Cabozantinib Labarun nasarori kan Kula da Caner - AASraw
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Cabozantinib

 

    1. Bayanin Cabozantinib
    2. Tsarin Cabozantinib Na Aiki
    3. Gurbin Cabozantinib
    4. Bugawa na Cabozantinib
    5. Labaran nasarorin Maganin Cabozantinib
    6. Summary

 

Cabozantinib description

Cabozantinib (CAS:849217-68-1) ana amfani dashi don magance ciwon daji na koda, wani lokacin a hada shi da wani magani da ake kira nivolumab. Ana kuma amfani da Cabozantinib don maganin cutar kansar hanta ga mutanen da a baya aka yiwa maganin sorafenib. Ana amfani da Cabozantinib don magance cutar sankarar thyroid wanda ya bazu zuwa sauran sassan jiki. Hakanan ana iya amfani da Cabozantinib don dalilai waɗanda ba a lissafa su a cikin wannan jagorar magani ba.

 

Cabozantinib Hanyar Nauyi

Tsarin kulawa shine sakamakon kimanin shekaru 100 na bincike da aka ƙaddamar don fahimtar bambance-bambance tsakanin kwayoyin cutar kansa da ƙwayoyin al'ada. Zuwa yau, maganin cutar kansa ya fi mai da hankali kan saurin rarraba ƙwayoyin halitta saboda fasali ɗaya na ƙwayoyin kansa shi ne cewa suna saurin rarrabawa. Abun takaici, wasu daga cikin kwayoyin mu na yau da kullun sun rabu da sauri, suna haifar da sakamako mai yawa.

Tsarin da aka kera shi ne game da gano wasu siffofin kwayoyin cutar ciwon daji. Masana kimiyya suna nema bambance-bambance daban-daban a cikin kwayoyin cutar kanjamau da kuma kwayoyin halitta. Ana amfani da wannan bayanin don ƙirƙirar farfado da aka yi nufi don kai hari ga kwayoyin cutar ciwon daji ba tare da lalata kwayoyin halitta ba, saboda haka ya haifar da ƙananan sakamako. Kowace nau'in farfadowa da aka yi niyyar aiki kaɗan kaɗan amma duk yana tsangwama tare da ikon ciwon kwayar halitta don yayi girma, raba, gyara da / ko sadarwa tare da wasu kwayoyin halitta.

Akwai nau'o'i daban-daban na maganin kwantar da hankalin, wanda aka tsara a cikin manyan fannoni uku. Wasu maganin kwantar da hankalin da aka yi niyyar mayar da hankali akan abubuwan da ke ciki da aikin ciwon daji. Harkokin gwagwarmayar da aka yi niyya sunyi amfani da kananan kwayoyin da zasu iya shiga cikin tantanin halitta kuma su rushe aikin da kwayoyin halitta ke haifar da su. Akwai hanyoyi iri-iri da aka yi niyya wanda ke mayar da hankali ga ɓangarorin ciki na sel. Sauran masu kula da maganin kwantar da hankalin da aka yi niyya da ke cikin tantanin halitta. Kwayoyin cutar da ke sa ran masu karɓa suna kuma kasancewa da sunan ƙwayoyin cuta guda daya. Masu maganin antiangiogenesis sun danganta jinin da ke samar da iskar oxygen a cikin kwayoyin halitta, wanda hakan ya haifar da kwayoyin cutar.

Cabozantinib magani ne mai mahimmanci wanda ke niyya kuma ya danganta ga tyrosine kinase masu karɓa da hanawa ayyukan ƙananan tyrosine kinases, gami da RET, MET, da VEGF a saman sel. Ta hanyar ɗaure ga waɗannan masu karɓar karɓa, cabozantinib ya toshe mahimman hanyoyin da ke haɓaka sashin kwayar halitta.

Binciken ya ci gaba da gano abin da za a iya magance cutar ta hanyar maganin cutar da kuma gano wasu ƙari don ƙarin ciwon daji.

 

Cabozantinib Side Gurbin

Samun taimakon likita na gaggawa idan kana da alamun rashin lafiyar abu; wuya numfashi; busa fuskarka, lebe, harshe, ko wuya.

Cabozantinib na iya haifar da rami (rami ko hawaye) ko kuma yoyon fitsari (hanya mara kyau) cikin cikinka ko hanjinka. Kira likitan ku idan kuna da matsanancin ciwon ciki, ko kuma idan kun ji kamar kuna shaƙewa da gumi lokacin da kuka ci ko sha.

