Yintoni entsha kwiNyango yeCarstate Cancer?

Unyango lomhlaza wesifo seprotate ongasigxina

Izinto ezininzi zatshintshile kunyango lomhlaza wesifo seprotate kwiminyaka embalwa edlulileyo. Oku kuyinyani ngokukodwa kwonyango lomhlaza we-prostate-resistant-resistant cancer (mCRPC). Lo mhlaza womhlaza wesifo seprotate owehlulekile unyango lokuqala (utyando, i-radiation njl njl) kwaye uye wahluleka ukunyanga i-hormonal treatment (androgen blockade okanye castration).

Oku kusebenza nakwizigulane ezibonelela ngesifo se-metastatic kwaye ziye zahlula unyango lwe-hormonal. Ngaphambi kokuqala kokusetyenziswa kwe-chemotherapy kwezi zi gulane ubude bomyinge obuphakathi kwangeenyanga ezi-8. I-Chemotherapy iphuculwe kule nto kodwa ayiyiyo yonyango.

Ukususela ngo-2010 unyango olutsha luye lwafumaneka kwizigulane nge-mCRPC. Oku kulandelayo kuchazwe emfutshane ngonyango olutsha.

1. I-Abiraterone Acetate (iZytiga) - i-Zytiga inhibisa ukuveliswa kwezinto zokunyusa i-testosterone kunye nokunciphisa amanqanaba e testosterone. Ngokuqhelekileyo kunikwa i-prednisone. I-Zytiga yayibonakaliswe okokuqala kwizigulane ezahluleka i- docetaxel (i-chemotherapy) kodwa uphando olutshanje luye lwabonisa inzuzo kwisigulana sangaphambili se-chemo. Olunye uphando lubonise ukuba ukusasazeka kwe-radiographic-free-ration (rPFS) yayingaphaya kweenyanga ezili-16 kwi-Abiraterone kunye ne-prednisone yeqela kunye neenyanga ezi-8 kwiqela lolawulo.
2. I-Enzalutamide (Xtandi) - Eyaziwa ngokusemthethweni njenge-MDV3100 le meyeza isibini kwisizukulwana kunye ne-androgen-receptor blocker. Isebenza kokubili ngaphakathi nangaphakathi kweseli. Kwakuqala kuboniswa kwizigulane zecrotherapy kwi-mCRPC kodwa izifundo zibonise inzuzo kwisigulana sangaphambili se-chemo. UKUFUNDA KWENKQUBO ebonisa ukuba ngokwemitha, i-enzalutamide ilibazise imfuno ye-chemotherapy ngeenyanga ezili-17 (28 vs 11). Kwakuboniswe ukuba ukusetyenziswa kwesi sigxina kuphuculwe ukuqhubela phambili kwe-radiographic ngo-81%.

1. I-Radium 223 Dichloride (Xofigo) - Nangona oku kungenayo injini yimizila ebizwa ngokuthi i-alpha radiation. Olu unyango lujoliswe ekujoliseni iiseli zomhlaza zesifo seprotate emathanjeni. Amagqabi anomhlaza womhlaza wesifo somhlaza wesithandam I-Radium ikhupha i-alfabhethi ye-alpha, eyona mfutshane kakhulu. Ingcamango yokubulala iiseli zomhlaza zesifo esinomonakalo omncinci kwithambo eliqhelekileyo. Oku kufuneka kube ngakumbi kujoliswe ngaphezu kwe-strontium-89, esetyenziswe ngaphambili. Izifundo zibonise ukunyuka okuqhubekayo kwizigulane ezine-mCRPC kunye ne-metastasis yamathambo.

1. I-Sipuleucel-T (Nika) -Sipuleucel-T ngumgomo wokugonywa ngumhlaza we-prostate umdlavuza. Kuthelelwe izigulane ezibonakalisa izilwanyana okanye iimpawu ezincinci ezine-mCRPC. Kuye umntu ngamnye kwisigulane kwaye ufuna idini legazi. Igazi lisebenza kwilebhu kwaye yaphinda iphethwe emva kweveki. Unyango lubonelelwa kathathu kwixesha leenyanga. Yiyo ye-FDA yokuqala yokuvuna isifo sokugonya somhlaza (ngokuchasene nomgomo wokugonya ukhuseleko). Ukusinda ngokubanzi kwandiswe ngokusetyenziswa kweMpahla kwiimpawu zeempawu ze-mCRPC ezibonakalisiweyo okanye ezincinane.

Imibuzo ekuqinisekiseni ukuba iyacaciswa kwixesha elizayo yintoni indlela yokulandelelana ngokuthelekiswa kwezi zonyango ezintsha? Xa isigulane siphumelela i-hormones, yiyiphi imithi kufuneka isetyenziswe kuqala okanye kufuneka i-chemo iqaliswe? Liliphi iyeza elinika ixabiso elifanelekileyo? Ngaba le miyeza kufuneka isetyenziswe yedwa okanye idibeneyo? Nangona kukho imibuzo emininzi kulezi zongezelelo zandul 'umdla we-prostate cancer armamentarium ziya kunceda izigulane ezininzi.

_Imithombo

_{URathkopf DE, Smith MR, De Bono JS, et al. Uhlalutyo lwesikhashana oluhlaziyiweyo (IA) lwe-COU-AA-302, isifundo se-phase ye-abiraterone (AA) esingahleliyo kwisigulane (i-pts) ngesifo somhlaza wesifo se-prostate (resistant-metant) esingaxhomekiyo (mCRPC) ngaphandle kwe-chemotherapy ngaphambili. J Clin Oncol. Ngo-2013;}

_{Beer TM kunye. al. I-Enzalutamide kumadoda ane-chemotherapy-naive yomdlavuza wesifo se-prostate (mCRPC): Iziphumo zesigaba III. J Clin Oncol 32, 2014 (umxhasi wesi-4; i-LBA1 ^).}

_{Parker C et al. I-Alpha Emitter Radium-223 kunye noKhuseleko kwiMetastatic Cancer Cancer. N Engl J Med. 2013; 369: 213.}

_{Longo DL (ngoJulayi 2010). "Iindlela ezintsha zokwelapha umdlavuza we-prostate-resistant". N. Engl. J. Med. 363 (5): 479-81.}