I-Imbruvica (ibrutinib) yipilisi yokuguqula i-paradigm ebonisa ukutshintsha kolwandle kwindlela esiphatha ngayo i-lymphocytic leukemia (CLL) kunye nezinye izibilini ze-B. Ngokukodwa, i-Imbruvica ishintshe unyango lwe-leukemia kude ne-buckshot ye-chemotherapy clumsiness kwi-finesse ene-enzymatic sniper.
Yintoni i-CLL?
I-lymphocytic leukemia engapheliyo i-leukemia yabantu abadala abaqhelekileyo kumazwe aseNtshona.
(Esi sifo sichaphazela abamhlophe kwaye sagqitha kakhulu abantu base-Afrika baseMelika, abantu baseSpeyin, nabase-Asiya.) Esi sifo sixhaphake kubantu abadala asebekhulile.
I-lymphocytic leukemia engapheliyo ngumhlaza we- B i-lymphocytes eziqhelekileyo zenza umzimba wokuzikhusela kwaye zisebenze njengenxalenye ebalulekileyo ye-immune system.
Nge-CLL, ukuxhaswa kwe-lymphocyte ye-B ye-leukemic iyabutha kwaye ixhamle ngaphandle kweeseli zegazi eziqhelekileyo emnxeni wethambo, igazi kunye ne-lymph nodes. Ngoxinzelelo lweeseli zamanzi ezidinga umzimba wethu njengeeseli ezibomvu zeeseli kunye neeseli zegazi ezimhlophe, i-CLL ingakwazi ukukhubaza ngokuhlukileyo ukukwazi ukulwa nesifo kunye nokudala i-anemia.
Ukuxela abantu abanomdla we-CLL uqhuba i-gamut. Abanye abantu banethamsanqa kwaye baphila iminyaka emininzi ngesifo esingasidlangalaleni okanye esiphantsi kwesi sifo esingafuneki unyango. Abanye, nangona kunjalo, bafumana inkqubo enobungozi kakhulu engavumelani nekhemotherapy.
Izimpawu eziqhelekileyo kulabo abahluphekayo nge-CLL zihamba phambili ziquka ezi zilandelayo:
- ukukhathala
- ukuhla ukusinda
- umkhuhlane
- ukukhupha ebusuku
- i-lymph nodes
- ipeni ephakanyisiweyo okanye isibindi ekuncediseni ukusabalalisa kwangaphambili (ukuvakalelwa kwangaphambili kokuzaliseka)
- usulelo oluphindaphindiweyo
Ngo-2015, iNational Cancer Institute iqikelele ukuba ngamacala angama-14620 e-CLL afunyanwe, kukho i-4650 yokufa.
Yintoni ekhethekileyo malunga ne-Imbruvica
Kuze kube kutshanje, unyango lwe-CLL lwalukhawulelwe kwikhemotherapy kunye ne-immunotherapy okanye i-chemoimmunotherapy.
Nangona i-chemotherapy ngokwayo imane nje ingabonakaliyo kwabanye balabo abane-CLL, ukongezwa kamsinya kwangoko kwe-rituximab, imithi ye-immunotherapy, kunokuncedisa ukwandisa ukusinda ngokunciphisa ukuxolelwa. Ngokukodwa, i-rituximab ijolise i-CD20 antigen kwi-lymphocytes B. Ngelishwa, i-subset ethile yabantu (abo abanokuguqulwa kwe-del [17p] / TP53 okanye ukususwa kwi-chromosome 17) baphendule kakubi i-chemoimmunotherapy.
I-Chemotherapy ye-CLL ibandakanya ukulawulwa kwama-parenteral (injection) yee-agent ahlukahlukeneyo ukwenzela ukuba abulale nje kuphela ukuhlula iinqununu zeeseli ngokukhawuleza kodwa ngokuqhelekileyo ukwahlula imigca yesellu, nayo. Indlela ye-buckshot ichaza ukuba kutheni abantu be-chemo bafumana iintlobo ezahlukeneyo zeziphumo eziquka ukulahlekelwa yintlungu, ukuxinzezeleka kwemizimba, kwaye, kwimeko ye-CLL, nokuba nemiphumo yokudityaniswa okanye i-humoral effects.
Nangona i-chemo ivumelanisa ukuchaneka kweklinikhi yomboni we-chain, i-Imbruvica ifana ne-scalpel yonyango kunye nokuchanekileyo kwindlela yayo. Ngokukodwa, i-Imbruvica ikhupha i-enzyme ebizwa ngokuthi i-tyrosine kinase (i-Btk) yeBruton eyahlukileyo kwii-cell ze-B ezinobungozi okanye ezinomhlaza. Ngokungahambi ngokungahambiyo kwi-Btk, i-Imbruvica iphosa isikhankqalazi seminki kwindlela yokufumana i-cell ye-B engapheliyo ukwenzela ukuvimbela ukukhula kweseli, ukusabalala kunye nokusinda kwamaseli angamaB.
Ngokuthakazelisayo, uphando lubonisa ukuba i-Imbruvica inokusebenza ngenye indlela enxulumene nayo equka ukujijiza i-microenvironment apho iiseli zamachiza zikhula khona. Ngokukodwa, kwaye njengoko kuchazwe kwiphephancwadi ethi Nature Biotechnology , i-Imbruvica inokuthi "ikhuphe i-chemokine receptor kunye nokubonakaliswa kokuhlanganiswa ngokukhusela i-BTK, ngoko ke ukufuduka kweseli kunye nokunamathela kwiiseli ezinqamlekileyo kwi-lymph node." Emva kwe-Imbruvica ukulawula, iiseli ze-CLL zanda kwigazi kwaye bafela apho, bebanjelwe i-microenvironment exhasa i-lymph node. "
Ngaphandle kwe-CLL, i-Imbruvica inceda nakwezinye iintlobo ezahlukeneyo zeB-cell.
Ngenxa yoko, ngaphezu kwe-CLL, i-FDA ikhuphe izidakamizwa ngokukhawuleza ezilandelelweyo okanye ukuqhutyelwa kwezokwelapha kwi-Waldenström's macroglobulinemia kunye ne-vestima ye-slim cell lymphoma. Asikho esinye isiyobisi esiye safumana le nkcazo yezobugcisa ezininzi!
Ukuba wena okanye othandekayo unobungozi be-CLL okanye enye i-B-cell malignancy, iqhosha lika-Imbruvica ngokuqinisekileyo into enokuyithandayo. Ngokubhekiselele ekubulaleni kwegazi, impumelelo ye-Imbruvica inokuqhathaniswa ne-rituximab. Ukongezelela, i-Imbruvica ayisebenzisi nje kuphela kune-rituximab njenge-monotherapy kodwa iphinde ilawulwe ngomlomo kwaye iluncedo kunye nezifo ezichasayo kunye nezifo.
Imithombo:
I-athimba ebizwa ngokuthi "Imbruvica-isilandela esikhulu esilwayo kwi-B-cell cancer-approved by FDA" nguMalini Guha opapashwe kwi- Nature Biotechnology ngo-2014.
I-athimba ebizwa ngokuthi "Ibrutinib (Imbruvica): I-Novel iTransed Treatment ye-Lymphocytic Leukemia" engapheliyo yi-S Parmar kunye nababhali-mbhali abapapashwe kwi-P & T ngo-2014.