Abin da kuke Bukatar Ku sani Game da Matsayin Nasarar Immunotherapy na Melanoma

Wadatacce

• Bayani
• Nau'in rigakafi
• Masu hana shingen bincike
• Cytokine far
• Oncolytic cutar magani
• Adadin nasarar immunotherapy
• Ipilimumab (Yervoy)
• 'Yancin (Keytruda)
• Nivolumab (Opdivo)
• Nivolumab + ipilimumab (Opdivo + Yervoy)
• Cytokines
• Talimogene laherparepvec (Imlygic)
• Sakamakon sakamako na immunotherapy
• Kudin immunotherapy
• Gwajin gwaji
• Canjin rayuwa
• Outlook

Bayani

Idan kana da ciwon sankarar fata na melanoma, likitanka na iya ba da shawarar rigakafin rigakafi. Irin wannan jiyya na iya taimaka haɓaka haɓakar garkuwar ku game da cutar kansa.

Akwai nau'ikan magungunan rigakafin rigakafi don maganin melanoma. A mafi yawan lokuta, ana ba da waɗannan magungunan ga mutanen da ke da mataki na 3 ko na 4 melanoma. Amma a wasu lokuta, likitanka na iya ba da umarnin rigakafi don magance ƙananan ƙwayar melanoma.

Karanta don ƙarin koyo game da rawar da immunotherapy na iya takawa wajen maganin wannan cuta.

Nau'in rigakafi

Don fahimtar yawan nasarar nasarar rigakafi, yana da mahimmanci a bambance tsakanin nau'ikan da ke akwai. Akwai manyan rukuni uku na maganin rigakafi da ake amfani dasu don magance melanoma:

• masu hana shingen bincike
• maganin cytokine
• maganin cutar kanjamau

Masu hana shingen bincike

Masu hana wuraren bincike sune magunguna waɗanda zasu iya taimaka wa garkuwar jikin ku ta gano da kashe ƙwayoyin kansar fata na melanoma.

Cibiyar Abinci da Magunguna (FDA) ta amince da nau'ikan hana shiga uku don hana melanoma:

• ipilimumab (Yervoy), wanda ke toshe sinadarin bincike CTL4-A
• pembrolizumab (Keytruda), wanda ke toshe furotin mai shinge PD-1
• nivolumab (Opdivo), wanda kuma ya toshe PD-1

Kwararka na iya ba da izini guda ɗaya ko fiye masu hana shiga idan kana da mataki na 3 ko mataki na 4 melanoma wanda ba za a iya cire shi ta hanyar tiyata ba. A wasu yanayin kuma, suna iya ba da umarnin hana masu rajistar abubuwan haɗin kai tare da tiyata.

Cytokine far

Jiyya tare da cytokines na iya taimakawa haɓaka tsarin garkuwar ku da ƙarfafa amsar sa game da cutar kansa.

FDA ta amince da nau'ikan cytokines guda uku don maganin melanoma:

• interferon alfa-2b (Intron A)
• pegylated interferon alfa-2b (Sylatron)
• interleukin-2 (aldesleukin, Proleukin)

Interferon alfa-2b ko pegylated interferon alfa-2b galibi an tsara shi bayan an cire melanoma tare da tiyata. Wannan an san shi da magani na adjuvant. Yana iya taimakawa rage damar da ciwon sankara ya dawo.

Proleukin galibi ana amfani dashi don magance mataki na 3 ko mataki na 4 melanoma wanda ya bazu.

Oncolytic cutar magani

Kwayar cututtukan cututtukan ƙwayoyin cuta sune ƙwayoyin cuta waɗanda aka canza don cutar da kashe ƙwayoyin kansa. Hakanan suna iya haifar da tsarin rigakafin ku don afkawa ƙwayoyin kansa a cikin jikin ku.

Talimogene laherparepvec (Imlygic) wata kwayar cutar oncolytic ce wacce aka amince da ita don magance melanoma. An kuma san shi da suna T-VEC.

