Izifundo ezungeze ukwelashwa kwe-Lupron noma Yokuhlinzeka ngokuphathelene nomdlavuza we-metastatic prostate , ukuqala ukwelashwa esiteji sangaphambili kwaholela ekuthuthukiseni okuphawulekayo imiphumela ye-antiticancer. Ngokufanayo, ukuhlola ukuhlola ukusebenza kahle kokuqala i-Taxotere ekuqaleni kwesigaba kubonisa into efanayo.
Ukuqala i-Taxotere esiteji sangaphambili
I-taxotere bekuyi-chemotherapy yokuhamba phambili yomdlavuza we-prostate omelana ne-hormone-resistant iminyaka engaphezu kwengu-10.
Yavunywe yi-FDA ngo-2004 ngemuva kokufakazelwa ukuthi ihlala isikhathi eside. Ngaphambi kokugunyazwa kwe-FDA ye-Taxotere, ama-chemical agents kuphela (i-Novantrone, i-Emcyt ne-Velban) ayitholakale enenani elingenamkhawulo. Isibonelo, iNovantrone inganciphisa ubuhlungu futhi ithuthukise izinga lokuphila. Kodwa-ke, kwakungekho nethonya ekusindeni. I-Taxotere yayivunyelwe yi-FDA emva kokuhlolwa okunamandla okukhulu okungahleliwe okuqinisekisile inzuzo yokuphila, noma kunjalo, inani lempilo yokuphila lilinganiselwe, kuphela ngokulandelana kwezinyanga ezimbalwa.
Sekuyiminyaka, ochwepheshe bebelokhu bezibuza ukuthi isikhathi esihle sokusebenzisa i-Taxotere. Ingabe kufanele iqalwe ngemuva kokuthi ukumelana noLupron kuqale noma kungaba ngcono yini ukuqala ngaphambi kokuqala kokumelana nama-hormone? Njengoba izifundo zokuqala eziholela ekugunyazweni kwe-FDA ye-Taxotere zihlolisise ukuphumelela kwayo emadodeni asebevele ephikisana ne-Lupron, inqubomgomo jikelele eyamukelwa odokotela bekumele igodle i-Taxotere kuze kufike i-Lupron engasebenzi.
Odokotela bangazicabangela ngale ndlela: "Njengoba i-Taxotere inezimbi ezihlukahlukene, futhi futhi, njengoba kungekho bufakazi bokuthi ukwelashwa kwangaphambili kuphumelela kakhulu, sizocoma kuphela ukuqala i-Taxotere ngemuva kokusebenza kwe-Lupron."
Kuyaziwa ukuthi amadoda amaningi ane umdlavuza we-metastatic prostate ekugcineni athuthukisa ukumelana ne-hormone.
Ngakho-ke, njengoba ukwelashwa kwangaphambili kuvame ukusebenza kangcono, kuyoba okunengqondo ukucabangela ukuhlasela lesi sifo ngaphambi kwamangqamuzana angagwinyeki ama-hormone aphinde aqhubekele futhi aguqule ama-clones angaguli. Ngonyaka ka-2014 no-2015 imiphumela yezivivinyo ezimbili zokwelashwa ezihlolwe lesi sisekelo sanyatheliswa.
Imiphumela yezifundo zakamuva
Isifundo sokuqala, CHAARTED (I-Chemo-hormonal Therapy Versus Androgen Ablation Yesivivinyo Esiyinkimbinkimbi Yesifo Esikhulu Kwegciwane Lesandulela Ngculaza), yanikezwa ngomhlangano waminyaka yonke ka-2014 we-American Society of Clinical Oncology (ASCO) futhi yanyatheliswa eNew England Journal of Medicine ngo-2015 Lokhu kubonisa ukuthi kubantu abesifo somdlavuza ovuthiwe osanda kutholakala, ezigulini eziye zaqala ukukhiqizwa kwe-metastase, ukungezwa kwezinyanga ezine ze-Taxotere zaqala ngokuhlanganyela noLupron okusinda okuthuthukisiwe ngokuqhathaniswa namadoda aqala uLupron yedwa bese eqala i-Taxotere uma i-Lupron yeka ukusebenza. Kulesi sifundo, ukusinda kwamadoda aphathwe nge-Taxotere ngesikhathi esifanayo njengoba uLupron eneminyaka engama-18 ubude kunamadoda aqale aphathwa ngeLupron kuphela.
Imiphumela yomunye, isilingo esifanayo, esibizwa nge-STAMPEDE (Ukwelashwa Okuyisimiso Ekuthuthukiseni noma Umdlavuza We-Prostate Metastatic: Ukuhlolwa kocwaningo lweDrug Efficacy), okwethulwa emhlanganweni we-ASCO ka-2015.
Kulesi sifundo cishe amadoda angu-3000 asanda kutholakala, amadoda angama-hormone, isigamu samadoda sinikezwe ngokushesha i-Taxotere kanye ne-Lupron. Ukuphila kwabo kwaqhathaniswa nengxenye eyayiqale ukuphathwa noLupron yedwa. Njengokwesifundo se-CHAARTED, leli qembu lesibili laphathwa nge-Taxotere ngemuva kokuthi uLupron eseke ukusebenza. Futhi futhi, njengokufana nesilingo se-CHAARTED, amadoda aqala i-Taxotere ngaphambi kokumelana nama-hormone ahlala isikhathi eside kakhulu.
Ngakho-ke ngenkathi ngaphambili i-Taxotere manje ingumkhuba osemusha, ekulawuleni nsuku zonke iziguli ezine-cancer yomzimba, indlela ezinye izinhlobo zokwelashwa okusha (njengeZytiga, Xtandi, Xofigo, neJevtana) ezikhethiwe zivame ukulandela kahle i- iphethini egqamile, elandelanayo.
Ukusebenzisa imithi ngaphandle kokulandelana noma inhlanganisela kuvame ukugcizelela. Indlela evamile ihamba ngokuzenzakalelayo ku-"Kuhlale kwenziwa ngaleyo ndlela."
Odokotela basebenzisa lokhu ukucabanga okungenakuqhathanisa ngezizathu eziningi futhi abahlolisisi njalo "ngaphandle kwebhokisi," izindlela zokwelapha. Kodwa-ke, ikakhulukazi manje ukuthi amanxusa amaningi amasha futhi asebenzayo ayagunyazwa yi-FDA, ukusebenzisa izindlela zokwelapha ngendlela ehamba phambili ngendlela engezansi kungase ihluleke ukwandisa amathuba okuba amathuluzi amasha okulwa ne-antiticancer.