Mene Ne Mafi Ingancin Magunguna Don Kula da Ciwon Nono?
AASraw yana samar da NMN da NRC foda a cikin girma!

Neratinib

 

  1. Nawa muka sani game da cutar sankarar mama?
  2. Sakamakon Clinical Ta FDA Apprvoal
  3. Menene Neratinib?
  4. Wanene Zai Iya Bukatar Neratinib?
  5. Taya zaka San Ko Neratinib yayi dai dai da kai?
  6. Yaya Neratinib ke aiki?
  7. Ta Yaya Za Mu ɗauki Neratinib?
  8. Me Za Mu Iya Ganin Illar Neratinib?
  9. Kammalawa

 

Nawa muka sani game da Ciwon daji na nono

Ciwon nono shine mafi yawan nau'in cutar kansa a cikin mata, wanda ke wakiltar kashi 15% na duk sababbin cututtukan daji a Amurka. A shekarar 2017, an yi kiyasin za a gano sabbin mutane 252,710 da suka kamu da cutar sankarar mama, kuma sama da mata 40,600 za su mutu daga cutar. Ciwon daji na iya, ba safai ba, zai iya shafar maza, tare da kimanin sabbin mutane 2470 da ake bincika kowace shekara.

Kusan 15% zuwa 20% na ciwon daji na nono sune HER2-tabbatacce. Ciwon daji na nono tare da babban matakin HER2 yana da haɗarin haɗari ga metastasis, rashin isasshen maganin jiyya, da sake dawowa.

Ci gaban da kuma yarda da Hukumar Abinci da Magunguna ta Amurka (FDA) na trastuzumab (Herceptin), mai karɓar mai karɓar HER2, ya canza yanayin maganin marasa lafiya da cutar HER2. Lokacin da aka kara trastuzumab zuwa chemotherapy, yawan rayuwar rayuwa ga mata masu matakin farko HER2-tabbataccen ciwon nono ya inganta har zuwa 37%. Koyaya, kusan 26% na marasa lafiya suna da cutar ta maimaituwa bayan jiyya tare da trastuzumab.

Sauran hanyoyin kwantar da hankalin da suka shafi HER2-tabbatacciyar cutar sankarar mama sun hada da pertuzumab (Perjeta), wani kwayar cutar ta monoclonal; ado-trastuzumab emtansine (Kadcyla), kwayar cutar monoclonal da ke hade da maganin cutar sankara; da lapatinib (Tykerb), mai hana kinase.

 

Abubuwan Bincike By FDA Apprvoal

Amincewar FDA na Neratinib ya dogara ne akan gwajin Phase III ExteNET, mai yawan jama'a, bazuwar, makafi biyu, gwajin gwajin wuribo na neratinib bayan adjuvant trastuzumab magani. Gwajin ya sanya mata 2,840 tare da matakin farko-HER2-tabbataccen ciwon nono kuma a cikin shekaru biyu na kammala adjuvant trastuzumab. An rarraba batutuwa don karɓar neratinib (n = 1420) ko placebo (n = 1420) na shekara guda. Sakamakon gwajin ExteNET ya nuna cewa bayan shekaru biyu na biyewa, rashin cutar mara lafiya (iDFS) ya kasance 94.2% a cikin batutuwa da aka yi wa maganin neratinib idan aka kwatanta da 91.9% a cikin waɗanda ke karɓar placebo.

Neratinib kuma an kimanta shi a cikin Phase III NALA gwaji, gwajin bazuwar neratinib da capecitabine a cikin marasa lafiya tare da HER2-tabbataccen ƙwayar ƙwayar nono waɗanda suka karɓi biyu ko fiye da rigakafin HER2. Gwajin ya sanya marasa lafiya 621 waɗanda aka bazu (1: 1) don karɓar neratinib 240 MG na magana sau ɗaya a rana 1-21 a hade tare da capecitabine 750 mg / m2 ana ba da baki sau biyu a rana 1-14 don kowane zagaye na 21 ( n = 307) ko lapatinib 1250 MG da baki sau ɗaya a rana sau 1-21 a haɗe tare da capecitabine 1000 mg / m2 ana bayarwa sau biyu kowace rana a ranakun 1-14 ga kowane zagayowar kwana 21 (n = 314). An kula da marasa lafiya har sai ci gaba da cutar ko cutar da ba za a yarda da ita ba. Jiyya tare da neratinib a haɗe tare da capecitabine ya haifar da ci gaba mai ƙididdigar ci gaba a rayuwa mai ci gaba (PFS) idan aka kwatanta da magani tare da lapatinib da capecitabine. Adadin PFS a watanni 12 ya kasance 29% ga marasa lafiyar da suka sami neratinib da capecitabine vs 15% ga marasa lafiya da suka karbi lapatinib da capecitabine; farashin PFS a watanni 24 ya kasance 12% vs 3%, bi da bi. Median OS watanni 21 ne ga marasa lafiya waɗanda suka karɓi neratinib a haɗe tare da capecitabine idan aka kwatanta da watanni 18.7 ga marasa lafiya da suka karɓi lapatinib a haɗe haɗe da capecitabine.

