Mene ne ya kamata ka sani game da ilimin ƙwayoyin cutar shan ƙari?
Idan an umurce ka ko wanda kake ƙauna da magani na rigakafin rigakafi na Opdivo (nivolumab), me kake bukatar ka sani? Yaya wannan magani yake aiki? Menene cututtuka za su iya amsa wannan magani? Sau nawa Opdivo yayi aiki kuma wane irin martani ne mutane suke da shi? A ƙarshe, menene sakamakon illa na kowa?
Opdivo (Nivolumab) -Definition
Opdivo (nivolumab) ana daukar nau'in maganin rigakafi na rigakafin rigakafin, magani na farko a cikin wannan rukunin ya yarda da cutar ciwon huhu (a cikin shekarar 2015) kuma yanzu an yarda da shi saboda wasu cututtuka.
Immunotherapy wani sabon nau'i ne na maganin ciwon daji wanda ke amfani da tsarin rigakafi ko ka'idoji na maganin rigakafi don yaki da ciwon daji.
Akwai matakan daban-daban na immunotherapy. Opdivo an dauke shi "mai hana magunguna" (wanda zamu tattauna a gaba).
Opdivo (nivolumab) ya kasance mai ban sha'awa don magance ciwon daji a cikin 'yan shekarun nan, kuma yawancin tashin hankali ba wai kawai ba. Wasu mutane suna da martani ga maganin da ba su ji ba kusan shekaru 5 da suka gabata. Abin takaici, Opdivo ba ya aiki ga kowa da kowa, amma idan yana da tasiri zai iya haifar da amsa mai dorewa (an bayyana a kasa). Hanyoyi masu lahani suna na kowa, amma a gaba ɗaya sun fi muni fiye da lalacewar da aka samo tare da wasu chemotherapy tsarin.
Shin Opdivo (Nivolumab) na Irin Kwayar Halitta?
Mutane da yawa suna rikita batun yadda chemotherapy da immunotherapy suna da alaka. Shin immunotherapy, kuma musamman nivolumab, wani irin chemotherapy?
Wani lokaci, ana amfani da chemotherapy a hankali don bayyana duk wani nau'i na miyagun ƙwayoyi da aka ba don magance ciwon daji. A wannan yanayin, ana iya kiran magungunan immunotherapy a wasu lokutan da ake kira chemotherapy. Duk da haka akwai wasu bambance-bambance mahimmanci. Kalmar "chemotherapy" yawanci tana nufin amfani da kwayoyi wanda zai shafi rarrabawar kwayar halitta ta hanyoyi masu girma.
Sakamakon ilimin ilmin chemotherapy ya tashi saboda, baya ga magance ciwon daji, waɗannan kwayoyi sun shafi kwayoyin da suka rabu da hanzari. Wannan aikin ne na chemotherapy akan kwayoyin lafiya, irin su wadanda suke cikin kututtukan kasusuwa (sakamakon mummunan ƙidaya da ƙari), gashin gashi (sakamakon lalacewar gashi), da magungunan narkewa (sakamakon sakamakon tashin hankali) wanda ya haifar da na kowa sakamako masu illa.
Ya bambanta, an tsara magungunan immunotherapy musamman don sauya tsarin jiki na jiki ko amfani da kayan da kwayoyin rigakafi suka yi don yaki da ciwon daji. Saboda haka, magungunan immunotherapy suna da ƙananan sakamako fiye da kayan gargajiya na chemotherapy.
Ta yaya Opdivo (Nivolumab) ke aiki?
Opdivo (nivolumab) wani maganin rigakafin rigakafin rigakafi ne wanda aka kirkira a matsayin mai hanawa.
Masu maganin bincike suna da sauƙin ganewa idan kunyi tunanin tsarin da ba ku da shi a matsayin mota, tare da masu zanga-zangar bincike suna kasancewa a kan mota. An tsara tsarinmu na rigakafi don magance kwayoyin cuta, ƙwayoyin cuta, har ma da kwayoyin cutar ciwon daji a jikinmu. Ƙungiyarmu ta rigakafi ta rigaya ta san yadda za a magance ciwon daji. Kamar dai yadda jikinmu ke yaki da kwayoyin cuta da ƙwayoyin cuta a cikin mu, an tsara shi don yaƙar ƙananan ƙwayoyin waje irin su ciwon daji.
