Kuyini i-EGFR Cancer Lung Cancer?

Ukuphathwa kwe-EGFR Cancer Lung Cancer

Kuyini ukuguquguquka kwe-EGFR futhi kungani kubalulekile ngomdlavuza wamaphaphu? Lokhu kuhlolwe kanjani futhi kuyaphathwa kanjani? Ubani ovame ukuguquguquka kwe-EGFR futhi kusho ukuthini ngokuchazwa kwakho?

Sibutsetelo

Umdlavuza wamaphaphu omuhle we-EGFR ubhekisela emangqamuzaneni amaphaphu ahlola ukuthi ayenomphumela wokuguqulwa kwe-EGFR. I-EGFR imele i-epithelial growth factor receptor, iphrotheni ekhona emkhatsini womabili amangqamuzana omdlavuza wesifo somdlavuza wamangqamuzana njengamaseli omdlavuza wamaphaphu.

Izinguquko ze-EGFR zivame kakhulu kubantu abane-lung adenocarcinoma (uhlobo lomdlavuza ongasona omncane wesifo samaphaphu,) luvame kakhulu nomdlavuza wamaphaphu kwabangewokubhema , futhi kuvamile kakhulu kwabesifazane kunamadoda.

Ukuguqulwa kwezakhi zofuzo ezibizwa nge-EGFR yiyona "evamile" yokuguquguquka komphakathi phakathi kwabantu abanomdlavuza wamaphaphu, okusho ukuthi yinguquko ejwayelekile kunazo zonke zezakhi zofuzo ezitholakalayo ezibhekiswe ngqo kumangqamuzana omdlavuza wamaphaphu. Ukuthuthukiswa okuphawulekayo kwenziwe ekwelapheni kwamagciwane ephasinapha nale phrofayli ethile yamathambo eminyakeni yamuva. Kusukela ngokuvunywa kwe-Iressa (gefitinib) ngo-2003-ngesikhathi esingaqondi kahle nge-EGFR- cishe isigamu semithi emisha eyamukelwe ukwelashwa komdlavuza wamaphaphu njengoba ngo-2016 ikheli lephrofayili ethile yamangqamuzana.

Kuyini ukuguqulwa kwe-EGFR?

Ukuguqulwa kwe-EGFR kubhekisela ekuguquleni (umonakalo) engxenyeni ye-DNA emangqamuzaneni omdlavuza wamaphaphu ophethe "iresiphi" yokwenza i-EGFR (i-epidermal growth factor receptor) amaprotheni.

I-nucleus yamaseli ethu ngayinye iqukethe i-DNA yethu, eyakhiwa nezakhi zofuzo. Lezi zakhi zofuzo zisebenza njengesimiso samaprotheni akhiqizwa emzimbeni wethu. Ngamanye amazwi, izakhi zethu zofuzo zifana namagama encwadini yokufundisa echaza indlela yokwakha zonke izingxenye zomzimba wethu.

Amanye amaprotheni akhiqizwa ngokusebenzisa lezi ziqondiso zofuzo zihileleke ekulawuleni ukukhula nokwahlukana kwamaseli.

Uma isakhi esithwala imiyalo yokudala i-EGFR yonakalisiwe-ishintshwe-ihunyushwa kuba amaprotheni angavamile.

kulesi simo, amaprotheni angavamile okukhula kwe-epithelial receptor (EGFR). Lezi protheyini ezingavamile, zenza umsebenzi "ongajwayelekile" ekulawuleni ukukhula kweseli. Kunezindlela eziningana ezahlukahlukene lapho lesi sakhi singaguqulwa khona (bheka ngezansi).

Yini ngempela i-EGFR?

Amaseli ethu anama-antigen amaningi (amaprotheni ayingqayizivele) ebusweni. I-EGFR (i-epidermal growth factor receptor) ingenye yalezi protheyini ezitholakalayo emangqamuzaneni omdlavuza kanye namaseli avamile. I-EGFR ingacatshangwa njengenguquko yokukhanya. Uma izici zokukhula (kulesi cala i-tyrosine kinases) zifakela ku-EGFR ngaphandle kweseli, kubangelwa isignali ithunyelwa kwinucleus yeseli esitshela ukuthi ikhule futhi ihlukanise.

