Ke ʻōlelo mākou "maʻi kanesa", ʻo kekahi o nā huaʻōlelo e hiki koke mai ana i ka noʻonoʻo ʻo ia ka "chemotherapy". Nui ka poʻe e makaʻu nei i kēia lāʻau lapaʻau no ka mea he mea ia e hāʻule ai ka lauoho a he mea paʻakikī no ke kino. Eia nō naʻe, me ka holomua o ka ʻepekema lapaʻau, ua hoʻolauna ʻia nā ʻano hana hou i ka honua e hiki ke kuhikuhi wale i nā hunaola kanesa a hōʻemi nui i ka hōʻino ʻana i nā hunaola olakino. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau i hana i kahi holomua nui i ka honua o ka mālama ʻana i ka maʻi kanesa, a hana e like me ka 'magic bullet'. ʻO ia ka Antibody-Drug Conjugates, a i ʻole ADCs e like me kā mākou e kapa nei iā lākou no ka pōkole.
I ka ʻōlelo maʻalahi, he aha kēia Antibody-Drug Conjugate (ADC)?
E noʻonoʻo, pono ʻoe e hāʻawi i kahi pūʻolo i hoʻokahi kanaka ma kahi piha kanaka. Pehea ka maʻalahi o ka loaʻa ʻana o kēlā kanaka a hāʻawi i ka pūʻolo ma mua o ka hāʻawi ʻana i nā mea āpau? ʻO ia ka hana a kēia ADC.
He hui pū ʻana o ʻekolu ʻāpana ʻo ADC. I ka pololei, ua like ia me kahi 'pōkā akamai' i hana ʻia me ka ʻenehana.
1. Antibody: ʻO kēia kā mākou 'mea ʻike'. Aia nā protein kūikawā (kapa mākou i kēia mau "antigens tumor") aia wale nō ma luna o ka ʻili o nā cell cancer. Hana ʻia kēia antibody e hele a pipili i nā protein ma luna o kēlā mau cell cancer. Ua like ia me ke kī e kūpono i loko o kona laka like. ʻOiai ʻaʻohe o kēia mau protein i nā cell olakino, ʻaʻole pipili kēia antibody iā lākou. No ka mea, ua hana kūikawā ʻia kēia mau mea i loko o nā keʻena hoʻokolohua, kapa mākou iā lākou he "Monoclonal Antibody".
2. Lāʻau lapaʻau chemotherapy: ʻO kēia ka mea i loko o kēlā pūʻolo. Hoʻohana ia i kahi lāʻau anti-cancer ikaika loa ma mua o ka mea i hāʻawi ʻia i ka chemotherapy maʻamau. No ka mea, hele pololei ia i loko o ke kelepona kanesa, hiki iā ia ke hāʻawi i kahi lāʻau ikaika me ka ʻole o ka hōʻeha ʻana i nā kelepona olakino ma waho.
3. Mea Hoʻopili: ʻO kēia ka 'gum' e hoʻopaʻa ana i ka kiu (Antibody) a me ka pōkā (Chemo drug). ʻO ka hana o kēia mea hoʻopili, ʻo ia ke kāohi i ka lāʻau mai ka hoʻokuʻu ʻia a hiki i ka loaʻa ʻana o ka antibody i ke kelepona kanesa a komo i loko. Ma hope wale nō o ke komo ʻana o ke kelepona kanesa, e haki ai kēia mea hoʻopili, e hoʻokuʻu ana i ka lāʻau.
Pehea e hana ai kēia 'missile biological'?
He mea hoihoi loa kēia kaʻina hana. E nānā kākou i ka mea e hana ʻia ma kēlā me kēia ʻanuʻu.
- KaʻAnuʻu Hana 1: Hoʻokomo ʻia ka lāʻau ADC i loko o ke aʻa o ka mea maʻi ma o kahi wai saline.