Tsarin tsarin na rigakafi, duk da haka, yana da kaya da ma'auni. Wadannan shafukan yanar gizon suna kula da tsarin na rigakafin don haka ba ya iya fahimta ko overperform. Kwayar cuta mai mahimmanci, ita ce, a gaskiya, matsalar da cututtuka na kamfanoni irin su cututtukan arthritis da lupus.
Ma'anar "motsi" na mota da ke rage tsarin shine sunadarai da ake kira masu zanga-zanga. Wadannan sunadarai na bincike suna jinkirta mayar da martani akan yadda ba'a da kyau. Daya daga cikin wadannan sunadarai shine PD-L1. PD-L1 yana ɗaure ga masu karba na PD-1 a kan T kwayoyin halitta (kwayoyin halitta a cikin tsarin rigakafi mafi yawan aiki wajen yaki da ciwon daji), yana gaya musu su yi shiru.
Kwayoyin ciwon daji suna da kyau. Wasu kwayoyin cutar kanjamau sun sami hanyar samar da PD-L1 mai yawa. Lokacin da wannan ya danganta ga masu karba na PD-1 a kan tantanin T , ya ba da damar ciwon daji na ci gaba ba tare da ɓoye ba, kusan kamar saka mask a kan kwayoyin cutar ciwon daji don haka tsarin da ba zai iya ganewa ba kuma ya kai musu hari.
Opdivo yana aiki ne ta hanyar ɗaurewa da kuma hanawa PD-1 ta hanyar PD-L1, da gaske da sake watsi da shinge a kan mota (tsarin rigakafi) don ya iya yaki da ciwon daji. Dukkancin, Opdivo yana aiki ta hanyar cire mask daga jikin kwayar cutar ciwon daji don haka ba zasu iya ɓoye daga tsarin rigakafin ba, kuma ƙarshen rushewar jikin mu ta ƙare.
Yaushe kuma Ta yaya Opdivo (Nivolumab Used)?
Ana amfani da Opdivo don ciwon sikila na IV (inoperable), cututtukan da ba za'a iya magance su ba tare da tiyata kuma yawanci sun yada zuwa wasu sassan jiki (wanda ake kira metastatic).
Ana bada Opdivo ta allurar rigakafi a kan wani lokacin jiko na kimanin awa daya. An ba da shi sau da yawa kowane mako biyu.
Mene Ne "Maganar Dalili" ke Ma'anar?
Kafin tattaunawa game da binciken akan kanvolumab, yana da gudummawa wajen ƙayyade lokaci wanda ake amfani akai-akai yayin da yake kwatanta amsa ga magungunan immunotherapy: kalmar nan "amsa mai dorewa."
Kyakkyawan "amsa mai mahimmanci" yana nufin maida martani mai dorewa akan ƙwayar ƙwayoyi zuwa miyagun ƙwayoyi. Babu lokacin da aka ƙayyade, amma "dogon lokaci" yana nufin na tsawon shekara 1 kuma wani lokaci ya fi tsayi.
Idan ka ga nazarin karatu game da "amsawar mai dacewa," wannan ya saba da irin nau'in amsa da ake tsammani daga chemotherapy. Tare da cike da ciwon ƙwayoyin cuta na IV, chemotherapy zai iya zama tasiri amma tumɓin kusan kullum yana da tsayayya ga chemotherapy bayan wani ɗan gajeren lokaci kaɗan (sau da yawa aka bayyana a watanni). Tare da maganin kwantar da hankali, lokaci mai karɓa ya fi tsawo, duk da haka juriya yakan tasowa a cikin shekara guda dangane da magungunan musamman, irin ciwon daji, da yawa.
Amsaccen amsa ba yana nufin "warkarwa" amma yana bada amsar cewa a hanyoyi da yawa shine mafi kyawun abu da muke da shi a wannan lokaci-yayin da yake aiki.
Ba kamar maganin ilimin kwayar cutar da kuma maganin farfadowa-wanda ke da tasiri ba idan dai mutum yana shan magani-ga wasu mutanen da suka dauki Opdivo, yana nuna cewa zai ci gaba da zama tasiri. Tare da ciwon daji na ƙwayar cutar kankara, wasu mutane sun sami amsa mai kyau har ma bayan dakatar da farfadowa.
Menene Za a Yi Maganin Cancers Tare da Opdivo?