Kwamanye amangqamuzana omdlavuza, la maprotheni akhathazekile kakhulu. Umphumela ufana nomshini wokukhanya oshiywe endaweni "ku-on", etshela iseli ukuthi liqhubeke likhula futhi lihlukanise ngisho nalapho kufanele liyeke. Ngale ndlela, ukuguquguquka kwe-EGFR ngezinye izikhathi kubizwa ngokuthi "ukuguqulwa okuguquguqukayo."

Manje sinezidakamizwa ezitholakalayo-i-tyrosine kinase inhibitors-"ngokuqondile" le phrotheni kwamanye amangqamuzana omdlavuza.

Lezi zidakamizwa zivimba izibonakaliso eziya ngaphakathi kweseli, futhi ukukhula kweseli kuyama.

Izingozi Nezingozi

Ukuguqulwa kwe-EGFR kukhona cishe ngamaphesenti angu-15 abantu abanomdlavuza wamaphaphu e-United States, nakuba le namba ikhuphuka ibe ngamaphesenti angama-35 kuya kwangu-50 kubantu baseMpumalanga Asia.

Kuvame ukutholakala kubantu abanomdlavuza omncane ongasona omncane okuthiwa i-lung adenocarcinoma. (Lezi zomshukela nazo zibizwa ngokuthi "umdlavuza wamaphaphu ongewona omncane wesifo samaphaphu.) Ngesikhathi samanje cishe amaphesenti angama-85 wamanqamu wamaphaphu angamakhrensi amaphaphu angasona amancane, futhi kulawa, amaphesenti angaphezu kwangu-50 angamaphaphu adenocarcinomas.

Izinguquko ze-EGFR ziyi:

• Okuvamile kubantu besifazane kunamadoda. (Kunezinto eziningi ezihlukile phakathi komdlavuza wamaphaphu emdlalweni wesifazane nomdlavuza emadodeni ,)
• Okuvame kakhulu kubantu abane- lung adenocarcinoma (kodwa kungatholakala kubantu abanamanye amancane omdlavuza omncane wesifo samaphaphu.)
• Kuvame ukutholakala kulabo ababhemayo noma abantu ababhema kalula. (Umuntu ongasoze obhemayo uchazwa njengomuntu ophumayo ama-cigarettes angu-100 noma ambalwa ngaphezu kokuphila kwabo.) Nakuba amaphesenti angu-15 emdlavuza wamaphaphu jikelele eveza i-EGFR, amanqamu emaphaphu kulabo abangabhemi cishe amathuba okuba nokushintshwa kwalo.
• Okuvamile kubantu abadala abasebasha abane nomdlavuza wamaphaphu. (Izinguquko ze-EGFR zikhona cishe ngamaphesenti angu-50 wamanqamu wamaphaphu kubantu abadala .)
• Kuvamile kubantu base-Asiya, ikakhulu abantu base-East Asia.
• Okungajwayelekile kubantu base-Afrika base-Afrika njengamaCaucasus.

Ukuhlola i-Gene

Manje kunconywa ukuthi wonke umuntu onomdlavuza wamaphaphu omncane ongewona omncane-ikakhulukazi i-lung adenocarcinoma-uneziprofetho ze- molecular (ukuhlolwa kofuzo) okwenziwe emathunjini abo ukuze afune ukuba khona kwezinto ezingavamile zofuzo emangqamuzaneni omdlavuza wamaphaphu.

Kungaba ukudideka ukuzwa mayelana nezakhi zofuzo emangqamuzaneni omdlavuza wakho konke okukhulunywa ngegciwane kanye nomdlavuza webele. Ngokuphambene nokuguqula izakhi zofuzo, lezo ezithwala ngokuzalwa, noma kunjalo, ukuguqulwa okutholakala ngokuprofetha kwamangqamuzana kutholakala ukuguquguquka kwesiginja (ukuguquguquka kwe-somatic.) Lezi zinguquko azikho ngesikhathi sokuzalwa kodwa zikhula kamuva ekuphileni iseli eba isifo somdlavuza.

