I-Imbruvica (ibrutinib) yisidakamizwa esishintshashintshayo-parabagm ekhombisa ukuguquka kolwandle endleleni esiphatha ngayo i-chronic lymphocytic leukemia (CLL) nezinye izidakamizwa ze-B-cell. Ngokuqondile, i-Imbruvica ishintshe ukwelashwa kwe-leukemia ngaphandle kwe-buckshot chemotherapy ekuhlanganyeleni ukuba i-finesse enzymatic efana ne-sniper.
Kuyini i-CLL?
I-lymphocytic i-leukemia engapheli yilezi zifo ezivamile kakhulu zegazi ezizweni zaseNtshonalanga.
(Lesi sifo sithinta kakhulu abamhlophe futhi sawela kakhulu abantu base-Afrika baseMelika, abantu baseSpain nabase-Asiya.) Lesi sifo sivame kakhulu kubantu asebekhulile abaneminyaka engu-72 ubudala.
I-lymphocytic leukemia engapheli ingumdlavuza we- B lymphocytes ovame ukunikeza igciwane lesandulela ngculazi futhi usebenze njengengxenye ebalulekile yesimiso sethu somzimba.
Ngenkampani ye-CLL, ukuguqulwa kwe-lymphocyte ye-leukemic B kuqoqa futhi kuqoqe amaseli ejwayelekile egazi emnothweni wegazi, igazi kanye namagciwane. Ngokweqile kwamangqamuzana egazi umzimba wethu udinga njengamaseli abomvu abomvu namaseli amhlophe egazi, i-CLL ingahlukumeza ngokulinganayo amandla ethu okulwa nokutheleleka futhi ibangele i-anemia.
Ukubikezela abantu abane-CLL kugijima i-gamut. Abanye abantu banenhlanhla futhi baphila amashumi eminyaka nge-indolent noma e-key-key isifo esingafuni ukwelashwa. Kodwa-ke, abanye bahlushwa inkambo eyingozi kakhulu engavumelani ne-chemotherapy.
Izimpawu ezijwayelekile kulabo abahluphekayo i-CLL eqhubekayo zihlanganisa lokhu okulandelayo:
- ukukhathala
- ukulahlekelwa isisindo
- umkhuhlane
- ukuthuka ebusuku
- i-lymph nodes ekhulisiwe
- ipeni ekhulisiwe noma isibindi esenza ukuba satiety zakuqala (umuzwa wokuqala wokugcwele)
- ukutheleleka okuvamile
Ngo-2015, i-National Cancer Institute inqume ukuthi amacala angu-14620 we-CLL afunyanisiwe, kwakunezingu-4650 zokufa.
Yini Okukhethekile Nge-Imbruvica
Kuze kube yamuva, ukwelashwa kwe-CLL kwakunomkhawulo wekhemotherapy kuhlanganiswe ne-immunotherapy noma i-chemoimmunotherapy.
Nakuba i-chemotherapy ngokwayo imane nje ilulaza abanye kulabo abane-CLL, ukungezwa okusheshayo kwe-rituximab, i-immunotherapy imithi, kungasiza ukulondoloza isikhathi eside ngokususa ukuxolelwa. Ngokuqondile, i-rituximab ihlose i-CD20 antigen kuma-lymphocyte B. Ngeshwa, i-subset ethile yabantu (labo abanokuguqulwa kwe-del [17p] / TP53 noma ukususwa kuma-chromosome 17) baphendula kabi ku-chemoimmunotherapy.
I-Chemotherapy ye-CLL ihilela ukuphathwa kwama-parenteral (injection) yama-ejenti ahlukahlukene ukuze kubulawe hhayi kuphela ukuhlukanisa izingqamuzana zeseli kodwa ngokujwayelekile ukuhlukanisa imigqa yeseli, futhi. Le ndlela ye-buckshot ichaza ukuthi kungani abantu be-chemo babhekana nemiphumela emibi ehlukahlukene ehlanganisa ukulahlekelwa izinwele, ukucindezeleka kwamathumbu, futhi uma kwenzeka ku-CLL, ngisho nemiphumela yokunciphisa imishanguzo noma imiphumela ye-humoral.
Nakuba i-chemo ivumelanisa ukunemba komtholampilo we-chain saw, i-Imbruvica ifana ne-scalpel yokuhlinza futhi iqondile ngendlela yayo. Ngokuqondile, i-Imbruvica ikhipha i-enzyme ebizwa ngokuthi i-tyrosine kinase (i-Btk) ye-Bruton ehlukaniswe namaseli angama-B anomzimba noma amancane. Ngokuzibophezela ngokungenakuqondakala ku-Btk, i-Imbruvica iphonsa isikhunta se-monkey ku-B cell receptor esebenzayo engavamile, kanjalo ivimbela ukukhula kwamangqamuzana, ukusabalala nokusinda kwamangqamuzana a-B awonakele.
Ngokuthakazelisayo, abacwaningi basikisela ukuthi i-Imbruvica ingase isebenze enye indlela ehlobene nayo ehlanganisa ukugxilisa i-microenvironment lapho amangqamuzana e-leukemic ekhula khona. Ngokuqondile, futhi njengoba kuningi emaphephandabeni, i- Nature Biotechnology , i-Imbruvica ingase "ivimbele i-chemokine receptor kanye ne-integrin ukufaka uphawu ngokuvimbela i-BTK, ngakho-ke ukuhamba kwamangqamuzana nokunamathela kumaseli agqamile e-lymph node. Ngemuva kokuphathwa kwe-Imbruvica, ama-CLL amangqamuzana egazini futhi bafela lapho, benqatshelwe i-microenvironment ezisekelwa yi-lymph node. "
Ngaphandle kwe-CLL, i-Imbruvica nayo iyasiza ngezinye izinhlobo ezihlukahlukene ze-B-cell malignancies.
Ngenxa yalokho, ngaphezu kwe-CLL, i-FDA ikhishwe lesi sidakamizwa esibizwa ngokusheshayo noma esiphuthumayo ukwelashwa kwe-Waldenström's macroglobulinemia kanye ne-mantle cell lymphoma. Asikho esinye isidakamizwa esithole lezi zinhlelo eziningi zokwelashwa eziphumelelayo!
Uma wena noma othandekayo ehlushwa i-CLL noma enye i-B-cell malignancy, i-debut ye-Imbruvica nakanjani into okufanele ijabule ngayo. Ngokuqondene nokubulawa kwegazi, impumelelo ka-Imbruvica engalindeleke ingafaniswa kuphela ne-rituximab. Ngaphezu kwalokho, i-Imbruvica ayiyona nje kuphela ephumelelayo kune-rituximab njenge-monotherapy kodwa iphinde isetshenziswe ngomlomo futhi isebenzise ngezifo eziphikisayo nezibuyiselwayo.
Imithombo:
Isihloko esithi "Imbruvica-isisulu esikhulu semithi yomdlavuza we-B-cell evunyelwe yi-FDA" nguMalini Guha eshicilelwe ku- Nature Biotechnology ngo-2014.
Isihloko esithi "i-Ibrutinib (Imbruvica): I-Novel The Targeted Therapy for Chronic Lymphocytic Leukemia" ngu-S Parmar nabalobi ababambisene nabo abashicilelwe eP & T ngo-2014.