Imlygic yawanci an tsara shi kafin aikin tiyata. An san wannan azaman magani neoadjuvant.

Adadin nasarar immunotherapy

Immunotherapy na iya taimakawa tsawan rayuwa a cikin wasu mutane tare da mataki na 3 ko mataki na 4 melanoma - gami da wasu mutanen da ke da melanoma waɗanda ba za a iya cire su da tiyata ba.

Lokacin da ba za a iya cire melanoma ta hanyar tiyata ba, an san shi azaman melanoma wanda ba a iya gyara shi.

Ipilimumab (Yervoy)

A cikin bita da aka buga a 2015, masu bincike sun tattara sakamakon binciken 12 da suka gabata a kan mai hana shiga wurin Yervoy. Sun gano cewa a cikin mutanen da ke da matsala 3 ko mataki na 4 melanoma, kashi 22 cikin ɗari na waɗanda suka karɓi Yervoy suna raye shekaru 3 daga baya.

Koyaya, wasu karatun sun sami ƙananan ƙananan nasara ga mutanen da aka bi da wannan magani.

Lokacin da masu bincike daga binciken EURO-VOYAGE suka duba sakamakon magani a cikin mutane 1,043 da ke dauke da cutar melanoma, sun gano cewa kashi 10.9 cikin dari da suka karɓi Yervoy sun rayu aƙalla shekaru 3. Kashi takwas na mutanen da suka karɓi wannan magani sun rayu tsawon shekaru 4 ko fiye.

'Yancin (Keytruda)

Bincike ya nuna cewa jiyya tare da Keytruda shi kaɗai na iya amfanar wasu mutane fiye da jiyya da Yervoy kawai.

A cikin, masana kimiyya sun kwatanta waɗannan jiyya a cikin mutanen da ba za a iya bayyana su mataki na 3 ko na 4 melanoma ba. Sun gano cewa kashi 55 cikin 100 na waɗanda suka karɓi Keytruda sun rayu aƙalla shekaru 2. Idan aka kwatanta, kashi 43 na waɗanda aka yiwa magani tare da Yervoy sun rayu tsawon shekaru 2 ko fiye.

Mawallafin wani binciken da aka yi kwanan nan sun kiyasta cewa yawan rayuwar da ke cikin shekaru 5 a cikin mutanen da ke da ƙwayar melanoma wanda aka bi da su tare da Keytruda ya kasance kashi 34. Sun gano cewa mutanen da suka karɓi wannan maganin sun rayu kimanin shekaru biyu na matsakaici.

Nivolumab (Opdivo)

Nazarin ya kuma gano cewa magani tare da Opdivo kadai na iya kara damar samun rayuwa fiye da magani da Yervoy kadai.

Lokacin da masu bincike suka kwatanta wadannan magungunan a cikin mutane masu fama da mataki na 3 ko kuma melanoma na mataki na 4, sai suka gano cewa mutanen da aka yiwa magani tare da Opdivo kadai sun rayu na matsakaicin matsakaici na kimanin shekaru 3. Mutanen da aka yiwa jinya tare da Yervoy kawai sun rayu na kimanin kimanin watanni 20.

Haka kuma binciken ya gano cewa tsawon rai na shekaru 4 gaba daya shine kashi 46 cikin dari na mutanen da aka yiwa magani tare da Opdivo kadai, idan aka kwatanta da kashi 30 cikin dari na mutanen da aka yiwa jiyya da Yervoy shi kaɗai.

Nivolumab + ipilimumab (Opdivo + Yervoy)

Wasu daga cikin cututtukan magani mafi kyau ga mutanen da ke fama da cutar melanoma marasa magani an same su a cikin marasa lafiyar da aka kula da su tare da haɗin Opdivo da Yervoy.

A cikin wani karamin binciken da aka buga a cikin Journal of Clinical Oncology, masana kimiyya sun ba da rahoton yawan rayuwa na tsawon shekara 63 cikin ɗari a tsakanin majiyyata 94 da aka yi wa wannan haɗin magunguna. Duk marasa lafiya suna da mataki na 3 ko melanoma na mataki na 4 wanda ba za a iya cire shi ta hanyar tiyata ba.