 

Neratinib

 

Abin da Is Neratinib?

Neratinib (CAS: 698387-09-6) magani ne wanda ake niyya (ilimin halittu) wanda yake toshe girma da yaduwar cutar sankarar mama. Neratinib shine sunan marasa magani. Sunanta mai suna Nerlynx.

 

Wanda Might Bukatar Neratinib?

Neratinib za a iya ba da shi ga mutanen da ke da cutar sankarar mama ta farko wanda duka biyu ne:

Rece Mai karɓar Hormone tabbatacce (ciwon nono wanda ke haɓaka don girma ta cikin kwayar halittar estrogen ko progesterone)

HER2 tabbatacce (ciwon nono wanda yake sama da matakin al'ada na furotin HER2)

 

Taya zaka San Ko Neratinib yayi dai dai da kai?

Akwai gwaje-gwaje da yawa da aka yi amfani dasu don gano idan kansar nono HER2 ce. Biyu daga cikin gwaje-gwaje na yau da kullun sune:

 

 IHC (ImmunoHistoChemistry)

Gwajin IHC yana amfani da fenti na sinadarai don lalata sinadaran HER2. IHC tana bayar da kashi 0 zuwa 3 + wanda ke auna adadin sunadaran HER2 a saman ɗakunan cikin samfurin nama na kansar mama. Idan maki ya kasance 0 zuwa 1 +, ana ɗaukarsa HER2-korau. Idan maki ya kasance 2 +, ana la'akari da iyaka. Sakamakon 3 + ana ɗaukar HER2-tabbatacce.

Idan sakamakon gwajin IHC ya kasance iyaka ne, akwai yiwuwar za a yi gwajin FISH a kan samfurin ƙwayoyin cutar kansa don sanin ko kansar HER2 ce mai kyau.

 

 FISH (Fluorescence A Cikin Gudanarwa)

Jarabawar FISH tana amfani da lakabobi na musamman waɗanda ke haɗe da sunadaran HER2. Alamomin na musamman suna da sunadarai da aka ƙara akan su don haka suna canza launi da haske a cikin duhu lokacin da suka haɗu da sunadaran HER2. Wannan gwajin shine mafi daidai, amma ya fi tsada kuma yana ɗaukar tsayi don dawo da sakamako. Wannan shine dalilin da ya sa gwajin IHC yawanci shine gwaji na farko da ake yi don ganin ko ciwon daji na HER2-tabbatacce ne. Tare da gwajin FISH, zaka sami maki na ko dai tabbatacce ko mara kyau (wasu asibitoci suna kiran sakamakon gwajin mara kyau "sifili").

 

Yaya Neratinib ke aiki?

HER2-tabbataccen ciwon nono yana yin yawancin furotin na HER2. Furotin HER2 yana zaune akan ƙwayoyin kansa kuma yana karɓar siginar da ke gaya wa cutar kansa girma da bazuwa. Kusan ɗaya daga cikin huɗu na mama na HER2-tabbatacce ne. HER2-tabbataccen cututtukan nono sun fi zama masu rikici da wuyar magancewa fiye da cutar ta nono ta HER2. Neratinib shine mai hana-pan-HER mai hanawa. Neratinib yana yaƙi da HER2-tabbataccen ciwon nono ta hanyar toshe ƙwayoyin ƙwayoyin kansa don karɓar siginar girma.

Neratinib shine Tarurrukan ci gaba, amma sabanin Herceptin (sunan sunadarai: trastuzumab), Kadcyla (sunan sunadarai: T-DM1 ko ado-trastuzumab emtansine), da Perjeta (sunan sunadarai: pertuzumab), ba magani ne na kariya ba. Magungunan kwantar da hankula da aka yi niyya su ne sifofin ƙwayoyin cuta waɗanda ke aiki kamar ƙwayoyin cuta waɗanda ƙwayoyin jikinmu suka yi. Neratinib mahaɗan sunadarai ne, ba antibody ba.

 

Ta Yaya Za Mu ɗauki Neratinib?

Adadin shawarar neratinib shine 240 MG (Allunan 6), ana shan shi sau ɗaya kowace rana tare da abinci, kuma ana amfani dashi tsawon shekara 1. Neratinib yana samuwa azaman kwamfutar hannu 40-mg.

Don maganin cututtukan cututtukan ciki, loperamide ya kamata a yi amfani dashi tare da kashi na farko na neratinib kuma ya ci gaba yayin zagaye na farko 2 (watau, kwanaki 56) na jiyya, sannan kuma kamar yadda ake buƙata. Yakamata a umarci marasa lafiya su kula da hanji 1 zuwa 2 a kullum, kuma ya kamata a ba su umarni kan yadda za a yi amfani da tsarin maganin cututtukan ciki.

