Ke ʻike ʻia kekahi me ka maʻi ʻaʻai umauma, kaumaha a makaʻu loa lākou. He mea maʻamau kēlā. Akā me ka ʻepekema lapaʻau holomua o kēia wā, hiki ke kāohi ʻia a hoʻōla ʻia ka hapa nui o nā ʻano maʻi ʻaʻai umauma . Eia nō naʻe, aia kekahi mau ʻano maʻi ʻaʻai i ʻoi aku ka paʻakikī o ka mālama ʻana ma mua o nā mea ʻē aʻe. Ua kapa ʻia kēia mau mea he "paʻakikī ke mālama i nā maʻi ʻaʻai umauma." Loaʻa i nā mea noiʻi lapaʻau nā manaʻolana kiʻekiʻe no kēia, no ka mea, ke hoʻomohala ʻia nei nā lāʻau lapaʻau hou i kēlā me kēia lā. E kamaʻilio kākou e pili ana i kēia i kēia lā.
No ke aha he paʻakikī ke mālama ʻana i kekahi mau maʻi ʻaʻai umauma?
I ka ʻōlelo maʻalahi, ʻo ka pahuhopu o nā lāʻau lapaʻau maʻi umauma holomua loa e kāohi i ke ʻano o ka ulu ʻana o nā hunaola maʻi kanesa. E noʻonoʻo i kēia ʻano: inā like kahi hunaola maʻi kanesa me ka puka, ʻo kekahi mau hormones a me nā protein e like me nā kī e wehe ai i kēlā puka. Hana nā lāʻau lapaʻau ma ke ālai ʻana i nā puka (nā mea loaʻa) i ʻole e hana kēia mau kī. Ua māhele ʻia ka maʻi kanesa umauma i ʻekolu mau ʻano nui e pili ana i ke ʻano o nā 'puka'.
I kēia manawa, e nānā kākou i ke ʻano o kēia mau ʻano ʻekolu.
| ʻAno maʻi kanesa | He wehewehe maʻalahi |
|---|---|
| Ka maʻi ʻaʻai hormone receptor positive (HR-positive) | Loaʻa i kēia mau ʻōpū kanesa nā mea loaʻa estrogen (ER) a me/a i ʻole nā mea loaʻa progesterone (PR), ka mea e ʻoi aku ai ko lākou pane ʻana i nā lāʻau hormonal. |
| Ka maʻi ʻaʻai HER2-maikaʻi (HER2-maikaʻi) | He nui loa ka protein i kapa ʻia ʻo HER2 i loko o kēia mau cell. No laila, hiki ke hoʻomalu ʻia me nā lāʻau lapaʻau e pili ana i ka mea loaʻa HER2. |
| Ka maʻi ʻaʻai umauma ʻekolu-maikaʻi ʻole (TNBC) | ʻO kēia ke ʻano paʻakikī loa. ʻAʻohe mea loaʻa estrogen i kēia mau cell cancer, ʻaʻohe mea loaʻa progesterone, a ʻaʻohe mea loaʻa HER2. ʻO ia hoʻi, ʻaʻohe o kēia mau cell i kēlā mau 'puka' ʻekolu aʻu i ʻōlelo ai ma mua. |
Ma waena o 10% a me 20% o nā maʻi maʻi umauma āpau i loaʻa i kēiaHe ʻano maʻi ʻaʻai umauma ia i kapa ʻia ʻo ka maʻi ʻaʻai umauma triple-negative (TNBC). ʻAʻole hana nā lāʻau lapaʻau hormone i hoʻohana pono ʻia no nā ʻano maʻi ʻaʻai ʻē aʻe no kēia ʻano maʻi ʻaʻai, no ka mea, ʻaʻohe ona mea loaʻa hormone. Eia kekahi, ʻaʻole kōkua nā lāʻau lapaʻau e kuhikuhi ana iā HER2.
Eia kekahi, ʻoi aku ka ikaika o ke kanesa TNBC ma mua o nā ʻano ʻē aʻe. ʻO ke ʻano kēia, ʻoi aku ka nui o ka laha ʻana o ke kanesa i nā ʻāpana ʻē aʻe o ke kino i ka wā e ʻike ʻia ai. He ʻokoʻa nō hoʻi kona ʻano i kēlā me kēia kanaka, a hiki ke loli i ka hala ʻana o ka manawa e kūʻē i kekahi mau lāʻau lapaʻau.
