Abasindile beCancer bahlala isikhathi eside kunanini ngaphambili, futhi lezi ziqhumane nezibopho ziyingxenye ngenxa yemithi emisha. Namuhla eChicago, enkomfeni yesayense ebizwa ngokuthi i-ASCO - umhlangano wonyaka we-American Society of Clinical Oncology - ochwepheshe bekhanda babhekana nezinselele eziyinhloko ku-oncology.
Bayazizwa benethemba langempela, futhi ngezinye izikhathi, bajabule.
Idatha yokuphumula emva kwesikhathi ibonisa ukuthi uGazyva, umuthi omusha wokulwa nomdlavuza , usiza iqembu elikhethekile labantu abalwa nohlobo lomdlavuza wegazi obizwa ngokuthi yi-non-Hodgkin lymphoma, noma i-NHL.
Mayelana ne-Lymphoma engeyona i-Hodgkin's
Kunezinhlobo ezimbili eziyinhloko ze-lymphoma: i-Hodgkin's lymphoma ne-NHL. Cishe amaphesenti angama-85 azo zonke izilonda ezitholakalayo ziyi-NHL. Ngokusho kweMelika Cancer Society, kulindeleke ukuthi abantu abangaba ngu-72 000 bazohlolwa ukuthi baneNHL e-United States ngo-2015, futhi cishe abangaba ngu-20 000 bazofa ngesifo.
Mayelana neSifundo
Izinketho ezinhle zikhona kakade kubantu abalwa nezinhlobo ezahlukene ze- khansa yegazi . Nokho, njengoba abasindile bebazi, ngezinye izikhathi akuyona nje indaba yokuwina impi eyodwa .
Abantu abaningi bajwayele i-rituximab (i-Rituxan), kanye nokuzuza ekusindeni okuhlobene nokusetshenziswa kwamagciwane anjalo omzimba - amaprotheni amakhulu ayenziwa ukuze ahlose futhi abhubhise amangqamuzana omdlavuza ngokubambisana ne-chemotherapy ngokuyimpumelelo kunokhemotherapy yedwa.
Ucwaningo olwethulwa e-ASCO lwalusebenzisa i-anti-monoplonal anti-novel ebizwa ngokuthi i-obinutuzumab eye yavunywa yi-FDA ngaphansi kwegama lezohwebo uGazyva kusukela ngo-2013 ukuze kutholakale ukwelashwa okungavamile kwe- lymphocytic i-leukemia ngokuhambisana ne-chlorambucil chemotherapy ezigulini ezingenayo ukwelashwa.
"Sathuthukise uGazyva ukuba sithuthukise imithi yamanje futhi sathokoze ukubona indlela enikeze ngayo inzuzo kubantu abayeke ukuphendula ezindinganisweni zokunakekelwa," kusho uNancy Valente, MD, iVice President, Global Hematology Development Genentech.
Ucwaningo, olubizwa ngokuthi isifundo se-GADOLIN, lubonisa amandla weGazyva kulezi zilungiselelo. UDkt. Valente uthi lolu hlelo luzofaka isicelo sokuvunywa kweGazyva ku-NHL ngokusekelwe kulolu datha nokuthi balangazelela ukubona imiphumela evela kwezinye izifundo ezimbili ezinkulu eziqhathanisa ikhanda nekhanda likaGazyva komunye wabo osungulwe imithi.
Iziguli
Abahlanganyeli kulolu cwaningo babengamadoda nabesifazane abanomdlavuza - 413 wabo. Bonke babe ne-NHL ekhula kancane noma engahloniphekile eyayithuthukile naphezu kokwelashwa. Ngokuqondile, amakhemikhali abo ayengafuni ukuhlinzeka ngemithi ebizwa ngokuthi i-rituximab - okuwukuthi, i-rituximab noma i-rituximab kanye ne-chemotherapy - okusho ukuthi isifo sabo siphumelele phakathi noma phakathi nezinyanga eziyisithupha zalolu cwaningo.
Ukwelapha
Abahlanganyeli bokufunda ne-NHL ekhulayo eyayiphathwa kancane bebekwe emaqenjini ahlukene amabili, ukuze uthole ukwelashwa okwengeziwe:
- Gazyva plus bendamustine, ilandelwa uGazyva yedwa
- I-Bendamustine chemotherapy yedwa
Imiphumela
- Ukwelashwa okusekelwe eGazyva kunciphisa ingozi yezifo eziqhubekayo noma ukufa ngamaphesenti angu-45 kuqhathaniswa ne-chemotherapy yedwa.