Amaseli e-Cancer angaba nezinguquko eziningi, kodwa bambalwa kuphela abahileleke ngokuqondile ekwenzeni umdlavuza. Lezi zinguquko ziholela ekukhiqizeni amaprotheni angavamile aqondisa ukukhula nokuthuthukiswa komakhalekhukhwini wesifo somdlavuza. La maprotheni angavamile "aqhuba" ukukhula nokusabalalisa komdlavuza ngakho-ke ukuguqulwa kwezakhi zofuzo okubhekiswe ekukhiqizeni kwabo kubizwa ngokuthi "ukushintshwa komshayeli." Ezinye, kodwa hhayi zonke "ukuguqulwa komshayeli" nazo ziguquguqukayo eziguqukayo "noma" ukuguquguquka okuguquguqukayo "okubhekisela ekuqinisweni ukuthi kungabhekwa izidakamizwa.

Kulinganiselwa ukuthi ukushintshwa komshayeli kukhona ngamaphesenti angu-60 abantu abane-lung adenocarcinoma, futhi le nombolo, kanye nezinguquko zomshayeli kwezinye izinhlobo zomdlavuza wamaphaphu, kulindeleke ukuba zikhule njengoba ukuqonda kwethu kwe-biology yomdlavuza kwanda. Izinguquko ezivamile zomshayeli zifaka:

• Izinguquko ze-EGFR
• Ukuhlelwa kabusha kwe-ALK
• Ukulungiswa kabusha kwe-ROS1
• Ukukhuliswa kwe-MET
• Izinguquko ze-KRAS
• Izinguquko ezingu-HER2

Eziningana zalezi zimo ezingavamile, izindlela zokwelashwa ezihlosiwe manje ziyatholakala. Lezi zinhlanzi zomdlavuza zihlose kakhulu futhi ngokuvamile ziba nemiphumela emibi kakhulu kunezidakamizwa zendabuko-izidakamizwa eziqondisa wonke amangqamuzana akhula ngokushesha.

Ngaphezu kwalokho, ukuvivinywa komtholampilo kukhona kwezinye izinhlobo zezinguquko kanye nezinguquko zofuzo kanye nezinhlobo ezahlukene zomdlavuza wamaphaphu. Ngokuvamile, abantu abavame ukuthi babe nokuningi kwalokhu kuguqulwa. Isibonelo, akunakwenzeka (kepha akunakwenzeka) komuntu onokuguquguquka kwe-EGFR futhi abe nokuhlelwa kabusha kwe-ALK noma ukuguquguquka kwe-KRAS kumaseli omdlavuza wamaphaphu.

Ukuxilongwa

I-Tissue Biopsy

Ukuze izakhi zofuzo zenziwe, isampula se-tumor yakho kuyodingeka itholakale. Esikhathini esiningi, ukuhlolwa kudinga isampula yamathambo atholakala ngesikhathi sokuphuza i-lungs . Lokhu kungenziwa nge-biopsy yenaliti, ngesikhathi se-bronchoscopy, noma nge-biopsy evulekile. Ngezinye izikhathi ukuhlolwa kwenziwa ngesikhumba esisuswe ngokuphelele ngesikhathi sokuhlinzwa komdlavuza wamaphaphu.

I-Biopsy yamanzi

Ngo-June ka-2016, ukuhlolwa okusha kwe-liquid biopsy kuvunyelwe ukuthola ukuguqulwa kwe-EGFR. Ngokungafani ne-biopsies engavamile kakhulu, lokhu kuhlolwa kungenziwa ngokuhlolwa kwegazi okulula. Ngesikhathi samanje, lezi zivivinyo zisabhekwa njengophenyo futhi azisetshenziselwa yedwa ukuqondisa ukuxilongwa nokuphathwa komdlavuza wamaphaphu, kepha zinikeza isithembiso esiningi. Kuthemba ukuthi lezi zivivinyo zizokwenza ukhetho lokuqapha abantu abane-EGFR emdlavuza wamaphaphu omuhle ngesikhathi sangempela esikhathini esizayo. Ngesikhathi samanje, sifunda kuphela ukuthi isisu sesigxile emitholampilo ekhomba i-EGFR uma ihluleka ukuphendula (iqala ukukhula noma isakazeka) kumaphoyinti amaphaphu. Ama-biopsies e-liquid anganika odokotela ithuba lokufunda isisu sesiphenduke-ngakho-ke sishintsha ekwelapheni okuphumelelayo-ngokushesha kunakwenzeka manje.

