Izifundo ezijikeleze uLupron okanye Ukunikezela unyango malunga nomhlaza wesifo se-prostate , ukuqala unyango kwinqanaba eliphambili kubangele ukuphuculiswa okubonakalayo kweempembelelo ze-antiticancer. Ngokufanayo, uphando lokuhlola ukuphumelela kokuqala i-Taxotere kwinqanaba eliphambili libonisa into efanayo.
Ukuqalisa i-Taxotere kwiSigaba sangaphambili
I-Taxotere iye yaya kwi-chemotherapy ukuya kwiminyaka engaphezu kweyishumi yomhlaza womhlaza wesifo se-prostate.
Yavunywe yi-FDA ngo-2004 emva kokubonakaliswa ukulondoloza ixesha lokusinda. Ngaphambi kokuvunyelwa kwe-FDA ye-Taxotere, i-agents kuphela ye-chemotherapeutic agents (iNovantrone, Emcyt, kunye neVelban) yayingumda wexabiso. Ngokomzekelo, iNovantrone inokunciphisa intlungu kunye nokuphucula umgangatho wobomi. Nangona kunjalo, ayinayo impembelelo ekusindeni. I-Taxotere yayivunyelwe i-FDA emva kokuvavanywa kweemvavanyo ezinkulu ezininzi eziqinisekisiweyo, kodwa ke, ukuphuculwa kokusinda kwakuncinane, kuphela kwimiqathango yeenyanga ezimbalwa.
Sekuyiminyaka, iingcali ziye zazibuza ngexesha elifanelekileyo lokusebenzisa i-Taxotere. Ngaba kufuneka iqaliswe emva kokumelana noLupron okanye kuya kuba ngempumelelo ukuqala phambi kokuqala kokumelana ne-hormone? Ekubeni iinjongo zangaphambili ezikhokelela kwi-FDA-Imvume ye-Taxotere yavandlakanya ukuphumelela kwayo kwindoda eyayisele i-Lupron-resistant, umgaqo-jikelele owamkelwa ngugqirha kufuneka ugodle i-Taxotere kude kube yi-Lupron engasebenzi.
Oogqirha baya kucinga ngale ndlela: "Njengoko i-Taxotere ineempembelelo ezahlukeneyo, kwaye, nangona kungabikho ubungqina bokuba unyango lwangaphambili lusebenza kakuhle, siya kukhuthaza kuphela ukuqala i-Taxotere emva kokuba i-Lupron iyeke ukusebenza."
Kuyaziwa ukuba abantu abaninzi abanomdlavuza wesifo se-prostate bagqiba ekuhlaseleni i-hormone resistance.
Ngenxa yoko, ekubeni unyango lwangaphambili lusebenza ngokucwangcisekileyo, kuya kuba lunengqiqo ukujonga ukuhlaselwa kwesi sifo ngaphambi kokuba amaseli angakhuselekanga ama-hormone aphindaphindiwe kwaye atshintshele kwii-clones ezinganyangekiyo. Ngo-2014 no-2015 iziphumo ezimbini zokuvavanywa kweemvavanyo zonyango zipapashwe.
Iziphumo zoPhando olutsha
Uvavanyo lokuqala, I-CHAARTED (iTra-hormonal Therapy kunye no-Androgen Ablation I-Randomized Trial for Extensive Disease in Cancer Prostate), yenziwa ngo-2014 kwintlanganiso yonyaka we-American Society of Clinical Oncology (ASCO) kwaye yapapashwa kwi-New England Journal of Medicine ngo-2015 . Kuboniswe ukuba kumadoda anesifo somhlaza esasandul 'uvavanyo olutsha olusandululweyo, kwizigulane ezazisetyenziselwe i-metastase, ukongezwa kweenyanga ezine ze-Taxotere zaqala ngokubambisana noLupron ekuphuculeni ukuphuculwa ngokumalunga namadoda aqala uLupron yedwa waza waqalisa i-Taxotere xa uLupron wayeka ukusebenza. Kule sifundo, ukusinda kwamadoda athathwe nge-Taxotere ngexesha elifanayo njengoko uLupron eneminyaka engama-18 ubude kunamadoda aqale aphathwa ngeLupron kuphela.
Iziphumo zenye, ityala elifanayo, elibizwa ngokuba yi-STAMPEDE (iTyhulwa yoCwangciso oluPhakamileyo okanye iMatastatic prostate umhlaza): UkuVavanywa kovavanyo lwezoLwelo), lwenziwa kwintlanganiso ye-ASCO ka-2015.
Kule sifundo malunga nabantu abangama-3000 abasandul 'ukuvavanywa, amadoda angama-hormone, isiqingatha samadoda sanikwa i-Taxotere kunye neLupron ngokukhawuleza. Ukusinda kwabo kwakufaniswa nesiqingatha esithile saqala ukuphathwa kunye noLupron yodwa. Njengoko kuqhutywe isifundo se-CHAARTED, eli qela lesibini lalashwa nge-Taxotere emva kokuba uLupron eyekile ukusebenza. Kwaye, kwakhona, njengolu vavanyo lwe-CHAARTED, amadoda aqale i-Taxotere phambi kokumelana ne-hormone bahlala ixesha elide.
Ngoxa i-Taxotere yangaphambili isingqungquthela esandula kusungulwa, kwindlela yokulawula imihla ngemihla yezigulane ezinomdlavuza wesibeletho, indlela ezinye iintlobo zonyango olutsha (ezifana neZytiga, Xtandi, Xofigo, kunye neJevtana) zikhethwe rhoqo zilandela iphetheni egugile, elandelelanayo.
Ukusebenzisa amayeza ngokulandelelana okanye ngokudibeneyo kudla ngokukhawuleza. Indlela eqhelekileyo iyafezekisa ukuba, "Kuhlala kwenziwe njalo ngale ndlela."
Oogqirha basebenzise ukucinga ngokugqithiseleyo ngezizathu ezininzi kwaye abahlali bavavanya "ngaphandle kwebhokisi," unyango lweendlela. Nangona kunjalo, ingoku ngoku ukuba amaninzi amaninzi kwaye asebenzayo asebenzayo ayavunyelwa yi-FDA, ukusebenzisa iindlela zokwelapha ngendlela elandelelanayo inokungaphumeleli ukwandisa ubunako kwezi zixhobo ezintsha zokulwa ne-antiticancer.