Kira likita a yanzu idan kana da:

Headache Ciwon kai mai tsanani, hangen nesa, bugawa a wuya ko kunnuwa;

Om Amai, gudawa, ko maƙarƙashiya mai tsanani da ke gudana;

▪ Kumburi a hannuwanku, hannuwanku, ƙafafunku, ko ƙafafunku;

Ru Rauni mai sauƙi ko zubar jini (zubar jini, gumis mai zub da jini, yawan jinin al'ada, ko duk wani jini wanda ba zai tsaya ba);

Ool kujerun jini ko na jinkiri, tari tare da dusar jini ko amai wanda yake kama da filin kofi;

Und Jaundice (raunin fata ko idanu);

▪ Jin zafi, kumburi, zubar jini, ko tsananin zafin rai a tafin hannayenku ko tafin ƙafarku;

▪ rikicewa, matsalolin tunani, rauni, canjin hangen nesa, kamuwa;

Jin kai mai haske, kamar kuna iya wucewa;

Pain Jin zafi na jaw ko na rashin nutsuwa, ja ko cizon kumburi, haƙoran hakora, ko jinkirin warkarwa bayan aikin haƙori;

Cell whiteananan ƙwayoyin jini sun ƙidaya-zazzabi, ciwon baki, ciwon fata, ciwon makogwaro, tari, matsalar numfashi;

Problems Matsalolin gland na ciki - tashin zuciya, amai, yawan gajiya, jiri, raunin jiki, suma; ko

▪ Alamun shanyewar barin jiki ko kuma daskarewar jini –dauɗewar rauni ko rauni a wani ɓangare na jikinku, matsalolin hangen nesa ko daidaito, matsalar magana ko fahimtar abin da aka faɗa muku, ciwon kirji, matsalar numfashi, kumburi ko ciwo a hannu ko kafa .

Kwananan ku na cabozantinib na iya jinkirta ko dakatar da su gaba ɗaya idan kuna da wasu lahani.

 

Hanyoyin cutar na iya haɗawa da su:

Pain Ciwon ciki, tashin zuciya, amai, rashin cin abinci, gudawa, maƙarƙashiya;

▪ Jin zafi, ja, kumburi, ko ciwo a bakinka ko maqogwaro;

Speaking Maganar wahala, canje-canje a dandano;

Symptoms Alamomin sanyi kamar su hanci, atishawa, ciwon makogwaro, tari;

▪ rash;

▪ Jin zafi a cikin tsokoki, ƙasusuwa, da haɗin gwiwa;

Tests Gwajin aikin hanta mara kyau ko wasu gwaje-gwaje na jini;

Tired Jin kasala;

Loss Rage nauyi; ko

Color Launin gashi ya koma haske.

Wannan ba cikakken lissafi ne na sakamakon lalacewa ba kuma wasu zasu iya faruwa. Kira likitan ku don shawara na likita game da illa mai lalacewa. Kuna iya bayar da rahoton abubuwan lalacewa zuwa FDA a 1-800-FDA-1088.

 

Bugawa Development Of Cabozantinib 

Cabozantinib ya sami matsayin maraya ta Hukumar Abinci da Magunguna ta Amurka (FDA) a cikin Nuwamba Nuwamba 2010 da Fabrairu 2017.

Exelixis ya gabatar da sabon aikace-aikacen magani tare da FDA a farkon rabin shekarar 2012 kuma a ranar 29 ga Nuwamba, 2012 cabozantinib a cikin kwalin kwafinsa ya sami izinin kasuwanci ta hannun FDA ta Amurka a karkashin sunan Cometriq don kula da marasa lafiya tare da medullary thyroid cancer. an yarda da shi a Tarayyar Turai don irin wannan manufar a cikin 2014.

A watan Maris 2016 Exelixis lasisi ne ga Ipsen haƙƙin duniya (a wajen Amurka, Kanada, da Japan) don tallata cabozantinib.

Exelixis 'Phase III na gwajin sakamakon gwajin maganin a cikin koda ciwon daji wanda aka buga a cikin NEJM a 2015. A watan Afrilun 2016 FDA ta ba da izinin tallata tallan kwamfutar hannu a matsayin layi na biyu na maganin koda ciwon daji kuma an yarda da hakan a Tarayyar Turai a watan Satumbar shekarar.

A watan Disamba na 2017, FDA ta ba da izinin cabozantinib (Cabometyx, Exelixis, Inc.) don maganin mutanen da ke da ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta (RCC). Amincewar ta dogara ne akan bayanai daga CABOSUN (NCT01835158), bazuwar, lakabin bude-lakabi na biyu nazarin manyan ɗalibai a cikin mahalarta 157 tare da matsakaici da talauci-haɗarin da ba a taɓa magance shi ba RCC.

