Ipilimumab ivunyiwe yi-Food and Drug Administration ukuphatha i-melanoma. Lezi zindaba ezinhle ezigulini, okwakukade kunezinketho ezimbalwa lapho i- melanoma isakaze kwezinye izindawo zomzimba ( isigaba IV isifo).
Iyini i-Melanoma?
U-Melanoma, uhlobo olubi kakhulu lomdlavuza wesikhumba, lukhula emangqamuzaneni (melanocytes) akhiqiza i-melanin - i-pigment enika isikhumba sakho umbala.
I-melanoma nayo ingaba emehlweni akho futhi, ngokungajwayelekile, ezingxenyeni zangaphakathi, ezifana namathumbu akho.
I-Ipilumumab isebenza kanjani?
I-Ipilumumab i-antibody evuselela isimiso somzimba samasosha omzimba ukuze silwe ne-melanoma ngokuvimbela i-molecule ye-cytotoxic T e-tymphocyte-ehlobene ne-anti-4 (CTLA-4). I-CTLA-4 iyi-molecule e-T-cell, uhlobo lwegciwane legazi elimhlophe elidlala indima ebalulekile ekulawuleni izimpendulo zamasosha omzimba. Ukuba khona kwe-CTLA-4 kuthinteka ekuphenduleni kwesistimu yomzimba wamagciwane ngezifo, ngakho ukuvimbela umsebenzi walo kuvuselela isimiso somzimba sokuvikela omzimba ukulwa ne-melanoma.
Ubufakazi Othi Ipilumumab Isebenza
Izivivinyo ezintathu zesigaba II zibonise ukuthi ukwelashwa nge-ipilimumab kubangela isilinganiso seminyaka esisodwa sokusinda samaphesenti angama-47 kuya kwangu-51 kubantu abanesifo se-melanoma yesigaba III noma se-IV, esicishe sibe kabili isilinganiso.
Ihlolwe ekuvivinyweni okuphambili (isigaba III) ngokwayo futhi kuhlanganiswe nemigomo, nezinye izifo zokuzivikela (njenge-interleukin-2), ne-chemotherapies (njenge-dacarbazine).
Izinga lokuphendula jikelele liphuma ngamaphesenti angu-13 nge-ipilimumab kanye nomgomo wokugoma ezigulini ezine-stage IV ezifinyelela kuma-17 no-22 amaphesenti nge-ipilimumab plus dacarbazine noma i-interleukin-2, ngokulandelana, ezigulini ezinezifo zemetastatic. Izimpendulo ziye zahlala isikhathi eside, futhi phakathi kwalabo ababhekene nemiphumela emibi kakhulu, ngisho namanani okuphendula aphezulu abonisiwe (kuze kube ngamaphesenti angu-36).
Le miphumela ibonisa ukuthi ngaphezu kwengxenye eyodwa kwezintathu zeziguli eziphathwe nge-ipilimumab ezinokuhlangenwe nakho kwe-melanoma ezithuthukisiwe, inzuzo engavamile yokwelapha lesi sifo.
Imiphumela emibi ye-Ipilumumab
Ngokungafani ne- chemotherapy , lapho imiphumela emibi ibonakala khona ngemva nje kokuqala ukwelashwa, imiphumela emibi ehambisana ne-ipilimumab ingahluka kakhulu, kungenzeka ukuthi isimiso somzimba sokuzivikela somuntu sihlukahluka komuntu.
Imiphumela emibi kakhulu yelilimumab ivela emathangeni omzimba (njengesifo sohudo nokuvuvukala kolononi) kanye nesikhumba (njengokugqwala nokuvuvukala kwesikhumba). Imiphumela emibi ejwayelekile eyenzeka njalo ihlanganisa isibindi, ukuvuvukala kwe-pituitary gland (hypophysitis), ukuvuvukala kweso ( uveitis ), nezinkinga zezinso (nephritis). Imiphumela emibi ivela ezigulini ezingamaphesenti angama-84 kodwa ngokuvamile ilula futhi iyaphathwa.
> Imithombo:
> Hersh E, Weber J, Powderly J, et al (2009). Ukusinda isikhathi eside kweziguli (pts) nge-melanoma ephakeme ephathwa nge-ipilimumab noma ngaphandle kwe-dacarbazine. J Clin Oncol 27: 15s (suppl; abstr 9038).
> Ledezma B (2009). Ipilimumab ye-melanoma ephakeme: Umbono wokunakekela izingane. I-Oncol Nurs Forum, 36 (1), 97-104.
> I-Mayo Clinic. I-Cancer Cancer.
> National Cancer Institute. Ipilimumab
> Sarnaik AA, Weber JS (2009). Ukuthuthukiswa kwamuva kusetshenziswa i-anti-CTLA-4 yokwelashwa kwe-melanoma. I-Cancer J. 2009 May-Jun; 15 (3): 169-73.