Opdivo (nivolumab) an yarda dashi don maganin mutane da ciwon huhu na huhu (irin kwayar nono ba tare da ƙananan ciwon huhu ba), ƙwayar ƙwayar kwayar cutar kwayar cutar ta jiki (wani nau'in kwayar cutar kanjamau). , ciwon daji da kuma wuyansa, Ciwon maganin Merkel, da kuma ƙwayar ƙwayar ƙwayar jikinsu (ciwon daji).
Menene Nazarin Ilimin Harkokin Gudanarwa da Gudanar da Ƙwararrakin Ƙididdigar Mu game da Opdivo?
Nazarin ya yi nazari game da sakamakon Opdivo a kan wasu cututtuka daban-daban maimakon cututtuka kamar duka:
- Magungunan ciwon huhu na kananan kwayoyin halitta - Binciken shekara ta 2017 na tara binciken da ya shafi mutane da mataki III da mataki na IV marasa ciwon kwayar cutar kanjamau sun gano cewa nivolumab (da atezolitumab da pembrolizumab) sun inganta rayuwa fiye da chemotherapy lokacin amfani da layi na biyu (da kuma pembrolizumab layin farko a PDL-1 tabbatacciyar ƙwayoyin cuta). Bugu da ƙari, mutane sun sami sakamako mai yawa a kan masu hana masu bincike a kan magunguna fiye da kan cutar chemotherapy. Ana iya amfani da Opdivo ko dai adenocarcinoma ko ƙwayar kwayoyin halitta daga cikin huhu . Ya kamata a yi amfani da Opdivo ne kawai ga mutanen da ba su da kayan maye gurbi ko kuma ba su amsa dasu ba.
- Metastatic melanoma - Opdivo yanzu an ba da shawarar layi na farko (a matsayin farkon magani) don meastometal metastatic .
- Harshen lymphoma Hodgkin - Opdivo na iya amfani dasu ga mutanen Hodgkin lymphoma wadanda ba su inganta ba bayan wani suturfan kwayar halitta da kuma amfani da maganin farfadowa.
- Magungun kwayar halitta da ƙwayar wucin gadi (ƙaddara ko sake ci gaba).
- Magunin ƙwaƙwalwar ƙwayar halitta - Opdivo an yarda da layi na biyu (bayan maganin anti-angiogenesis inhibitor remedy) don ciwon ƙwayar halittar jini wanda yafi yawan kwayar cutar koda.
- Magunin Urothelial Carcinoma - An yarda Opdivo ne ga mutanen da ke dauke da irin wannan ciwon daji da ke fama da ciwon magungunan ciwon daji wanda ba sa cigaba da cutar chemotherapy.
- Merkel cell carcinoma
Yaya Immunotherapy ya fi aiki?
Binciken a kan Opdivo da sauran kwayoyin rigakafin ƙwayar rigakafi har yanzu yana da matashi, amma tare da ciwon huhu a cikin akalla, ana ganin mutane da suka taba shan taba a baya sun fi dacewa su amsa maganin miyagun ƙwayoyi fiye da waɗanda basu taba taba taba taba ba. Wannan yana da hankali lokacin da ake tunani game da tsarin. Ciwon huhu na huhu a cikin mutanen da suka yi kyafaffen suna da "matsayi mafi girma." A wasu kalmomi, kwayoyin cutar ciwon daji suna da yawancin maye gurbin da aka samu a cikin kwayoyin cutar ciwon daji wanda ke faruwa a yayin da kwayar halitta ta zama abin ƙyama. (Wannan ba shi da dangantaka da ladabi kuma waɗannan maye gurbin ba su wuce a cikin iyali). Sel ɗin da ke da karin maye gurbin tabbas sun kasance sun kasance mafi hasara (ƙasa da ƙwayoyin jiki) zuwa tsarin na rigakafi, yin jiyya da suke amfani da tsarin rigakafi ko ka'idodin da zai iya tasiri.
Hanyoyi na Yanayi na Opdivo (Nivolumab)
Kamar yadda yake tare da duk wani maganin ciwon daji, akwai sanadiyar cutar da Opdivo.