Izinguquko Zezakhi ZamaKhansela Emdlavuza

Ukuze uqonde kangcono ukuprofetha kwamangqamuzana kanye nemithi ehlosiwe yomdlavuza wamaphaphu, kuyasiza ukuchaza izimiso ezimbalwa eziyisisekelo zofuzo. Kunezinhlobo eziningana ezahlukene zezitshalo zofuzo ezingase zenzeke emangqamuzaneni yomdlavuza. Lokhu kufaka:

• Izinguquko - Ukuguqulwa komzimba kuyishintsho ekulandeleni kwe-DNA eyenza isakhi.
• Ukuhlelwa kabusha - Ngokuhlelwa kabusha, ukulandelana kwe-DNA kuhlelwa kabusha.
• Ukudluliselwa komhlaba - Lezi zinguquko zenzeka uma ingxenye yesakhi ku-chromosome eyodwa isuswa endaweni ehlukile ye-DNA.
• I-Gene fusion - I-gene "fusion" iyenzeka uma ukudluliswa kwezinto kuhlanganisa ndawonye izakhi ezimbili zama-genes ezingavamile.
• Ukuphambanisa kubhekisela ekukhiqizweni kwamakhophi amaningi wegesi futhi kuvamile emangqamuzaneni omdlavuza.

Kukhona nezinhlobo ezahlukene zezakhi zokuguqulwa komzimba. Ezinye zazo, ngokulula, zifaka:

• Ukuguqulwa kwamaphuzu - Ukuguqulwa kwamaphuzu kubhekisela ekuguqulweni kwesisekelo esisodwa esisithathiselwa omunye.
• Ukususwa - Ekukhipheni, ucezu lwezinto eziphathekayo zofuzo lulahlekile noma lususwe esakhiweni
• Ukufakelwa - Uma kufakwa, ucezu lwezinto eziphathekayo zofuzo lufakwe kwisakhi.

Izinhlobo

Ukuguqulwa kwe-EGFR akubhekiseli ekungafaneni kwesigamu esisodwa. Kunalokho, kunezinhlobo eziningi zezinguquko ze-EGFR ezihlukahluka kokubili uhlobo lokuguqulwa komzimba (njengoba kuchazwe ngenhla) futhi endaweni yokuguqulwa kwesigcawu. Ngamanye amazwi, kunezindlela eziningi lapho i-EGFR ingashintshwa ngokofuzo

Izinguquko ku-EGFR zingenzeka ezindaweni ezihlukene kusukela ku-18 ukuya ku-21. Ukuguqulwa kwe-EGFR ejwayelekile kunazo zonke (cishe amaphesenti angu-90) kungamaphesenti angama-19 (okungafaki ukukhiqizwa kwezakhi zofuzo) noma i-exon 21 L858 yokuguqulwa kwamaphuzu. (Bheka izinguquko ezingu-T790 ezingezansi ezivame ukuphikiswa.)

Ukwelapha

Kukhona okwamanje imithi emithathu evunyelwe i-FDA etholakalayo ukuphatha i-EGFR emihle ye-adenocarcinoma, kanye ne-squamous cell carcinoma kanye ne-EGFR yomdlavuza wamaphaphu omelana kahle. Le mithi ibizwa ngokuthi i-tyrosine kinase inhibitors. Bavimbela umsebenzi we-protein ye-EGFR.

Imithi evunyelwe ye-lung adenocarcinoma ihlanganisa:

• I-Tarceva (erlotinib)
• I-Gilotrif (afatinib)
• Iressa (gefitinib)

Imithi evunyelwe ukuguqulwa kwe-T790 ihlanganisa:

• I-Tagrisso (i-osimertinib)

Ungase uzwe inkulumo yakho ye-oncologist "ngezizukulwane" zale mithi. I-Tarceva yi-inhibitor yesizukulwane sokuqala i-EGFR, uGilotrif uyisizukulwane sesibili, futhi u-Tagrisso, isizukulwane sesizukulwane sesithathu se-EGFR.

I-EGFR Inhibitors ye-Lung Adenocarcinoma

Ngemithi emithathu etholakalayo yokuqala ye-EGFR enhle ye-adenocarcinoma, odokotela bakhetha ukuthi yiyiphi yalezi zinhibitors ezinomthamo we-tyrosine kinase ongase asebenze kangcono ngomdlavuza wakho othize?