Pehea ka hopena o nā hoʻololi genetic i kēia?
ʻO kekahi o nā ala maikaʻi loa e ʻike mua ai i kahi maʻi kanesa e like me TNBC, ʻo ia ka ʻike ʻana i ka poʻe i loaʻa i ka pilikia kiʻekiʻe. No ka hana ʻana i kēia, ke aʻo nei nā kānaka noiʻi i nā loli genetic (mutations) i hoʻoili ʻia ma o nā hanauna a pili pū me ka maʻi kanesa o ka umauma.
- BRCA1 (gene maʻi ʻaʻai umauma 1)
- BRCA2 (Kumuhana Kanesa ʻUma 2)
Inā hoʻoilina ʻoe i kahi mutation i loko o kekahi o kēia mau genes ʻelua, ʻoi aku kou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai umauma a me ka maʻi ovarian. Inā loaʻa iā ʻoe kēia mutation, ʻoi aku ka nui o kou loaʻa ʻana o ka maʻi ʻaʻai i ka wā ʻōpiopio.
ʻO ka hapa nui o nā maʻi ʻaʻai umauma me kahi hoʻololi gene BRCA1 he triple-negative . No laila, ʻo ka hoʻomaopopo ʻana i kēia gene e hiki ke kōkua i ka loaʻa ʻana o nā ala maikaʻi e mālama ai iā TNBC.
Manaʻo kekahi mau kauka e hoʻāʻo ʻia nā mea a pau me TNBC no nā genes e pili ana i ka maʻi kanesa, me BRCA1 a me BRCA2. Inā ua ʻike ʻia ʻoe me TNBC ma mua o 60 mau makahiki, a inā paha ua loaʻa i kekahi o kou ʻohana ka TNBC, hiki i kāu kauka ke paipai i kēia hoʻāʻo genetic. Hiki i kēia ke kōkua iā ʻoe a me kāu kauka e koho i ka lāʻau lapaʻau kūpono loa nāu.
He aha kāu e pono ai e ʻike e pili ana i ka maʻi ʻaʻai umauma metastatic?
ʻO kekahi ʻano maʻi kanesa paʻakikī ke mālama ʻia, ʻo ia ka maʻi kanesa umauma i pālahalaha i nā wahi mamao o ke kino. Ua kapa ʻia kēia he maʻi kanesa umauma metastatic . Hiki iā ia ke pālahalaha i nā wahi ʻē aʻe o ke kino, e like me nā iwi, ka lolo, ke akepaʻa, a i ʻole nā māmā. I kekahi manawa ua ʻike ʻia ke kanesa ke pālahalaha ma kēia ʻano. Akā ʻoi aku ka pinepine, hoʻi mai ke kanesa a pālahalaha ma hope o ka pōʻai mua o ka mālama ʻana, i kekahi manawa he mau makahiki ma hope.
Kou maʻi ʻaʻai umaumaInā ua pālahalaha ke kanesa i nā wahi mamao, ʻo ka pahuhopu nui o ka mālama ʻana, ʻo ia ke kāohi i ke kanesa. ʻO ka lāʻau lapaʻau systemic ka lāʻau maʻamau no kēia. E hoʻoholo kāu kauka i kāu lāʻau lapaʻau ma muli o kāu mau hōʻailona, nā lāʻau lapaʻau ma mua, kahi i pālahalaha ai ke kanesa, a me ke ʻano o nā hunaola kanesa.
He aha nā lāʻau lapaʻau hou loa no kēia?
Ua hoʻomaikaʻi nui ʻia nā lāʻau lapaʻau no TNBC, ka metastatic a me ka recurrent breast cancer, i nā makahiki i hala iho nei. ʻO Chemotherapy ka lāʻau lapaʻau nui no kēia. Hāʻawi nā kauka iā ia i kēia manawa me ka hui pū ʻana me nā lāʻau lapaʻau ʻē aʻe.
