Ibrutinib, Brentuximab, iBlinatumomab ne-Idelalisib
I-American Society of Hematology (ASH) ngumphakathi omkhulu kunazo zonke ochwepheshe emhlabeni obhekene nezimbangela kanye nokwelashwa kwezifo zegazi. Njalo ngonyaka, okuhle kakhulu futhi okugqamile emhlabeni jikelele kuza ukuza ku-ASH.
Kulo nyaka, kube neseshini mayelana nemithi emisha e-FDA evunyelwe izimo ze-hematologic. Kwakubanjwe ngoba odokotela bafuna ukwaziswa okwengeziwe mayelana nokuvunyelwa kwe-FDA yakamuva.
Abathengi babuyekeze uhla lwemininingwane ngemithi emisha, kuhlanganise ne-ibrutinib (Imbruvica), ne-idelalisib (iZydelig).
Kwabaningi, umhlangano kaDisemba we-ASH usebenza njengombukiso wentuthuko eyenziwe ngonyaka odlule ku-hematology kanye ne-oncology. Nazi ezinye zezinto abantu ababezikhuluma ngazo.
Ibrutinib (Imbruvica)
Amaprotheni ahlukene noma ama-complexes, njengama-enzyme, adlala indima ekuboniseni iseli-inqubo yilapho amangqamuzana "alalela" futhi aphendule izibonakaliso zamakhemikhali. I-Tyrosine Kinase (BTK) ye-Bruton, i-enzyme edlala indima ebalulekile ekuthuthukiseni kwe-B cell, isibonelo se-enzyme elawula ukusayina kweseli. I-Ibrutinib iyi-molecule encane evimba i-enzyme BTK.
Ngokuvimbela le enzyme, i- ibrutinib iphazamisa indlela yokubonisa ukuthi amanye amangqamuzana omdlavuza athembele. Ngokususelwa empumelelweni kuze kube manje, i-FDA ikhethe ibrutinib njengendlela yokwelashwa okuphumelelayo, enendima ekwelapheni izidakamizwa ezilandelayo:
- Iziguli ezithathelwanayo ze-lymphocytic leukemia (CLL) ezithole okungenani ukwelashwa okulodwa okukodwa
- Iziguli ezingapheli ze-lymphocytic leukemia (CLL) ezinokukhishwa okungu-17p
- Iziguli ze-Mantle cell lymphoma (MCL) ezithole okungenani ukwelashwa okulodwa ngaphambi kokuqala
I-Ibrutinib iyiphilisi ethathwa kanye ngosuku futhi ibekezelela kahle. Ukusetshenziswa kwe-ejenti kubuye kuphhenywe ekwelapheni kwamanye amagciwane, kokubili yedwa futhi kuhlangene nemithi ehlukahlukene.
I-Idelalisib (iZydelig)
I-Idelalisib i-FDA-evunyelwe abantu abane- leukemia engapheliyo e-Lymphocytic (CLL) , ephindaphindiwe e-B-cell engeyona i-Hodgkin lymphoma (FL), futhi ephindaphinda i-lymphocytic lymphoma (SLL, enye uhlobo lwe-non-Hodgkin lymphoma).
Ukuvunyelwa kusekelwe ekutholeni isilingo kwiziguli ezingu-220 ezine-CLL ephindaphindiwe, lapho okwakungakahlelwa khona ngamakhemikhali ajwayelekile. Umgomo wawuwu-idelalisib + rituximab noma i- placebo + rituximab. Leli cala labonisa ukunciphisa okungu-82% engozini yokuqhubeka komdlavuza nge-idelalisib, ngakho bawayeka masinyane, bavumela iziguli zendawo ye-rituximab zikwazi konke nge-idelalisib futhi zinikeze izidakamizwa ezintsha. Zonke iziguli ezisesigabeni se-rituximab + se-placebo zaqala ukuthola i-idelalisib.
I-Brentuximab i-vedotin (i-Adcetris)
Le-ejenti iyisilwane sokumnika okufakwe ngaphakathi. I-brentuximab i-vedotin inezinqubo ezithakazelisayo zesenzo. I-antibody engakhiwe - ihlangene ne-ejenti esiza ukubulala amangqamuzana omdlavuza uma efinyelela ekuhlosweni kwawo. Ihloselwe iphrotheni ebizwa ngokuthi i-CD30, ekhona kwi-classic Hodgkin lymphoma (HL) nase-systemic amaplastiki enkulu i-cell lymphoma (i-SALCL).
Ucwaningo oluxoxwa nge-ASH lwaluyinto yokuqala e-lymphoma ukukhombisa ukuthi ukwengezwa kwesidakamizwa sesondlo emva kokufakelwa kungabonakalisa ngcono imiphumela yeziguli.
Esigamekweni se-AETHERA, cishe amaphesenti angama-63 ezigameko eziphezulu zengozi ye-lymphoma ezaphathwa ngezidakamizwa zathola ukuqhubeka kwezinyanga ezingu-24 zokusinda ngaphandle kokuqhathaniswa ne-51% weziguli ezithole i-placebo.
I-Blinatumomab (iBlincyto)
Lesi sidakamizwa yimithi yokuqala ye-BITE (i-Bi-specific T Cell Engager) ezovunyelwa. Luye wabonisa umsebenzi ophawulekayo e-B-cell acute leukemia (ALL) iziguli ezinesifo esincane esinqunyiwe ngemuva kokukhipha ukwelashwa , ngokusho kwabacwaningi base-ASH. I-Blinatumomab isuse amangqamuzana omdlavuza we-residual kusuka ku-78% weziguli ezingu-112 eziphathwayo.
Ngokusho kweNational Cancer Institute, i-blinatumomab i-antibody engakhiwe engakwazi ukuvuselela amasosha omzimba futhi ilandele umdlavuza ngemisebenzi ye-antineoplastic.
I-FDA ivunyiwe i-blinatumomab ukuphatha iziguli nge- Philadelphia chromosome -negative precursor B-cell acute lymphoblastic leukemia (B-cell ALL), ifomu engavamile YONKE.
Buka uNiccola Gokbuget, MD, uchaze ukuthi i-blinatumomab isebenza kanjani.
Ama-CAR ahamba phambili ku-ALL KULUNGILE
Idatha yesikhathi eside kusuka esilingweni esebenzisa amangqamuzana e-SY-antigen receptor (CAR) i-T yabonisa ukuthi lawa maseli aphrintiwe athatha isikhathi esithile, enza umsebenzi wawo, eholela ekukhipheni okuhle okude. Abaningi emphakathini wesayense banethemba ngaloluhlobo oluthile lwezokwelapha ezihlukahlukene ze-khansa okunye okunzima ukuzenza.
Qaphela kumiphumela emibi
Ngokuphawula, wonke lawa ma-agent anemiphumela emibi, ezinye zazo zingase zibe sína, futhi ezinye zazo zingase zingakaziwa. Njengazo zonke izidakamizwa, isinqumo sokwelapha sithonywa yilokho okuyaziwayo ngezingozi nezinzuzo zokwelapha nezici zesiguli ngasinye.
Imithombo
I-National Cancer Institute. Ukwaziswa kwesiguli seBlinatumomab. http://www.cancer.gov/drugdictionary?cdrid=487684. Ifinyelele ngoDisemba 2014.
I-MedPageToday. http://www.medpagetoday.com/MeetingCoverage/ASHHematology/48998. Ifinyelele ngoDisemba 2014.