Ukukhethwa kwe-EGFR inhibitor ethize kuxhomeke kakhulu ekuthandweni kwakho kwe-oncologist (nendawo yakho) Kukhona umehluko omncane . U-Iressa unedumela lokuba nemiphumela emibi kakhulu futhi angabhekwa njengento yokuqala kumuntu oneminye yemithi emikhulu noma asebekhulile. Ngokuphambene nalokho, uGilotrif angase abe nemiphumela emibi kakhulu (ikakhulukazi izilonda zomlomo) kodwa angase abe nenzuzo enkulu yokusinda jikelele. I-Gilotrif ingase isebenze kangcono kubantu abane-exon 19 yokususwa kwezakhi zofuzo. Kodwa-ke, kunezinye izici eziningi i-oncologist yakho ezofisa ukucabanga ngayo nomdlavuza wakho.

I-EGFR ne-Squamous Cell Carcinoma yamaLungula

Indlela ye-EGFR ingase ihloselwe futhi nabantu abane-squamous cell carcinoma yamapayipi abangenayo izinguquko ze-EGFR, kodwa ngendlela ehlukile.

Esikhundleni sezinguquko ze-EGFR ezihamba ngalezi zomshukela, ukukhula kunalokho kuhlobene nokukhuliswa kwe-EGFR . Futhi esikhundleni sokusebenzisa i-tyrosine kinase inhibitors ukukhomba ukuguqulwa kwe-EGFR, amasosha omzimba we-anti-EGFR ayiklasi lemithi esetshenziselwa ukubopha ku-EGFR ngaphandle kweseli (kumagciwane angenayo ishintsho se-EGFR) ukuphazamisa indlela yokubonisa.

I-Portrazza (necitumumab) yavunywa ngo-2015 kanye ne-chemotherapy kubantu abane-advanced squamous cell carcinoma yamapayipi abangakatholanga ukwelashwa kwangaphambi. I-Portrazza i -antibody yamonoclonal (i-antibody eyenziwe ngomuntu) evimbela umsebenzi we-EGFR. Izidakamizwa zokulwa namagciwane e-anti-EGFR-njenge-Erbitux imithi (cetuximab) ne-Vectibix (panitumumab) -yasetshenziswa namanye ama-cancer.

Ngokungafani nezidakamizwa ezisetshenziselwa i-adenocarcinoma ngenhla ezinikezwa ngomlomo, i-antira-EGFR yokwelapha i-Portrazza yemithi inikezwa ngaphakathi.

Ukuphikiswa Ukwelashwa

Ngeshwa, nakuba umdlavuza wamaphaphu ungaphendula kahle kuma-inhibitors okuthiwa yi-tyrosine kinase ekuqaleni, cishe ahlale ephikisana nesikhathi. Isikhathi esingaphambi kokumelana nokukhula, noma kunjalo, singashintsha kakhulu. Ngenkathi isikhathi sesikhathi esiphakathi phakathi kokuqala kokwelashwa kanye nokuthuthukiswa kokumelana nezinyanga ezingu-9 kuya kwezi-13, le mithi ihlale isebenza kahle kwabanye abantu iminyaka eminingi.

Ngesikhathi samanje, sivame ukuthola ukuthi isisu sesiphelele lapho siqala ukukhula noma ukusakazeka. Ukuphindaphindiwe kwe-biopsy, okulandelwa ukuprofetha kwamangqamuzana kuvame ukwenza ngaleso sikhathi. Njengoba kuphawuliwe ngenhla, sithembele ukuthi ama-biopsies amanzi ayoba yindlela yokunquma ukuthi isifo sikhuphuka nini esikhathini esizayo.

Ukwelashwa kwe-EGFR ephikisayo ye-Lung Cancer

Njengoba nje kunezinhlobo ezihlukahlukene zezinguquko ze-EGFR, kunezinqubo eziningana lapho i-Cancer ingakwazi ukumelana nayo. Amaseli e-Cancer ahlale eguqukayo, futhi ngokuvamile ahlakulele ukuguqulwa kwezinto ezenza ukuba ziphikisana nezidakamizwa ezisetshenziswayo.