- Ucwaningo lwavalwa ekuseni ngenxa yezinga eliphakeme lokuhlomula elibonwe eqenjini leGazyva uma kuqhathaniswa neqembu le-bendamustine - okungukuthi, bekungeke kube nokuziphatha okuhle ukugcina iqembu le-bendamustine libe yimpumputhe mayelana nemiphumela yeqembu le-Gazyva.
Kubekho amasignali okuphepha angalindelekile aboniswe ne-Gazyva.
Lokho kusho
Umuntu onenhlanhla ye-NHL ngokuvamile uhamba ngokuphindaphindiwe nokubuyiswa, futhi izinketho zinganciphisa uma ukwelashwa okusekelwe e-rituximab kuyeka ukusebenza. Ngakho-ke, inhlanganisela entsha ebonakala isebenza kahle kwiziguli eziphikisayo iindaba ezinhle.
"Abantu abaningi abane-NHL indolent bephindaphindiwe, futhi ukhetho lwezokwelapha lube luncane kakhulu futhi izimpendulo zokwelashwa zivame ukuba zihlale zingapheli isikhathi ngasinye lapho lesi sifo sibuya. Ngikhuthazwa idatha yeGADOLIN ngoba i-obinutuzumab ne-bendamustine iyinhlanganisela yenombala ebonakala iphumelela kakhulu, "kusho uLaurie Sehn, MD, wezokwelapha zezokwelapha e-BC Cancer Agency kanye noProfesa Associate Professor eYunivesithi yaseBrithani Columbia.
Mayelana neGazyva
Esifundweni samanje se-lymphoma, i-Gazyva yandisa isikhathi abantu abahlaselayo be-NHL abaphikisayo ngaphandle kokugula kwabo. U-Genentech noRoche, izinkampani ze-biotechnology ezithuthukisa lo muthi, zizothumela idatha kulolu cwaningo eziphathweni ezilawulayo e-United States, eYurophu nasemhlabeni wonke ukuze zivunyelwe ukucutshungulwa.
I-Gazyva i-anti-monoclonal antibody eyenzelwe ukunamathela ku-CD20, iphrotheni etholakala kuphela kuma-B-cells, iphrotheni efanayo elibhekiswe ku-rituximab. I-Gazyva ibhubhisa i-CD20 ephethe amangqamuzana ngokuqondile kanye kanye nesistimu yomzimba womzimba. I-Gazyva icatshangwa ukuthi inamandla okwandisa ukudala ukufa kwe-cell ngokuqondile futhi yenza umsebenzi omkhulu ekusebenziseni amasosha omzimba ukuze ahlasele i-B-cells - i-cytotoxicity yamaselula exhomeke ku-antibody, noma i-ADCC - uma iqhathaniswa ne-rituximab.
Imiphumela emibi nezenzakalo ezimbi
Uma isetshenziselwa yodwa, imiphumela emibi yeGazyva, ngokuvamile, ayifuni kakhulu kunemiphumela emibi ye-chemotherapy agents. Imiphumela ejwayelekile kunazo zonke ngeGazyva yizimpendulo zokungenisa ukumfutho, ukubalwa kwamaseli amhlophe wegazi eliphansi, ukubala okuphansi kweplatelet, ukubala okuphansi kwe-cell cell, fever, ukukhwehlela, ukucwenga, kanye nesifo sohudo.
I-Gazyva ingabangela izenzakalo ezimbi ezinzima noma ezisongela ukuphila: Ukuvuselelwa kwe-Hepatitis B, i-letifenceal leukoencephalopathy eqhubekayo, noma i-PML, ukusabela kwamakhambi, i-tumor lysis syndrome kanye nezifo. Futhi, i-Gazyva ingabangela ukusabela kwe-infusion, ukwehla kwamanani e-white cell kanye nokuncipha kwezibalo zeplatelet ezingaba yingozi noma ezongela ukuphila.
Imithombo
I-GADOLIN: Imiphumela eyinhloko kusukela ocwaningweni lwesigaba III se-obinutuzumab plus bendamustine uma kuqhathaniswa ne-bendamustine kuphela ezigulini ezine-rituximab-refractory indulent non-Hodgkin lymphoma. J Clin Oncol 33, 2015 (suppl; vstr LBA8502).
Ukwelashwa okuhloswe kwe-leukemia engapheli yelummycytic: amandla emtholampilo we-obinutuzumab. Pharmacogenomics and Medicine Personal. 2014; Dec 22; 8: 1-7.