Ruptionididdigar takamaiman kashi da / ko shawarwarin rage kashi, gwargwadon haƙuri na mutum ɗaya, an bayyana su a cikin bayanin bayanin. Ga marasa lafiya masu fama da larurar hanta, ya kamata a rage matakin farko na neratinib zuwa 80 MG.

 

Bayanin kula: duk bayanan sun kasance kawai a matsayin tunani, daga NERLYNX (neratinib) allunan (PDF)

 

Me Za Mu Iya Ganin Illar Neratinib? 

Tsananin gudawa jim kaɗan bayan fara neratinib sakamako ne na gama gari. A cikin gwajin ExteNET, kimanin kashi 40% na matan da aka kula da su neratinib suna da zawo mai tsanani a matsayin sakamako na gefe.

Amincewar FDA ta ba da shawarar cewa loperamide (sunayen sunaye sun haɗa da Imodium, Kaopectate 1-D, da Pepto Diarr Control) tare da neratinib na kwanakin 56 na farko na magani sannan kuma kamar yadda ake buƙata don taimakawa wajen sarrafa gudawa.

 

Sauran illolin gama gari na neratinib su ne:

▪ amai

Use tashin zuciya

Pain ciwon ciki

▪ gajiya

▪ rash

▪ ciwon baki

 

A cikin lokuta masu yawa, neratinib na iya haifar da babbar matsalar hanta. Faɗa wa likitanku nan da nan idan kuna da wasu alamun alamun matsalolin hanta:

▪ rawaya fata ko fararen idanu

Urine fitsari mai duhu ko ruwan kasa

▪ jin kasala sosai

▪ rashin cin abinci

Ciwo a gefen dama na sama na ciki

▪ zub da jini ko rauni a cikin sauki fiye da yadda aka saba

AASraw shine ƙwararren masanin masana'antar Neratinib.

Da fatan za a danna nan don bayanin zance: Saduwa da mu

 

Kammalawa

Amincewar FDA na neratinib, mai hana kainase kinase, ya nuna samfuran zaɓin magani na farko wanda aka faɗaɗa ga marasa lafiya masu dacewa da matakin farko, nono na HER2 ciwon daji. Marasa lafiya tare da HER2-tabbatacce ciwon nono wanda ya karba neratinib don shekara 1 ta sami ingantaccen ingantaccen rayuwa na shekaru 2 masu cutar marasa cutar idan aka kwatanta da marasa lafiyar da suka karɓi placebo, bayan chemotherapy da trastuzumab na tushen adjuvant therapy.

 

reference

[1] Chan A, Delaloge S, Holmes FA, et al; don Kungiyar Nazarin ExteNET. Neratinib bayan maganin adjuvant na tushen trastuzumab a marasa lafiya tare da HER2positive nono (ExteNET): mai yawan multicentre, bazuwar, makafi biyu, placebocontrolled, lokaci 3 gwaji. Lancet Oncol. 2016; 17: 367-377.

[2] Hukumar Abinci da Magunguna ta Amurka. FDA ta amince da sabon magani dan rage barazanar kamuwa da cutar sankarar mama. Sanarwar sanarwa. 17 ga Yuli, 2017.

[3] Nerlynx (neratinib) allunan [bada bayanai]. Los Angeles, CA: Kimiyyar Fasaha ta Puma; Yuli 2017.

[4] Cibiyar Cancer ta Kasa. Ma'aikatan da aka yi niyya akan HER2-tabbataccen ciwon nono: tambayoyi da amsoshi. An sabunta Yuni 1, 2014. www.cancer.gov/types/breast/research/altto-qa. An shiga Satumba 22, 2017.

[5] Singh J, Petter RC, Baillie TA, Whitty A (Afrilu 2011). "Mayar da kwayoyi masu kwazo". Yanayi Bayani. Gano Magunguna. 10 (4): 307-17. Doi: 10.1038 / nrd3410. PMID 21455239. S2CID 5819338.

[6] Minami Y, Shimamura T, Shah K, LaFramboise T, Glatt KA, Liniker E, et al. (Yuli 2007). "Manyan cututtukan da suka kamu da cutar sankarar huhu na ERBB2 suna oncogenic kuma suna da alaƙa da ƙwarewa ga mai hana EGFR / ERBB2 mai hana HKI-272". Oncogene. 26 (34): 5023-7. Doi: 10.1038 / sj.onc.1210292. PMID 17311002.

[7] Cibiyar Cancer ta Kasa. Maganin kansar nono na maza (PDQ) - fasalin ƙwararrun masu lafiya. An sabunta Mayu 25, 2017. www.cancer.gov/types/breast/hp/male-breast-treatment-pdq. An shiga Satumba 22, 2017.

0 Likes
339 Views

Za ka iya kuma son

Comments an rufe.