A Janairu 2019, da FDA ta amince da cabozantinib (Cabometyx, Exelixis, Inc.) ga mutanen da ke fama da cutar sankarar hanta (HCC) waɗanda a da aka ba su magani tare da sorafenib. Amincewar ta dogara ne akan CELESTIAL (NCT01908426), bazuwar (2: 1), makafi biyu, mai sarrafa wuribo, fitina mai yawan gaske a cikin mahalarta tare da HCC waɗanda suka karɓi sorafenib a baya kuma suna da lahani na Yara.

Ana binciken Cabozantinib don inganci azaman magani ga nau'in 1 neurofibromatosis.

Hukumar Abinci da Magunguna (FDA) kwanan nan ta amince da cabozantinib don maganin cututtukan hepatocellular marasa lafiya waɗanda a baya suka karɓi sorafenib.

Cabozantinib shine mai hana cin hanci da rashawa na MET, VEGFR, da AXL.Receptor tyrosine kinases suna taka muhimmiyar rawa a cikin aikin salula na yau da kullun da kuma hanyoyin maganin cuta, gami da oncogenesis, metastasis, tumor angiogenesis, da kuma kula da ƙwayar microenvironment.

FDA ta fara amincewa da cabozantinib don maganin medullary thyroid ciwon daji. Daga baya, FDA ta amince da amfani da shi a cikin ƙwayar sankara a cikin ƙwayar koda.

 

Labaran nasarorin Maganin Cabozantinib 

Labari na 1: Cabozantinib Ya Bi da Layin-Farko na Cutar Ciwon Hoto na Renal

A ranar 19 ga Disamba, 2017, Hukumar Abinci da Magunguna ta Amurka (FDA) ta ba da izini na yau da kullun ga cabozantinib (Cabometyx) don kula da marasa lafiya da keɓaɓɓiyar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta (RCC).

FDA a baya ta amince da cabozantinib a cikin 2016 don kula da marasa lafiya tare da RCC mai ci gaba waɗanda suka karɓi maganin antiangiogenic kafin. Yarjejeniyar yau ta ba da magani a cikin saitin layi na farko.Cabozantinib

Wannan amincewar ta dogara ne da bayanai daga gwajin CABOSUN, bazuwar, lakabin bude-lakabi na II binciken yawan fannoni a cikin marasa lafiya 157 tare da matsakaici- da kuma kasada-kasadar da ba a magance RCC ba. Marasa lafiya sun sami cabozantinib (n = 79) 60 MG na magana yau da kullun ko sunitinib (Sutent) (n = 78) 50 MG na magana a kowace rana (makonni 4 a kan magani da aka bi bayan makonni 2) har sai ci gaba da cutar ko cutar mai guba. Ididdigar rayuwa ba tare da ci gaba ba (kamar yadda aka duba ta hanyar kwamitin binciken rediyo mai zaman kansa) don marasa lafiya da ke shan cabozantinib watanni 8.6 ne (95% tazarar amincewa [CI] = 6.8-14.0) idan aka kwatanta da watanni 5.3 (95% CI = 3.0-8.2) don marasa lafiya da ke shan sunitinib (haɗarin haɗari = 0.48; 95% CI = 0.31-0.74; P = .0008).

Mafi yawan rahoton da aka ruwaito (≥ 25%) mummunan sakamako a cikin shirin cabozantinib na asibiti sune gudawa, gajiya, tashin zuciya, rage ci, hauhawar jini, palmar-plantar erythrodysesthesia, asarar nauyi, amai, dysgeusia, da stomatitis.

Mafi yawan halayen rashin tasirin 3-4 (≥ 5%) a cikin marasa lafiya waɗanda aka kula da su tare da cabozantinib akan CABOSUN sune hauhawar jini, gudawa, hyponatremia, hypophosphatemia, palmar-plantar erythrodysesthesia, gajiya, ALT karuwa, rage ci abinci, stomatitis, zafi, tashin hankali, da kuma aiki tare Abun da aka ba da shawarar na cabozantinib shine 60 MG a baki, sau ɗaya kowace rana.

Hakanan an yarda da Cabozantinib don maganin medullary ciwon daji na thyroid kuma ana tallatawa a ƙarƙashin sunan kasuwanci Cometriq. Cometriq da Cabometyx suna da tsari daban-daban kuma basu canzawa.