- KaʻAnuʻu Hana 2: Ke hele nei kēia lāʻau lapaʻau ma ke kino holoʻokoʻa ma o ke koko. Eia nō naʻe, i kona hele ʻana, hana ka ʻāpana antibody e like me ka GPS, e ʻimi ana i kahi o nā hunaola kanesa.
- KaʻAnuʻu Hana 3: Ke loaʻa kahi pūnaeho kanesa, hele ka antibody a 'laka' ma kahi protein kikoʻī (antigen) ma luna o ka ʻili o kēlā pūnaeho.
- KaʻAnuʻu Hana 4: Ke paʻa ʻia e like me kēia, manaʻo ka ʻōpū kanesa he mea kēia āna e makemake ai. No laila huki ia i kēia pūʻolo ADC holoʻokoʻa i loko ona iho.
- KaʻAnuʻu Hana 5: Ke komo i loko o ke kele kanesa, e wāwahi nā enzymes i loko i kēlā 'linker'.
- KaʻAnuʻu Hana 6: I ka wā e haki ai ka mea hoʻopili, ua hoʻokuʻu ʻia ka lāʻau chemotherapy ikaika loa i hoʻopaʻa ʻia iā ia i loko o ke kele kanesa.
- KaʻAnuʻu Hana 7: Ma muli o ka ikaika o kēia lāʻau lapaʻau, ua luku ʻia ke hunaola kanesa mai loko mai.
ʻO ka mea nui, ʻo ia ka hana ʻana o kēia kaʻina holoʻokoʻa i loko o ke keena kanesa. No laila, he liʻiliʻi loa ka hōʻino ʻana i nā keena olakino a puni. ʻO kēia ka pōmaikaʻi nui o nā ADC ma mua o ka chemotherapy maʻamau.
He aha nā ʻano maʻi kanesa i mālama ʻia me ADC?
ʻAʻole ʻo ADC kahi lāʻau lapaʻau no nā ʻano maʻi kanesa āpau. I kēia manawa, noʻonoʻo nā kauka i kēia lāʻau lapaʻau no kekahi mau ʻano maʻi kanesa, ʻoiai ke hāʻule ʻole nā lāʻau lapaʻau ʻē aʻe (`(refractory cancer)`), ua hoʻi mai ke kanesa (`(recur)`), a ua pālahalaha paha i nā ʻāpana ʻē aʻe o ke kino (`(metastasize)`).
E wehewehe hou aku kākou i kēia ma ka papa ma lalo nei.
| Māhele maʻi ʻaʻai | Nā hiʻohiʻona o nā ʻano maʻi kanesa i mālama ʻia |
|---|---|
| Nā maʻi ʻaʻai koko |
|
| Nā puʻupuʻu paʻa |
ʻO kekahi mau lāʻau ADC i hoʻohana ʻia ma ka honua
Aia ma mua o hoʻokahi kakini mau lāʻau ADC i ʻāpono ʻia e nā keʻena e like me ka FDA ma ʻAmelika Hui Pū ʻIa. Eia kekahi mau laʻana:
- ʻO Brentuximab vedotin (Adcetris®): Hoʻohana ʻia no nā maʻi ʻaʻai koko e like me Hodgkin lymphoma.
- Trastuzumab emtansine (Kadcyla®): Hoʻohana ʻia no ka maʻi ʻaʻai umauma HER2-positive i laha a puni ke kino.
- ʻO Sacituzumab govitecan (Trodelvy®): Hoʻohana ʻia no ka maʻi ʻaʻai umauma triple-negative a me ke kanesa ʻōpū.
ʻAʻohe hopena ʻaoʻao o kēia lāʻau lapaʻau?