Sakamakon abubuwan da suka shafi kowa (wadanda suke faruwa a cikin kashi 10 ko fiye da mutane) sun hada da:
- Cikakken fata
- Itching (pruritis)
- Matsanancin matakin potassium ( hyperkalemia ) da ƙananan sodium matakin (hyponatremia)
- Magungunan halayen hanta masu mahimmanci irin su ALT da alkaline phosphatase
- Ƙara
- Rawancin numfashi
- Wulo
- Darajar jinin jini mara kyau
- Maganin tsoka musamman tare da ciwon huhu na huhu
Abubuwa marasa rinjaye amma masu tsanani sun haɗa da:
- Kusan wani abu da ya ƙare tare da suffix "itis" - ma'ana ƙonewa; irin su colitis, pneumonitis, hepatitis, nephritis, pancreatitis, da sauransu
- Yanayin ido kamar uveitis da idanu bushe
- Endocrine matsaloli shafe thyroid gland shine gland shine, adrenal gland, da kuma pituitary gland shine
Gargaɗi Duk da haka a kan Opdivo (Nivolumab)
Mutane da ke daukar Opdivo ya kamata a kula da su don bayyanar cututtukan ƙwayoyin cuta, kuma idan akwai, likita za a buƙaci a gudanar ko tsaya. Wadannan sun haɗa da yanayin irin su pneumonitis, encephalitis, nephritis, da colitis. Da miyagun ƙwayoyi na iya sa irin na ciwon sukari, kuma ya kamata a kula da jini.
Cikakken hanzari ko gajiya mai wahala zai iya faruwa, kuma mutane ya kamata su fahimci yiwuwar wannan yanayin da yiwuwar bayyanar cututtuka.
Raunin haɗari mai tsanani irin su Stevens-Johnson zai iya faruwa, kuma ya kamata ka yi magana da likitanka game da kowane rashes da ka ci gaba.
Duk da haka, duk da haka, halayen mummunan halayen da ke da alaƙa da dakatar da miyagun ƙwayoyi ba su da sabawa, yana faruwa a ƙasa da kashi 1 cikin dari na lokaci. Tabbatar yin magana da likitan ka game da sauran alamun bayyanar cututtuka da kuma lokacin da ya kamata ka kira.
Kalma Daga
Opdivo (nivolumab) wani sabon magani ne wanda aka tsara a matsayin irin immunotherapy. Ga wadanda wa] annan magunguna suke da tasiri, a wasu lokutan mun ga irin maganganun ciwon daji masu ci gaba wanda ba a iya kwatanta su ba kamar 'yan shekaru da suka wuce. Wannan ya ce, ba sa aiki ga kowa da kowa, kuma har yanzu ba mu da kyakkyawan hanyar sanin wanda zai dace da magani.
Hanyoyi masu lahani sune na kowa, musamman bayyanar cututtuka irin su rash, itching, da thyroid dysfunction. Babban halayen halayya mai tsanani zai iya faruwa a wasu lokuta. Bugu da ƙari, duk da haka, an dakatar da Opdivo fiye da maganin gargajiya.
An sami farin ciki ƙwarai daga al'ummar likita saboda wasu dalilai. Ana iya amfani da Opdivo don magance magungunan ciwon daji. Bugu da ƙari, zai iya zama tasiri a wasu nau'o'in ciwon daji. Wata ila ana amfani da sabon amfani ga miyagun ƙwayoyi a nan gaba, kuma yawancin gwaje-gwaje na asibiti suna ci gaba da nazarin sakamakon Opdivo akan nau'o'in ciwon daji daban-daban, da kadai, kuma a hade tare da wasu magungunan immunotherapy.
> Sources:
> Abdel-Rahman, O., > Halatta >, H., Petrausch, U. et al. Abun da ke da nasaba da cututtuka marasa lafiya a cikin marasa lafiya masu wutsiya da aka yi tare da masu haɓaka kallon bincike ba tare da jimawa ba. Gwani Review na Anticancer Far . 2017. 17 (4): 387-394.
> Ellis, P., Vella, E., da Y. Ung. Ma'aikatan Binciken Bincike na Bincike marasa lafiya ga marasa lafiya da ciwon ciwon marasa lafiya na NonSmall-Cell. Clinic Lung Cancer . 2017 Feb 16. (Epub gaba da bugu).
> Bayani >, M., da J. Wolchok. Abun da ke ciki tare da Mai sarrafawa mai kulawa Immunotherapy. UpToDate . Updated 05/31/17.
Wang, X., Bao, Z., Zhang, X. et al. Amfani da Tsaro na PD-1 / PD-L1 masu hanawa a cikin maganin Tumatattun ƙananan tumatir: Wani Binciken Tsaro da Mita-Analysis. Oncotarget . 2017 Mayu 31. (Epub gaba da bugu).