Manaʻolana hou no ka maʻi ʻaʻai umauma: E aʻo kākou e pili ana i nā PI3K Inhibitors ma ke ʻano maʻalahi (PI3K Inhibitors no ka ER+ Breast Cancer)

Ke lohe kākou i ka huaʻōlelo maʻi ʻaʻai umauma, nui ka poʻe o kākou e makaʻu nei. Akā, ʻo ka mea nui e pono ai kākou e hoʻomaopopo, ʻaʻole like nā maʻi ʻaʻai umauma a pau. He ʻano like ʻole ko lākou. ʻO kekahi o nā ʻano maʻamau ka 'estrogen receptor positive' a i ʻole e like me kā mākou e kapa nei ma ke ʻano lapaʻau , ER+ (Estrogen-Receptor-Positive) maʻi ʻaʻai umauma . ʻO ka ʻoiaʻiʻo, he 80% wale nō o nā maʻi ʻaʻai umauma i ʻike ʻia no kēia ʻano. No laila, i kēia lā e kamaʻilio mākou e pili ana i kahi papa lāʻau lapaʻau hou a holomua i ʻike ʻia e mālama i kēia mau maʻi ʻaʻai umauma ER+.

ʻO ka mea mua, e nānā kākou, he aha ka maʻi ʻaʻai umauma ER+?

I ka ʻōlelo maʻalahi, kōkua ka hormone estrogen i loko o ko kākou kino i kēia mau hunaola kanesa e ulu. E noʻonoʻo he mau 'loka' kūikawā (nā mea loaʻa) kēia mau hunaola kanesa ma ko lākou ʻili e hiki ai i ka hormone estrogen ke hoʻopili. Ke komo ke 'kī' i kapa ʻia ʻo ka hormone estrogen i loko o kēia 'loka', loaʻa i nā hunaola kanesa kahi 'hōʻailona' e māhele a ulu.

ʻO kēia ke kumu e mālama pinepine ai nā kauka i nā maʻi kanesa ER+ me ka lāʻau lapaʻau hormone . Hana kēia mau lāʻau lapaʻau ma ke kāohi ʻana i ke 'kī' (estrogen) mai ka hoʻopaʻa ʻana i ka 'loka' (nā mea loaʻa). Akā i kekahi manawa, ʻoiai ke pālahalaha ka maʻi kanesa ma ke kino holoʻokoʻa (holomua a metastatic paha), lilo kēia mau hunaola kanesa i mea maalea loa. Lilo lākou i kūʻē i kēia mau lāʻau lapaʻau hormone, ʻo ia hoʻi, ʻaʻole lākou e pane maikaʻi i ka lāʻau lapaʻau. ʻO kēia ka manawa e pono ai mākou i nā lāʻau lapaʻau hou a ʻoi aku ka maikaʻi.

ʻO ke 'kuhi ulu' o nā hunaola kanesa - nā genes PI3K a me PIK3CA

I ka ʻimi ʻana o nā kauka a me nā kānaka ʻepekema i nā kumu o kēia mau maʻi ʻaʻai kūʻē i ka hormone, ua loaʻa iā lākou kahi mea kūikawā: kahi kīnā i ke ala PI3K (Phosphatidylinositol-3-Kinase) , kahi ʻōnaehana hōʻailona koʻikoʻi e kaohi ana i ka ulu ʻana, ka mahele ʻana, a me ke ola ʻana o nā cell i loko o ko mākou kino.

E noʻonoʻo i kēia ala PI3K ma ke ʻano he 'papa hoʻololi' nui i loko o kahi kelepona. Hoʻomalu ia i nā hoʻoholo e pili ana i ka ulu ʻana a i ʻole ka māhele ʻana o kahi kelepona. ʻO kekahi o nā genes nui e hoʻomalu nei i kēia papa hoʻololi ʻo ia ka gene PIK3CA .

I kekahi poʻe maʻi kanesa, loaʻa i kēia gene PIK3CA kahi mutation , ʻo ia hoʻi kahi loli a kīnā paha. Ua like ia me ke kuapo 'ulu' ma ka papa kuapo e paʻa ana a 'ā mau'. A laila hoʻomaka nā cell e māhele a ulu me ka hiki ʻole ke kāohi. ʻO kēia ke kumu nui o ka maʻi kanesa. Ua ʻike ʻia ka noiʻi ma kahi o 40% o nā maʻi me ka maʻi ʻaʻai umauma ER+ i loaʻa kēia mutation gene PIK3CA.

No laila he aha kēia mau mea hoʻopale PI3K?

Maanei, ma ke ʻano he hopena no kēia pilikia, ke hoʻolauna ʻia nei kahi papa o nā lāʻau i kapa ʻia ʻo PI3K inhibitors . ʻO ka mea maʻalahi loa a kēia mau lāʻau e hana ai, ʻo ia ke hoʻopau pono i ka 'growth switch' (ala PI3K) aʻu i ʻōlelo ai ma mua i paʻa 'ma'.