Kodayake masu bincike sun danganta wannan hadewar magunguna da ingantaccen tsarin rayuwa, amma kuma sun gano yana haifar da mummunar illa fiye da kowane magani kawai.

Ana buƙatar manyan karatu akan wannan haɗin haɗin.

Cytokines

Ga yawancin mutane da ke fama da melanoma, fa'idodin magani tare da maganin cytokine sun zama ƙanƙanta fiye da waɗanda suke ɗaukar masu hana shiga. Duk da haka, wasu marasa lafiya waɗanda ba su amsa da kyau ga sauran jiyya na iya amfana daga maganin cytokine.

A cikin 2010, masu bincike sun wallafa nazarin karatu akan interferon alfa-2b don maganin mataki na 2 ko mataki na 3 melanoma. Mawallafin sun gano cewa marasa lafiyar da suka karɓi allurai na interferon alfa-2b bayan tiyata suna da mafi ƙarancin ƙarancin rayayyar rayuwa ba tare da cuta ba, idan aka kwatanta da waɗanda ba su sami wannan magani ba. Sun kuma gano cewa marasa lafiyar da suka sami interferon alfa-2b bayan tiyata sun sami sauƙin rayuwa gabaɗaya.

Wani bincike kan pegylated interferon alfa-2b ya gano cewa a cikin wasu karatuttukan, mutanen da ke da mataki na 2 ko na 3 melanoma waɗanda suka karɓi wannan magani bayan tiyatar suna da ƙimar rayuwa mai saurin dawowa. Koyaya, marubutan sun sami ƙaramin shaidar ingantaccen rayuwa.

A cewar wani nazarin, binciken ya gano cewa melanoma ya zama ba za a iya ganowa ba bayan jiyya tare da yawan maganin interleukin-2 a cikin kashi 4 zuwa 9 na mutanen da ke da ƙwayar melanoma. A wani kaso 7 zuwa 13 na mutane, an nuna yawan allurai na interleukin-2 don rage ƙwayoyin melanoma da ba za a iya rabasu ba.

Talimogene laherparepvec (Imlygic)

Binciken da aka gabatar a Europeanungiyar Tarayyar Turai ta 2019 don Taron Kiwon Lafiyar Kiwon Lafiyar Jama'a ya nuna cewa gudanar da Imlygic kafin a cire melanoma ta hanyar tiyata na iya taimaka wa wasu marasa lafiya tsawon rai.

Wannan binciken ya gano cewa a tsakanin mutanen da ke fama da ciwan daji melanoma waɗanda aka yi wa aikin tiyata su kaɗai, kashi 77.4 cikin 100 sun rayu aƙalla shekaru 2. Daga cikin waɗanda aka yi wa magani tare da haɗin tiyata da Imlygic, kashi 88.9 cikin ɗari sun rayu na aƙalla shekaru biyu.

Ana buƙatar ƙarin bincike kan tasirin tasirin wannan magani.

Sakamakon sakamako na immunotherapy

Immunotherapy na iya haifar da sakamako masu illa, wanda ya bambanta dangane da takamaiman nau'in da kashi na rigakafin rigakafin da kuka karɓa.

Misali, illa mai illa sun haɗa da:

• gajiya
• zazzaɓi
• jin sanyi
• tashin zuciya
• amai
• gudawa
• kumburin fata

Waɗannan kawai wasu ƙananan sakamako ne masu illa da ke iya haifar da rigakafin rigakafi. Don ƙarin koyo game da tasirin illa na takamaiman magungunan rigakafi, yi magana da likitanka.

Illolin cututtukan rigakafin rigakafi yawanci sauki ne, amma a wasu lokuta suna iya zama masu tsanani.

Idan kuna tsammanin kuna iya fuskantar illa, sanar da likitanka nan da nan.