Ezingxenyeni zabantu, ukuguqulwa kwesibili-ukukhishwa kwe-exon engu-EGFR T790 kuqala. Lokhu kuguquguquka kuthinta isifunda se-EGFR okuyi-first and second-line tyrosine kinase inhibitors (njenge-Tarceva) ebophezela, okwenza yonke imithi emithathu ngenhla (i-Tarceva, i-Gilotrif, ne-Iressa) engasebenzi. Kulabo abanomdlavuza we-EGFR T790 we-metastatic positive, okungakawona omncane wesifo somdlavuza wamaphaphu, umuthi we-Tagrisso noma i-AZD9291 (osimertinib) usuvunyelwe manje. Noma kunjalo, njengoba nje ukuphikiswa kuvela emithini yokuqala yezizukulwane, kutholakala ukumelana kungase kuqhubekele kusizukulwane sesithathu tyrosine kinase inhibitors kanjalo. Ngethemba ukuthi izidakamizwa zizoqhubeka zithuthukiswa ngenxa yezicubu eziphikisanayo, ukuze abantu abaningi bazokwazi ukuhlala nomdlavuza wamaphaphu njengesimo sesifo esingapheli-esingelapheki, kodwa elawulwa nale mithi.

Xhumanisa ku-Bra kuma-Metastases

Ngeshwa, ngenxa yobungozi begazi-indawo yezingqamuzana ezinamathele ezihlanganisa amakilasi angama-capillary ebuchosheni-eziningi zalezi mithi azikwazi ukufinyelela amathrekhi omdlavuza oye waya ebuchosheni. Isivinini segazi-eklanyelwe ukunciphisa ikhono lezinto ezinobuthi ukuze zifinyelele ebuchosheni, kodwa ngeshwa, ngokuvamile kuvimbela ukwelashwa kwamakhemikhali kanye nemithi yokwelapha ekufinyeleleni ebuchosheni kanye. Njengoba umdlavuza wamaphaphu unomkhuba wokusabalalisa ebuchosheni, lokhu bekuyinkinga enkulu kulabo abanomdlavuza wamaphaphu abane-metastases yobuchopho .

Imithi eyodwa okwamanje isacutshungulwa ekuhlolweni kwemitholampilo - i-AZD3759 yenzelwe ukungena ngesibambiso segazi, kanti isethemba ukuthi lesi sidakamizwa, noma abanye bahlolwe, singasiza labo abanomdlavuza wamaphaphu omuhle we-EGFR futhi abanesifo se-brainstuff noma i-leptomeningeal .

Imiphumela Yokwelashwa Side Side

Umphumela ovame kakhulu ohlangothini oluvame kakhulu we-tyrosine kinase inhibitors, okhona cishe ngamaphesenti angu-80 abantu, ukuqhuma isikhumba. Ngaphansi kancane, isifo sohudo singase senzeke.

I-Tarceva (erlotinib) izikhukhula zesikhumba (kanye nezixuku ezivela kwamanye ama-tyrosine kinase inhibitors) zifana ne-acne, ezenzeka ebusweni, phezulu nasemuva. Ngokusho kwesici, uma kungekho amhlophe amhlophe, ukhilimu we-corticosteroid (i-hydrocortisone ukhilimu, isibonelo) isetshenziswa. Uma amakhanda amhlophe ekhona futhi ukugqwaza kubheka igciwane, ama-antibiotic ngomlomo asetshenzisiwe. Ngesinye isikhathi umthamo wemithi uzodinga ukunciphisa.

Izivivinyo zemitholampilo

Njengoba kuphawuliwe ekuqaleni, kwenziwa inqubekela phambili enkulu kokubili ukuhlonza izinguquko zofuzo nomdlavuza wamaphaphu kanye nemithi yokwelashwa ukuze kusetshenziswe lezi zinguquko. Kunezilingo eziningi zokwelapha okwamanje ezibheke eminye imithi yokwelapha i-EGFR mutation emihle yomdlavuza wamaphaphu, kanye nokwelapha kwezinye izinguquko zamangqamuzana kumaseli omdlavuza.

Ngokusho kweNational Cancer Institute, abantu abanomdlavuza wamaphaphu kufanele bacabange ukuthi bahlanganyele ekuvivinyweni kwemitholampilo. Imithi eminingi manje eseyisebenzisayo yayitholakala kuphela njengengxenye yesilingo somtholampilo esikhathini esifushane esedlule. Izinhlangano eziningana zomdlavuza wamaphaphu zisebenzisene ndawonye ukuze zenze isevisi yomlinganiso wekliniki yemayelana nomtholampilo yamaphaya kunoma ubani onomdlavuza wamaphaphu. Ngalesi sevisi samahhala, odokotela bangakwazi ukufanisa nomdlavuza wakho wamaphaphu emilenzeni yokwelashwa eyenziwa noma kuphi emhlabeni.

