Immunotherapy ya Metastatic Renal Cell Carcinoma

Zamkati

• Kodi immunotherapy ndi chiyani?
• Ziphuphu
• Interleukin-2 (IL-2)
• Kuphatikizira-alfa
• Zoletsa zoletsa
• Nivolumab (Opdivo)
• Ipilimumab (Yervoy)
• Zotsatira zoyipa
• Tengera kwina

Chidule

Pali mankhwala angapo a metastatic renal cell carcinoma (RCC), kuphatikiza opaleshoni, chithandizo chamankhwala, komanso chemotherapy.

Koma nthawi zina, mutha kusiya kuyankha kuchipatala. Nthawi zina, mankhwala omwe amalangizidwa amatha kuyambitsa zovuta zina kapena zovuta zina.

Izi zikachitika, dokotala wanu angakulimbikitseni mtundu wina wa chithandizo chotchedwa immunotherapy. Nazi izi mwatsatanetsatane za immunotherapy, komanso ngati zili zoyenera kwa inu.

Kodi immunotherapy ndi chiyani?

Immunotherapy ndi mtundu wa chithandizo cha khansa chomwe chimagwiritsa ntchito zinthu zachilengedwe komanso zopangira kusintha momwe maselo amthupi lanu amakhalira. Mitundu ina ya immunotherapy imagwira ntchito yolimbana kapena kuwononga maselo a khansa. Ena amalimbitsa kapena kulimbikitsa chitetezo cha mthupi lanu ndikuthandizira kuthana ndi zizindikilo ndi zovuta za khansa yanu.

Pali mitundu iwiri ikuluikulu ya mankhwala a immunotherapy a metastatic RCC: cytokines ndi checkpoint inhibitors.

Ziphuphu

Cytokines ndimitundu yama protein yomwe imapangidwa ndimthupi yomwe imathandizira ndikulimbikitsa chitetezo cha mthupi. Ma cytokines awiri omwe amagwiritsidwa ntchito kwambiri pochiza khansa ya impso ndi interleukin-2 ndi interferon-alpha. Awonetsedwa kuti amathandizira kuchepetsa khansa ya impso mwa ochepa peresenti ya odwala.

Interleukin-2 (IL-2)

Ichi ndiye cytokine yothandiza kwambiri pochiza khansa ya impso.

Mlingo waukulu wa IL-2, komabe, umatha kuyambitsa zovuta zoyipa komanso nthawi zina zakupha. Zotsatirazi zimaphatikizapo kutopa, kuthamanga kwa magazi, kupuma movutikira, kuchuluka kwa madzi m'mapapu, kutuluka m'mimba, kutsegula m'mimba, ndi matenda amtima.

Chifukwa cha chiopsezo chake, IL-2 nthawi zambiri imangoperekedwa kwa anthu omwe ali ndi thanzi lokwanira kupirira zotsatirapo zake.

Kuphatikizira-alfa

Interferon-alfa ndi cytokine ina yomwe nthawi zina imagwiritsidwa ntchito pochiza khansa ya impso. Nthawi zambiri amaperekedwa ngati jakisoni wocheperako katatu pamlungu. Zotsatira zake zoyipa zimaphatikizapo zonga chimfine, nseru, ndi kutopa.

Ngakhale zotsatirazi ndizochepa kuposa IL-2, interferon siyothandiza mukamagwiritsa ntchito yokha. Zotsatira zake, nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwala osokoneza bongo otchedwa bevacizumab.

Zoletsa zoletsa

Chitetezo chanu cha mthupi chimadziteteza kuti chisalowe m'maselo abwinobwino amthupi lanu pogwiritsa ntchito malo osaka. Awa ndi mamolekyulu omwe ali m'maselo anu oteteza thupi omwe amafunika kutsegulidwa kapena kuzimitsidwa kuti ayambitse chitetezo chamthupi. Sakani ma cell nthawi zina amagwiritsa ntchito malowa kuti asalimbane ndi chitetezo cha mthupi.

Checkpoint inhibitors ndi mankhwala omwe amayang'ana malo osakira. Amathandiza kuteteza mayankho a chitetezo cha mthupi mwanu ku maselo a khansa.

Nivolumab (Opdivo)

Nivolumabis choletsa chitetezo cha mthupi chomwe chimayang'ana ndikuletsa PD-1. PD-1 ndi mapuloteni m'maselo anu amthupi a T omwe amawateteza kuti asalimbane ndi ma cell ena mthupi lanu. Izi zimathandizira kulimbitsa chitetezo chanu cha mthupi motsutsana ndi maselo a khansa ndipo nthawi zina kumachepetsa kukula kwa zotupa.

Nivolumab nthawi zambiri amapatsidwa kudzera m'mitsempha kamodzi pamasabata awiri. Ndi njira yabwino kwa anthu omwe RCC yayambiranso kukula atagwiritsa ntchito mankhwala ena.

Ipilimumab (Yervoy)

Ipilimumab ndi chinthu china choteteza chitetezo cha mthupi chomwe chimayang'ana puloteni ya CTLA-4 pama cell a T. Amapatsidwa kudzera m'mitsempha, nthawi zambiri kamodzi pamasabata atatu pazithandizo zinayi.

Ipilimumab itha kugwiritsidwanso ntchito kuphatikiza nivolumab. Izi ndi za anthu omwe ali ndi khansa yayikulu ya impso omwe sanalandirebe chithandizo.

Kuphatikizana kumeneku kwawonetsedwa kuti kukuwonjezera kwambiri kuchuluka kwa zopulumuka. Kawirikawiri amaperekedwa muzigawo zinayi, kenako ndi nivolumab yokha.

Zambiri kuchokera ku kafukufukuyu zomwe zidasindikizidwa mu New England Journal of Medicine zidawonetsa kupulumuka kwa miyezi 18 pothandizidwa ndi nivolumab ndi ipilimumab.

Pa Epulo 16, 2018, a FDA adavomereza kuphatikiza uku kochizira anthu omwe ali ndi vuto la renal cell carcinoma.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri za chitetezo cha mthupi ndi zotopa, zotupa pakhungu, kuyabwa, ndi kutsegula m'mimba. Nthawi zambiri, PD-1 ndi CTLA-4 inhibitors zitha kubweretsa zovuta ku ziwalo zomwe zitha kupha moyo.

Ngati mukulandira mankhwala a immunotherapy ndi imodzi kapena mankhwala onsewa ndikuyamba kukumana ndi zovuta zina, muuzeni dokotala nthawi yomweyo.

Tengera kwina

Chithandizo chomwe inu ndi adokotala mungasankhe chimadalira pazinthu zingapo. Ngati mukukhala ndi metastatic RCC, lankhulani ndi dokotala za zomwe mungachite.

Pamodzi, mutha kukambirana ngati ingakhale njira yothandiza yothandizira inu. Akhozanso kulankhula nanu za nkhawa zilizonse zomwe muli nazo pazotsatira zake kapena kutalika kwa chithandizo.