhedzisiro mhedzisiro yeununotherapy inowanzo kuve yakapfava, asi mune dzimwe nguva inogona kuve yakakomba.

Kana iwe uchifunga kuti ungave uri kusangana nemhedzisiro, ita chiremba wako azive nekukasira.

Mutengo we immunotherapy

Mari yekunze-kwehomwe yemununotherapy inosiyana, zvinoenderana nechikamu chikuru pa:

• mhando uye muyero weununotherapy unogashira
• kunyangwe uine inshuwarhu yehutano yekurapa
• kuti unokodzera here kana kuti kwete zvirongwa zvekubatsira varwere
• kunyangwe iwe uchigamuchira kurapwa sechikamu chekiriniki kuyedzwa

Kuti udzidze zvakawanda pamusoro pemutengo wehurongwa hwako hwekurapa, taura nachiremba wako, wemishonga uye mupi weinishuwarenzi.

Kana iwe uchiona zvichinetsa kuti uwane mari yekuchengetedza, rega timu yako yekurapa izive.

Ivo vanogona kukurudzira shanduko kuchirongwa chako chekurapa. Kana ivo vanogona kunge vachiziva nezve chirongwa chekubatsira icho chinogona kubatsira kuvhara mitengo yekutarisirwa kwako. Mune zvimwe zviitiko, ivo vanogona kukukurudzira iwe kunyoresa mukuedzwa kwekiriniki iyo inokutendera iwe kuwana mushonga uyu mahara uchitora chikamu mukutsvaga.

Kliniki miedzo

Pamusoro pekurapwa kwemununotherapy kwakatenderwa kurapa melanoma, vesaenzi parizvino vari kudzidza dzimwe nzira dzekuyedza dzemununotherapy.

Vamwe vaongorori vari kugadzira uye kuyedza mhando nyowani yemununotherapy mishonga. Vamwe vari kudzidza nezvekuchengetedza pamwe nekubudirira kwekusanganisa akawanda marudzi eunonotherapy. Vamwewo vaongorori vari kuyedza kutsvaga nzira dzekufunda idzo varwere vangangobatsirika pakurapwa kupi.

Kana chiremba wako achifunga kuti ungabatsirike nekugamuchira kurapwa kwekuyedza kana kutora chikamu mune ongororo yekuongorora nezve immunotherapy, vanogona kukukurudzira kunyoresa mukuedzwa kwekiriniki.

Usati wanyoresa chero muedzo, ita shuwa kuti unonzwisisa izvo zvinogona kubatsira uye njodzi.

Mararamiro anochinja

Kuti ubatsire kutsigira hutano hwako hwepanyama uye hwepfungwa paunenge uchienda kunotora immunotherapy kana mamwe marapirwo ekenza, chiremba wako anogona kukukurudzira kuti uchinje mararamiro.

Semuenzaniso, vanogona kukukurudzira ku:

• gadzirisa tsika dzako dzekurara kuti uwane zororo rakawanda
• tweak chikafu chako kuti uwane zvakawanda zvinovaka muviri kana macalorie
• chinja maitiro ako ekurovedza muviri kuti uwane chiitiko chakaringana, pasina kubhadharisa muviri wako zvakawandisa
• geza maoko ako uye ganhurira kugona kwako kune vanorwara kuti uderedze njodzi yekutapukirwa
• kukudziridza kusagadzikana manejimendi uye ekuzorodza maitiro

Mune zvimwe zviitiko, kugadzirisa maitiro ako ezuva nezuva kunogona kukubatsira kutsungirira mhedzisiro yekurapwa. Semuenzaniso, kuzorora zvakanyanya kunogona kubatsira iwe kubata kuneta. Kuita shanduko pakudya kwako kunogona kukubatsira iwe kudzora kusvotwa kana kurasikirwa nechido.

Kana iwe uchida rubatsiro kugadzirisa ako ehupenyu maitiro kana kugadzirisa mhedzisiro yekurapwa, chiremba wako anogona kukuendesa iwe kune nyanzvi kuti uwane rutsigiro. Semuenzaniso, nyanzvi yezvokudya inogona kukubatsira kugadzirisa tsika dzako dzekudya.

Outlook

Maonero ako nekenza yemelanoma zvinoenderana nezvinhu zvakawanda, zvinosanganisira:

• hutano hwako hwese
• danho rekenza rauinaro
• kukura, nhamba, uye nzvimbo yemamota mumuviri wako
• mhando yekurapwa kwaunogashira
• muviri wako unoita sei pakurapwa

Chiremba wako anogona kukubatsira kuti udzidze zvakawanda nezve mamiriro ako uye kwenguva refu maonero. Vanogona zvakare kukubatsira iwe kunzwisisa ako marapirwo sarudzo, kusanganisira mhedzisiro inogona kurapwa kurapwa pahurefu uye hunhu hwehupenyu hwako.