 

Labari 2: Cabozantinib Maganin Ciwon Cancer na Medullary

FDA ta amince da cabozantinib (Cometriq) don magance metastatic medullary thyroid cancer (MTC) a watan Nuwamba 2012. Ya dogara ne da sakamako daga ƙasashen duniya, masu yawa, bazuwar, makafi biyu, gwajin sarrafawa gami da batutuwa 330. Masu shiga sun buƙaci su nuna cutar ta ci gaba a cikin watanni 14 kafin a shiga karatun, wanda aka tabbatar ta hanyar kwamiti na nazarin rediyo mai zaman kansa ko likitan da ke kula da shi.

An rarraba marasa lafiya don karɓar cabozantinib 140 MG ko placebo a baki sau ɗaya kowace rana har sai cutar ta ci gaba ko cutar mai guba. Randomization ya daidaita daidai da shekaru <65 shekaru vs> shekaru 65 da kuma amfani da baya na mai hana cin hanci da rashawa tyrosine kinase.Cabozantinib

Mahimman bayanan farko sun kasance ba tare da ci gaba ba (PFS), amsar maƙasudin (OR), da kuma lokacin amsawa wanda ke amfani da ƙididdigar RECIST. Marasa lafiya a cikin ƙungiyar cabozantinib sun tsawanta PFS idan aka kwatanta da waɗanda ke karɓar wuribo (P <.0001). Musamman, PFS na tsakiya a hannun cabozantinib ya kasance watanni 11.2 kuma PFS na tsakiya a hannun placebo ya kasance watanni 4.0.

Marasa lafiya kawai da ke shan cabozantinib sun sami amsa ta musamman (27% vs 0; P <.0001). Bugu da ƙari, matsakaiciyar lokacin na OR ya kasance watanni 14.7 ga waɗanda aka yi wa magani tare da magani. Babu wani bambance-bambance mai mahimmanci a cikin rayuwa gabaɗaya da aka lura tsakanin makamai.

A cikin 2019 meta-da nazarin tattalin arziki na kimanta amfanin cabozantinib da vandetanib a cikin marasa lafiya na Hukumar Kiwan Lafiya ta Ingila, Tappenden et al. Kammalawa.

“Gwaje-gwajen da aka gano sun nuna cewa cabozantinib da vandetanib sun inganta PFS fiye da placebo; duk da haka, ba a nuna mahimman fa'idodin OS ba. Nazarin tattalin arziki ya nuna cewa a tsakanin yawan masu lakabin EU, ICERs [ƙarin haɓaka mai fa'ida mai fa'ida] don cabozantinib da vandetanib sune> £ 138,000 a kowace QALY (shekara mai inganci mai daidaituwa) da aka samu. A cikin ƙayyadaddun yawan Tarayyar Turai (Tarayyar Turai) -label, ana sa ran ICER na vandetanib zai kasance £ 66,000 a kowace QALY da aka samu. ”

 

Labari 3: Maganin Cabozantinib Ciwon Cutar Sanda

A watan Janairun 2019, FDA ta amince da allunan cabozantinib don marasa lafiya carcinoma hepatocellular (HCC) da aka sha magani da sorafenib. Amincewar ta dogara ne da sakamako daga gwajin CELESTIAL.

A cikin bazuwar (2: 1), makafi biyu, sarrafa wuribo, gwaji da yawa, marasa lafiya bazuwar zuwa cabozantinib 60 MG da baki sau ɗaya kowace rana (n = 470) ko placebo (n = 237) har zuwa lokacin ci gaban cuta ko rashin karɓa. yawan guba.Cabozantinib

Matsayin farko shine OS. PFS da ORR, waɗanda masu binciken suka tantance ta amfani da RECIST 1.1, an kuma auna su. Amfani da Cabozantinib yana da alaƙa da OS na tsakiya na watanni 10.2 (95% CI: 9.1-12.0) da watanni 8 (95% CI: 6.8-9.4) don waɗanda ke karɓar placebo (HR 0.76; 95% CI: 0.63, 0.92; P = .0049). PFS na Mediya ya kasance watanni 5.2 (4.0-5.5) a cikin hannun cabozantinib idan aka kwatanta da watanni 1.9 (1.9-1.9) a cikin hannun placebo (HR 0.44; 95% CI, 0.36, 0.52; P <.001). ORR ya kasance 4% (95% CI, 2.3, 6.0) a cikin waɗanda ke shan cabozantinib vs 0.4% (95% CI, 0.0, 2.3) a cikin waɗanda ke shan placebo.