Kudin immunotherapy

Kudin aljihun aljihun rigakafin rigakafi ya bambanta, dangane da babban ɓangare akan:

• nau'in da kashi na rigakafin rigakafi da ka karɓa
• shin ko kana da inshorar kiwon lafiya don maganin
• ko ko kun cancanci shirye-shiryen taimakon haƙuri don maganin
• ko kuna karɓar magani a matsayin ɓangare na gwajin asibiti

Don ƙarin koyo game da farashin shirin shawarar da aka ba da shawarar, yi magana da likitanka, likitan magunguna, da kuma mai ba da inshora.

Idan kuna da wahala ku iya biyan farashin kulawa, bari ƙungiyar kula da ku ta sani.

Suna iya bayar da shawarar canje-canje ga shirin maganinku. Ko kuma suna iya sani game da shirin taimako wanda zai iya taimakawa biyan kuɗin kulawar ku. A wasu lokuta, suna iya ƙarfafa ka ka yi rajista a cikin gwajin asibiti wanda zai ba ka damar samun damar maganin a kyauta yayin shiga cikin bincike.

Gwajin gwaji

Baya ga magungunan rigakafi da aka yarda da shi don magance melanoma, masana kimiyya a halin yanzu suna nazarin wasu hanyoyin gwajin rigakafin gwaji.

Wasu masu bincike suna haɓakawa da gwada sababbin nau'ikan magungunan rigakafi. Sauran suna nazarin aminci da inganci na haɗa nau'ikan nau'ikan rigakafin rigakafi. Sauran masu binciken suna ƙoƙarin gano dabarun don koyon waɗanne marasa lafiya ne ke iya cin gajiyar waɗanne jiyya.

Idan likitan ku yana tsammanin zaku iya amfana daga karɓar gwajin gwaji ko kuma shiga cikin binciken bincike akan rigakafin rigakafi, za su iya ƙarfafa ku ku shiga cikin gwajin gwaji.

Kafin ka shiga kowane gwaji, ka tabbata ka fahimci fa'idodi da kasada.

Canjin rayuwa

Don taimakawa tallafawa lafiyar jikinku da lafiyarku yayin da kuke shan rigakafin rigakafi ko wasu magungunan ciwon daji, likitanku na iya ƙarfafa ku don yin wasu canje-canje na rayuwa.

Misali, suna iya ƙarfafa ka zuwa:

• daidaita yanayin bacci don samun karin hutu
• gyara abincinka don samun karin abubuwan gina jiki ko adadin kuzari
• canza halayen motsa jiki don samun isasshen aiki, ba tare da sanya harajin jikinka da yawa ba
• wanke hannuwan ka ka rage iya mu'amalar ka da marasa lafiya domin rage kamuwa da cutar
• haɓaka ƙwarewar kulawa da dabarun shakatawa

A wasu lokuta, daidaita dabi'un ka na yau da kullun na iya taimaka maka ka jurewa tasirin magani. Misali, samun karin hutu na iya taimaka maka wajen sarrafa gajiya. Yin canje-canje ga abincinka na iya taimaka maka sarrafa jin jiri ko rashi.

Idan kuna buƙatar taimako don daidaita halayenku na rayuwa ko kula da lahanin magani, likitanku na iya tura ku zuwa ƙwararren masani don tallafi. Misali, likitan abinci zai iya taimaka maka ka daidaita yanayin cin abincinka.

Outlook

Hangenku game da cutar kansa na melanoma ya dogara da dalilai da yawa, gami da:

• lafiyar ku baki daya
• matakin kansar da kuke dashi
• girman, lamba, da kuma wurin ciwace ciwace a jikin ku
• nau'in magani da aka karɓa
• yadda jikinka ke amsar magani

Kwararka zai iya taimaka maka ƙarin koyo game da yanayinka da hangen nesa. Hakanan zasu iya taimaka maka fahimtar zaɓin maganin ka, gami da tasirin da magani zai iya yi akan tsawon da ingancin rayuwar ka.