ʻO ka maʻamau, hele mai kēia mau mea ma ke ʻano o nā lāʻau lapaʻau waha. I ka manawa pinepine, hāʻawi ʻia kēia lāʻau lapaʻau i nā maʻi me ka hui pū ʻana me ka lāʻau lapaʻau hormone i ʻōlelo ʻia ma mua (estrogen blocker).

Pehea e ʻike ai inā kūpono kēia lāʻau lapaʻau iaʻu?

He nīnau koʻikoʻi loa kēia. ʻAʻole hāʻawi ʻia nā PI3K Inhibitors i nā poʻe maʻi maʻi umauma āpau. Ua hoʻolālā kūikawā ʻia lākou no:

• No nā wahine postmenopausal a me nā kāne maʻi.
• Pono ke kanesa HR+ (Hormone-Receptor-Positive) a me HER2-Negative .
• ʻO ka mea nui loa: Pono i nā hunaola kanesa ke loaʻa ka hoʻololi ʻana o ka gene PIK3CA .

No ka ʻike ʻana inā loaʻa i kāu maʻi ʻaʻai kēia hoʻololi hoʻoilina, e hana kāu kauka i kahi hoʻokolohua kūikawā. ʻO ka maʻamau, pili kēia i kahi hāpana koko a i ʻole kahi ʻāpana liʻiliʻi o ka ʻiʻo (biopsy) i lawe ʻia mai ka puʻupuʻu. ʻO nā hopena o kēlā hoʻokolohua e hoʻoholo ai inā kūpono kēia lāʻau iā ʻoe.

He aha nā hopena ʻaoʻao e hiki ai i kēia mau lāʻau lapaʻau ke hana?

E like me nā lāʻau lapaʻau maʻi kanesa, hiki i nā mea hoʻopaʻa PI3K ke hana i kekahi mau hopena ʻaoʻao. Eia naʻe, ʻaʻole like kēia mau mea i nā kānaka a pau. Eia kekahi, aia nā ala e hoʻokele ai i kēia mau hopena ʻaoʻao.

ʻO kekahi o nā hopena ʻaoʻao maʻamau:

• Ka luaʻi a me ka luaʻi
• Ka nalowale o ka makemake a me ka pohō kaumaha
• ʻEha waha
• Pohō lauoho
• Nā hopena ma ka hana o nā puʻupaʻa, ke akepaʻa, a i ʻole ka pancreas
• Hiki ke loaʻa nā ʻōhū ʻili, i kekahi manawa ʻino loa, e hoʻoulu ai i ka ʻili e ʻili a pehu paha.
• Ke Koko Koko Kiʻekiʻe: He hopena ʻaoʻao maʻamau kēia e pili ana i kēia papa o nā lāʻau lapaʻau, ʻoiai ke ala PI3K e pili ana i ka metabolism kō i loko o ko mākou kino.

Mai hopohopo i kēia mau hopena ʻaoʻao. E nānā mau kāu kauka iā ʻoe no kēia mau mea. Inā pono, e hōʻemi ʻo ia i ka nui o ka lāʻau lapaʻau, e hoʻōki i ka lawe ʻana no kekahi manawa (lāʻau lapaʻau), a hāʻawi paha iā ʻoe i kahi lāʻau ʻē aʻe e kāohi i nā hopena ʻaoʻao. Mai hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke noi ʻana i kāu kauka.

Ua hōʻike ʻia e ka noiʻi ʻana e hiki i ka lawe ʻana i ka lāʻau maʻi diabetes e kāohi i nā pae kō koko a i ʻole ka hahai ʻana i kahi papaʻai haʻahaʻa-carb a kiʻekiʻe-momona ( ʻai ketogenic ) ke hoʻonui i ka pono o kēia lāʻau. Eia nō naʻe, he mea nui e kamaʻilio me kāu kauka ma mua o ka hana ʻana i kekahi mau hoʻololi ʻai.

He kūpono maoli anei kēia lāʻau lapaʻau?

ʻAe. ʻO kēia ka mea nui loa. Ua hōʻike ʻia nā hoʻokolohua lapaʻau he nui e hiki i nā poʻe maʻi me ka maʻi ʻaʻai umauma ER+ me kahi hoʻololi PIK3CA ke pōmaikaʻi mai kahi mea hoʻopaʻa PI3K i hui pū ʻia me ka lāʻau lapaʻau hormone.

Ua ʻike ʻia kekahi noiʻi nui he 11 mau mahina ka lōʻihi o ke ola ʻana o nā maʻi i loaʻa i kēia hui lāʻau. ʻAʻole i emi iho kēia ma mua o 6 mau mahina no nā maʻi me ka hoʻololi like ʻana o ka genetic i loaʻa ʻole i nā mea hoʻopaʻa PI3K. He loli nui kēia a he nui ka manaʻolana. Ma muli o kēia holomua, ke hoʻomohala ʻia nei nā lāʻau hou i kēia papa o nā lāʻau.