Matakan 3 ko 4 abubuwan da suka faru sun kasance mafi girma a cikin marasa lafiya da ke shan cabozantinib (68%) fiye da waɗanda ke shan placebo (36%).

Marubutan gwajin CELESTIAL sun kammala tare da masu zuwa: “Daga cikin marasa lafiyar da ke fama da cutar sankarar hanta ta hanta, magani tare da cabozantinib ya haifar da rayuwa gaba daya da rashin ci gaba fiye da placebo. Adadin manyan abubuwan da suka faru a cikin rukunin cabozantinib ya ninka sau biyu wanda aka gani a cikin rukunin placebo. ”

 

Summary

Cabozantinib shine mai hana cin hanci da rashawa tyrosine kinase wanda aka yi amfani dashi don magance ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta, da ciwon daji na hanta, da ciwon daji na maganin kawan. An fara yarda da Cabozantinib a cikin 2012 kuma shine mai takamaiman takamaiman tyrosine kinase. Da farko an amince da shi a cikin Amurka a ƙarƙashin sunan mai suna Cometriq, wanda aka nuna don maganin cututtukan cututtukan ƙwayar cuta na ƙwayar cuta. A cikin 2016, samfurin kwalliya (Cabometyx) an amince da shi don maganin cututtukan ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta mai ɗan ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin kumburin da ke jikinku, kuma wannan tsarin ya sami ƙarin amincewa a duka Amurka da Kanada a cikin 2019 don kula da cutar sankarar hanta a cikin marasa lafiyar da aka kula da su a baya.

 

reference

[1] Choueiri TK, Escudier B, Powles T, et al. Cabozantinib da everolimus a cikin ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta (METEOR): sakamakon ƙarshe daga bazuwar, lakabin buɗewa, gwajin 3 na zamani. Lancet Oncol. 2016; 17: 917-27.

[2] Tappenden P, Carroll C, Hamilton J, et al. Cabozantinib da vandetanib don ƙananan ci gaba na cikin gida ko ƙananan ƙwayoyin maganin karoid: nazari na yau da kullun da tsarin tattalin arziki. Kiwon Lafiya na Technol. 2019; 23: 1-144.

[3] George DJ, Hessel C, Halabi S, et al. Cabozantinib tare da sunitinib don marasa lafiya marasa magani tare da ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar matsakaici ko mummunan haɗari: nazarin ƙananan ƙungiyoyi na gwajin A031203 CABOSUN gwaji. Oncologist 2019; 24: 1-5.

[4] Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Muller T, Ratain MJ , Salgia R: Ayyuka na XL184 (Cabozantinib), mai hana maganin tyrosine kinase, a cikin marasa lafiya tare da medullary thyroid cancer. J Clin Oncol. 2011 Jul 1; 29 (19): 2660-6. Doi: 10.1200 / JCO.2010.32.4145. Epub 2011 Mayu 23.

[5] Abou-Alfa GK, Meyer T, Cheng AL, et al. Cabozantinib a cikin marasa lafiya tare da ci gaba da ci gaba da ciwon hanta na hanta. N Engl J Med. 2018; 379: 54-63.

[6] Hukumar Abinci da Magunguna ta Amurka. FDA ta amince da cabozantinib don cutar sankarar hanta. Akwai a: https://www.fda.gov/drugs/fda-approves-cabozantinib-hepatocellular-carcinoma Samun damar Agusta 28, 2019.

[7] Yakes FM, Chen J, Tan J, Yamaguchi K, Shi Y, Yu P, Qian F, Chu F, Bentzien F, Cancilla B, Orf J, Ku A, Laird AD, Engst S, Lee L, Lesch J, Chou YC , Joly AH: Cabozantinib (XL184), wani labari mai suna MET da VEGFR2 inhibitor, a lokaci guda yana hana metastasis, angiogenesis, da ci gaban tumo. Mol Ciwon daji Ther. 2011 Dec; 10 (12): 2298-308. Doi: 10.1158 / 1535-7163.MCT-11-0264. Epub 2011 Sep 16.

[8] "Maganin ciwon sankara na maganin karoid cabozantinib ya tsawaita PFS". An adana daga asali ranar 2012-04-02. An dawo da 24 Oktoba 2011.

[9] "Tsarin Cabozantinib Marayu Marayu da Amincewa". Hukumar Abinci da Magunguna ta Amurka (FDA). 29 Nuwamba 2010. An dawo da 11 Nuwamba Nuwamba 2020.

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