Unyango lwe-Immunotherapy kwiMetastatic Renal Cell Carcinoma

Umxholo

• Yintoni i-immunotherapy?
• IiCytokines
• I-Interleukin-2 (IL-2)
• I-Interferon-alfa
• Inhibitors zokujonga
• INivolumab (Opdivo)
• Ipilimumab (Yervoy)
• Iziphumo ebezingalindelekanga ezinokubakho
• Yise kude

Ushwankathelo

Kukho unyango oluninzi lwe-metastatic renal cell carcinoma (RCC), kubandakanya utyando, unyango ekujoliswe kulo, kunye nekhemotherapy.

Kodwa kwezinye iimeko, unokuyeka ukuphendula kunyango olujolise kulo. Ngamanye amaxesha, amachiza onyango ekujoliswe kuwo anokubangela iziphumo ebezingalindelekanga ezibi okanye iimpendulo ezingafunekiyo.

Ukuba oku kuyenzeka, ugqirha wakho unokucebisa olunye uhlobo lonyango olubizwa ngokuba yi-immunotherapy. Nantsi inkangeleko eneenkcukacha zokuba yintoni i-immunotherapy, nokuba ikulungele na.

Yintoni i-immunotherapy?

I-Immunotherapy luhlobo lonyango lomhlaza olusebenzisa izinto zendalo kunye nezinto ezenziweyo ukutshintsha indlela iiseli zomzimba wakho eziziphatha ngayo. Ezinye iintlobo ze-immunotherapy zisebenza ukulwa okanye ukutshabalalisa iiseli zomhlaza. Abanye bomeleza okanye baxhase amajoni akho omzimba kwaye bancede ukulawula iimpawu kunye neziphumo ebezingalindelekanga zomhlaza wakho.

Zimbini iintlobo eziphambili zonyango lwe-immunotherapy kwi-RCC ye-metastatic: ii-cytokines kunye ne-inhibitors yokujonga.

IiCytokines

IiCytokines ziinguqulelo ezenziwe ngabantu zeeproteni emzimbeni ezenza ukuba zisebenze kwaye zomeleze amajoni omzimba. Ii-cytokines ezimbini zihlala zisetyenziselwa ukunyanga umhlaza wezintso zi-interleukin-2 kunye ne-interferon-alpha. Baye baboniswa ukuba banceda ukunciphisa umhlaza wezintso kwipesenti encinci yezigulana.

I-Interleukin-2 (IL-2)

Le yeyona cytokine isebenzayo kunyango lomhlaza wezintso.

Amanani aphezulu e-IL-2, nangona kunjalo, kunokubangela iziphumo ezibi kakhulu kwaye ngamanye amaxesha zibulale. Ezi ziphumo zibandakanya ukudinwa, uxinzelelo lwegazi oluphantsi, ingxaki yokuphefumla, ulwakhiwo lwamanzi emiphungeni, ukopha emathunjini, urhudo kunye nokuhlaselwa yintliziyo.

Ngenxa yobume bayo obunobungozi obuphezulu, i-IL-2 ihlala inikwa kuphela abantu abaphilayo ngokwaneleyo ukuba bakwazi ukumelana neziphumo ebezingalindelekanga.

I-Interferon-alfa

I-Interferon-alfa yenye ye-cytokine ngamanye amaxesha esetyenziselwa ukunyanga umhlaza wezintso. Ngokwesiqhelo inikwa inaliti engaphantsi kathathu ngeveki. Iziphumo zalo zibandakanya iimpawu ezinje ngomkhuhlane, isicaphucaphu, kunye nokudinwa.

Ngelixa iziphumo ebezingalindelekanga zingaphantsi kwe-IL-2, i-interferon ayisebenzi xa isetyenziswa yodwa. Ngenxa yoko, ihlala isetyenziswa ngokudibanisa neziyobisi ekujoliswe kuzo ezibizwa ngokuba yi-bevacizumab.

Inhibitors zokujonga

Amajoni akho omzimba ayazikhusela ekuhlaseleni iiseli eziqhelekileyo emzimbeni wakho ngokusebenzisa “iindawo zokuhlola.” Ezi ziimolekyuli kwiiseli zakho zomzimba ezifuna ukuvulwa okanye ukucinywa ukuqala impendulo yomzimba. Rhoxisa iiseli ngamanye amaxesha zisebenzisa ezi ndawo zokujonga ukuthintela ukujolisa kumkhosi wamajoni.

Ii-inhibitors zokujonga iziyobisi zijolise kwezi ndawo zokujonga. Banceda ukugcina ukuphendula komzimba wakho kwiiseli zomhlaza.

INivolumab (Opdivo)

I-Nivolumabis i-immune checkpoint inhibitor ejolise kunye neebhloko ze-PD-1. I-PD-1 yiprotein ekwiiseli zomzimba wakho zeT iiseli ezibathintela ekuhlaseleni ezinye iiseli emzimbeni wakho. Oku kunceda ukukhulisa impendulo yakho yomzimba ngokuchasene neeseli zomhlaza kwaye ngamanye amaxesha kunciphisa ubungakanani bamathumba.

I-Nivolumab inikezelwa ngokuthe ngcembe emva kweeveki ezimbini. Lukhetho olusebenzayo kubantu i-RCC yabo eqale ukukhula kwakhona emva kokusebenzisa ezinye iindlela zonyango.

Ipilimumab (Yervoy)

I-Ipilimumab yenye ye-immune system inhibitor ejolise kwiprotheyini ye-CTLA-4 kwiiseli ze-T. Inikwa ngaphakathi, ngokufuthi kube kanye kwiiveki ezintathu zonyango ezine.

I-Ipilimumab inokusetyenziswa ngokudibanisa ne-nivolumab. Le yeyabantu abanesifo somhlaza sezintso esele bengekafumani unyango.

Olu dibaniso lubonakalise ukuba lukonyusa ngokubonakalayo amazinga okusinda. Inikwa ngokubanzi ngeedosi ezine, ilandelwe yikhosi ye-nivolumab iyodwa.

Idatha evela kolu phando yapapashwa kwi-New England Journal of Medicine ibonakalise iinyanga ezili-18 ezithandekayo zokuphila ngenyango yokudibanisa i-nivolumab kunye ne-ipilimumab.

Nge-16 ka-Epreli, ngo-2018, i-FDA ivume olu manyano kunyango lwabantu abanomngcipheko ophakathi kunye nomngcipheko ophakathi we-renal cell carcinoma.

Iziphumo ebezingalindelekanga ezinokubakho

Iziphumo ebezingalindelekanga ezixhaphakileyo ze-immune checkpoint inhibitors kukudinwa, irhashalala, ukurhawuzelela, kunye norhudo. Kwiimeko ezinqabileyo, i-PD-1 kunye ne-CTLA-4 inhibitors zinokukhokelela kwiingxaki ezinzulu zomzimba ezinokubusongela ubomi.

Ukuba okwangoku ufumana unyango lwe-immunotherapy ngolunye okanye omabini la machiza kwaye uqale ukufumana naziphi na iziphumo ebezingalindelekanga ezintsha, zixele kugqirha ngoko nangoko.

Yise kude

Unyango wena nogqirha wakho niza kuthatha isigqibo luxhomekeke kwizinto ezininzi. Ukuba uhlala ne-RCC ye-metastatic, thetha nogqirha wakho malunga nokhetho lwakho.

Ngokudibeneyo, ninokuxoxa ukuba ingaba yindlela efanelekileyo yonyango na kuni. Banokuthetha nawe malunga nayiphi na inkxalabo onayo malunga neziphumo ebezingalindelekanga okanye ubude bonyango.