Eia kekahi mau koho lapaʻau hou ʻē aʻe:
Nā mea hoʻopaʻa PARP
He ʻano lāʻau kēia e hoʻopau ai i ka DNA o nā hunaola kanesa i loko o ka poʻe me nā hoʻololi ʻana o ka gene BRCA a me ke kanesa HER2-negative a me ka metastatic. ʻO nā hiʻohiʻona e like me ka `olaparib (Lynparza)` a me ka `talazoparib (Talzenna).` Ua hōʻike pū kēia mau mea i nā hopena maikaʻi no ka TNBC mua.
Hoʻōla lāʻau pale
Hoʻoulu kēia mau lāʻau lapaʻau i ka ʻōnaehana pale ponoʻī o ke kino e luku i nā hunaola kanesa. ʻO Pembrolizumab (Keytruda) kekahi o ia mau lāʻau. Hāʻawi pinepine ʻia lākou me ka chemotherapy.
Nā hui pū ʻana o ka antibody-drug (ADCs)
He ʻenehana hoihoi loa kēia. E noʻonoʻo iā ia e like me kahi ʻōnaehana GPS e alakaʻi ana i kahi lāʻau i kāna pahuhopu. Loaʻa i nā antibodies i loko o kēia mau lāʻau nā cell cancer, hoʻopili iā lākou, a luku i nā cell cancer me ka lāʻau i hoʻopili ʻia, me ka ʻole o ka hōʻeha ʻana i nā cell olakino. ʻO `Sacituzumab govitecan (Trodelvy)` kahi lāʻau ADC i ʻāpono ʻia no ka TNBC holomua.
Nā lāʻau lapaʻau hoʻohui
Aia kekahi mau lāʻau lapaʻau hou i hāʻawi ʻia me ka hui pū ʻana me ka lāʻau lapaʻau hormone no nā maʻi ʻaʻai hormone receptor (HR)-positive. ʻO Abemaciclib (Verzenio) kekahi o ia mau lāʻau lapaʻau.
He aha nā manaʻolana e hiki mai ana ma kēia ʻano?
Ke hana mau nei nā kānaka noiʻi e hoʻonui i nā koho lapaʻau no kēia mau maʻi kanesa, me ka loaʻa ʻana o nā pūhui immunotherapy hou a me ka ʻike ʻana i nā māka e hiki ke wānana i nā hopena lapaʻau.
Ke noiʻi nei hoʻi lākou inā he pono nā lāʻau lapaʻau i ʻae ʻia no nā maʻi ʻē aʻe no TNBC. Ke noiʻi nei hoʻi lākou i nā ala e hoʻohana ai i nā lāʻau lapaʻau e like me nā mea hoʻopaʻa PARP ma ke ʻano ākea. Ke hoʻāʻo nei kekahi mau noiʻi e hoʻohana i nā nanoparticles e pono ai ke kino e pepehi i nā hunaola kanesa kūʻē i ka lāʻau.
No laila, ʻoiai ke ola ʻana me kēia ʻano maʻi kanesa hiki ke paʻakikī, aia ka manaʻolana no nā lāʻau lapaʻau hou. ʻO ka mea nui loa, ʻo ke kamaʻilio pinepine ʻana me kāu kauka a hoʻoholo i ka hoʻolālā lapaʻau e kūpono loa iā ʻoe.
Leka Lawe-Home
- He paʻakikī ke mālama ʻana i kekahi mau maʻi kanesa o ka umauma, ʻoiai ʻo ka Triple-Negative Breast Cancer (TNBC) , no ka mea, ʻaʻohe o lākou mea loaʻa hormone a i ʻole ka protein HER2.
- He mea nui nā hoʻololi ʻana o ka genetic, e like me BRCA1 a me BRCA2 , i ka hoʻoholo ʻana i kou pilikia o TNBC a me kāu lāʻau lapaʻau. Inā loaʻa iā ʻoe ka TNBC, e kamaʻilio me kāu kauka e pili ana i ka hoʻāʻo genetic.
- ʻO ka pahuhopu o ka mālama ʻana no ke kanesa metastatic ka kaohi ʻana i ka maʻi.
- ʻO nā lāʻau lapaʻau hou e like me nā mea hoʻopaʻa PARP, immunotherapy, a me nā antibody-drug conjugates (ADCs) ke hāʻawi nei i ka manaʻolana nui no nā maʻi ʻaʻai paʻakikī ke mālama.
- Me ka nānā ʻole i kou kūlana, he mea nui loa e hana pū me kāu kauka e koho i ke koho lapaʻau maikaʻi loa.
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