Ukusekela nokuphikisana

Uma usanda kuthiwa unomdlavuza wamaphaphu, wenza enye yezinto ezinhle kakhulu ongayenza-uthatha isikhathi sokufunda ngomdlavuza wakho. Nazi amathiphu ambalwa wokuthi ungathola kanjani ulwazi lomdlavuza omuhle ku-intanethi, kanye nezinye izinyathelo zokuqala zokuthatha uma usanda kutholakala .

Ngaphezu kokufunda ngomdlavuza wakho, ukufunda ukuzivikela njengesiguli somdlavuza kwenza umehluko kubantu abaningi. Ngenkathi ungase ujwayeke izibambo ezibomvu kunamakhanda omdlavuza omhlophe wamaphaphu, umphakathi wesisekelo somdlavuza wamaphaphu, uqinile futhi uqina. Abantu abaningi bakuthola kuwusizo ukuba bahlanganyele kulezi zinhlangano zokusekela kanye nemiphakathi hhayi kuphela njengendlela yokuthola ukwesekwa komunye "owake wahlala" kodwa njengendlela yokuhlala engalingani nocwaningo lwamuva ngalesi sifo.

Izinga lokusindisa-futhi lokubonga ngokubonga-umdlavuza wamaphaphu ziyathuthuka, futhi kukhona ithemba eliningi. Kwakukhona ukwelashwa okusha okuvunyelwe phakathi kuka-2011 no-2015 kunokuba phakathi nenkathi engama-40 engaphambi kuka-2015. Noma kunjalo, umdlavuza ngumarathon, hhayi i-sprint. Uma ulwa nomdlavuza, finyelela emndenini nabangani bakho futhi uvumele ukuba bakusize. Ukugcina isimo sengqondo esihle ngomdlavuza kusiza ngezikhathi ezithile, kodwa qiniseka ukuthi unabangane abambalwa abaseduze ongavuleka ngokuphelele futhi uveze imizwa yakho engeyona enhle neyesabayo. Uma kungumngane wakho othandekayo oye wathola, hlola le micabango ngalokho okuthandayo ukuhlala nomdlavuza .

_Imithombo:

_{Greenhalgh, J., Dwan, K., Boland, A. et al. Ukwelashwa kokuqala kwe-epidermal ukukhula kwe-factor receptor (EGFR) okuguquguqukayo okungenayo i-squamous non-small encane yomdlavuza wamaphaphu. I-Cochrane Database yezibuyekezo ezihleliwe . 2016. 5: CD010383.}

_{Hasegawa, T., Ando, ​​M., Maemondo, M. et al. Indima yokuma ukubhema ekuhambeni kokungaqhubeki kokuqhubeka kwamagciwane omdlavuza wesifo samangqamuzana angasona amancane abambelela ekusebenziseni ukuguqulwa kwe-epidermal factor factor receptor (EGFR) okuthola umthamo wokuqala we-EGFR tyrosine kinase inhibitor nge-platinum doublet chemotherapy: ukuhlaziywa kwe-meta-analysis of trials okungahleliwe randomised . Oncologist . 2015. 20 (3): 307-15.}

_{Tan, C., Cho, B., no R. Soo. Isizukulwane esilandelayo isi-epidermal growth factor receptor tyrosine kinase inhibitors epidermal ukukhula kwe-factor receptor -mutant non-small cell cell lung cancer. I-Cancer Lung . 2016. 93: 59-68.}

_{I-Tan, D., Yom, S., Tsao, M. et al. I-International Association ye-Study of Lung Cancer isitatimende sokuqinisekisa ukuphathwa kwe-EGFR ukuguqulwa komdlavuza omuhle wesifo samangqamuzana omzimba: isimo ngo-2016. I-Journal ye-Thoracic Oncology . 2016 Meyi 20. (Epub ngaphambi kokuphrinta).}

_{Isikhungo se-Cancer Vanderbilt. MyCancerGenome.org. I-EGFR ku-Non-Small Cell Lung Cancer (NSCLC). Kubuyekezwe 06/18/15. https://www.mycancergenome.org/content/disease/lung-cancer/egfr/}