ʻOiai ua ʻōlelo ʻia "he mea liʻiliʻi ka pōʻino i nā ʻāpana olakino", ʻaʻole kēia manaʻo ʻaʻohe hopena ʻaoʻao o kēia lāʻau. Eia naʻe, i ka hoʻohālikelike ʻia me ka chemotherapy maʻamau, hiki ke hoʻokele pinepine ʻia kēia mau mea. Hiki ke ʻokoʻa nā hopena ʻaoʻao e kū mai ana mai ka mea maʻi a i ka mea maʻi, ma muli o ke ʻano o ke kanesa, kona pae, a me ke olakino holoʻokoʻa o ka mea maʻi.
E nānā pono kāu hui oncology iā ʻoe i loko o kāu mālama ʻana. Inā loaʻa kekahi hopena ʻaoʻao, e hāʻawi koke lākou iā ʻoe i ka lāʻau lapaʻau.
Nā hopena ʻaoʻao maʻamau:
- Luhi
- Ka luaʻi a me ka luaʻi
- Anemia
- Leukopenia (helu haʻahaʻa o nā keʻena koko keʻokeʻo)
- Ka helu haʻahaʻa o nā platelet koko (`(Thrombocytopenia)`)
- ʻAʻohe ʻono
- Ka paʻa ʻana o ka ʻōpū a i ʻole ka maʻi kahe
- ʻEha poʻo, kuni
- ʻO ka neuropathy peripheral - ka ʻeha a me ka ʻāʻī ʻana o nā lālā
- ʻŌhū ʻili
He mea nui loa e hoʻomaopopo koke i kāu kauka e pili ana i kekahi o kēia mau mea, ʻoiai inā he mau mea liʻiliʻi.
Hiki iā mākou ke loaʻa ka manaʻolana no kēia lāʻau lapaʻau?
ʻAe, ʻoiaʻiʻo nō. He lāʻau lapaʻau ʻo ADC i lawe mai i ka manaʻolana hou i nā poʻe maʻi kanesa he nui. Ua hōʻike ʻia nā noiʻi e ola lōʻihi ana nā poʻe maʻi e loaʻa ana i ka lāʻau ADC ma mua o ka poʻe e loaʻa ana i ka chemotherapy maʻamau wale nō.
A ke ulu wikiwiki nei kēia kahua. I kēia manawa, ʻoi aku ma mua o 100 mau hoʻokolohua lapaʻau e hana ʻia nei a puni ka honua. Ke hoʻāʻo nei nā kānaka ʻepekema e hoʻomohala i nā ADC i ʻoi aku ka maikaʻi a me nā hopena ʻaoʻao liʻiliʻi no nā ʻano maʻi kanesa. No laila, hiki iā mākou ke manaʻolana i ka wā e hiki mai ana, e hiki iā mākou ke loaʻa kēia lāʻau lapaʻau 'magic bullet' no nā ʻano maʻi kanesa he nui.
Leka Lawe-Home
- ʻO nā Antibody-Drug Conjugates (ADCs) kahi ʻano lāʻau 'akamai' e kuhikuhi ana a hoʻouka wale i nā hunaola kanesa.
- Hāʻawi kēia i kahi lāʻau anti-cancer ikaika loa i loko o ke kele kanesa, e hōʻemi ana i ka hōʻino ʻana i nā kele olakino.
- Hoʻohana wale ʻia kēia no kekahi mau ʻano maʻi kanesa, ʻoiai ke holo pono ʻole nā lāʻau ʻē aʻe.
- ʻOiai hiki i kēia lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao, e mālama pono kāu hui lapaʻau iā lākou. E kamaʻilio me kāu kauka e pili ana i kekahi ʻeha.
- He manaʻolana nui ʻo ADC ma ke kahua o ka mālama ʻana i ka maʻi kanesa. Me ka hoʻomau ʻana o ka noiʻi, e hoʻonui hou ʻia kona mau pono i ka wā e hiki mai ana.
- Inā loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai ka maʻi kanesa, e kūkākūkā mau i nā koho lapaʻau me kāu kauka oncology. Mai hoʻokumu i kāu mau hoʻoholo ma luna wale nō o kāu mea i heluhelu ai ma ka pūnaewele.
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