Inā ʻoe a i ʻole kekahi āu i ʻike ai he maʻi ʻaʻai umauma, hiki i ke aʻo ʻana e pili ana i nā lāʻau lapaʻau hou ke lilo i mea manaʻolana a piha hoʻi i nā nīnau. I kēia lā, e kamaʻilio mākou e pili ana i hoʻokahi manaʻolana hou, kahi lāʻau i kapa ʻia ʻo Trodelvy. He lāʻau lapaʻau ia no ʻelua ʻano kikoʻī o ka maʻi ʻaʻai umauma (ka maʻi ʻaʻai umauma Triple-negative - TNBC a me HR+/HER2- ka maʻi ʻaʻai umauma) i pālahalaha loa a hiki ʻole ke wehe ʻia e ke ʻoki kino a i ʻole ʻaʻole i pane i ʻelua mau lāʻau lapaʻau ʻē aʻe. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi a me ke aloha.
Pehea e hana ai ʻo Trodelvy i loko o ke kino?
I ka ʻōlelo maʻalahi, ʻo Trodelvy kahi "lāʻau lapaʻau i hoʻopaʻa ʻia." ʻO ke ʻano kēia, ma kahi o ka hele wale ʻana a puni ke kino, hele pololei kēia lāʻau lapaʻau e ʻimi a hoʻouka i nā hunaola kanesa.
E noʻonoʻo i kēia me he missile e hele pololei ana i ka pahuhopu.
1. Ke ʻike ʻana i nā hunaola kanesa: He nui nā hunaola kanesa umauma he protein i kapa ʻia ʻo Trop-2 ma ko lākou ʻili. Loaʻa i ka lāʻau Trodelvy kahi ʻāpana kūikawā (monoclonal antibody) hiki ke hoʻopili i kēia protein Trop-2. ʻO kēia ka mea e ʻike pono ai i ke hunaola kanesa.
2. Ke lawelawe ʻana i ka lāʻau lapaʻau: Ma hope o ka hoʻopili ʻana i ke kelepona kanesa, hoʻokuʻu ʻo Trodelvy i kahi lāʻau kemika ikaika (kahi lāʻau chemotherapy i kapa ʻia ʻo SN-38) i hūnā ʻia i loko o ke kelepona kanesa.
3. Ka luku ʻana i nā hunaola kanesa: Ke komo i loko o ke hunaola kanesa, hoʻōki kēia lāʻau SN-38 i ke hunaola mai ka māhele ʻana a me ka hana ʻana i nā hunaola hou aʻe (e kope ana i kāna DNA). A laila, ʻaʻole hiki i ke hunaola kanesa ke ulu hou a make.
ʻO ka pōmaikaʻi nui o kēia ʻano hana , ʻo ia ke kuhikuhi a hoʻouka wale i nā hunaola kanesa, e hōʻemi ana i ka hōʻino ʻana i nā hunaola olakino.
Pehea e hāʻawi ʻia ai kēia lāʻau lapaʻau?
He lāʻau lapaʻau ʻo Trodelvy i hāʻawi ʻia ma ke ʻano he wai saline i loko o kahi aʻa (IV Infusion) . E loaʻa iā ʻoe kēia ma kahi haukapila a i ʻole ke kikowaena mālama maʻi kanesa, ma lalo o ka nānā ʻana a ke kauka a i ʻole nā limahana kahu maʻi i aʻo ʻia.
Hāʻawi ʻia ka lāʻau lapaʻau i loko o kahi pōʻaiapuni 21 lā. ʻO ia hoʻi, hāʻawi ʻia ka lāʻau lapaʻau i ka lā mua a me ka lā ʻewalu . A laila, hoʻopau ʻia ka pōʻaiapuni 21 lā, a hoʻomaka hou ka pōʻaiapuni aʻe.
- ʻO ka manawa mua e hāʻawi ʻia ai ka lāʻau lapaʻau, hiki ke hala ma kahi o 3 mau hola.
- Ma hope o kēlā, hiki iā ʻoe ke hoʻopau iā ia i loko o 1-2 mau hola i ka manawa i hāʻawi ʻia .
Ma mua o ka hāʻawi ʻana i ka lāʻau lapaʻau, e hāʻawi kāu kauka iā ʻoe i ka acetaminophen (e like me Panadol), nā antihistamines (e like me Pyridoxine) , a me nā steroids paha e pale aku i nā mea e like me ke kuni, ka nausea, a me nā maʻi ʻaleka ʻili.
He aha ka noiʻi i hana ʻia e pili ana i ka pono o kēia lāʻau lapaʻau?
Ua hana ʻia kekahi mau haʻawina lapaʻau nui e hōʻoia i ka palekana a me ka pono o Trodelvy. ʻO ASCENT lāua ʻo TROPiCS-02 ʻelua o nā haʻawina nui.
Ua hoʻohālikelike kēia mau haʻawina i nā maʻi i loaʻa iā Trodelvy me nā maʻi i loaʻa i ka chemotherapy maʻamau. Ua kālele lākou i ʻelua mau kumu nui:
- Ola Holomua-ʻAʻohe Ola (PFS): ʻO kēia ka lōʻihi o ke ola ʻana o ka mea maʻi me ka ʻole o ka ʻino ʻana o ke kanesa.
- Ola Holoʻokoʻa (OS): ʻO ia hoʻi, ka manawa holoʻokoʻa e ola ai ka mea maʻi.
Nā hopena maikaʻi i hōʻike ʻia e ka noiʻi
Ua hōʻike kēia mau haʻawina ʻelua i nā hopena maikaʻi loa.
Haʻawina ASCENT (no ka maʻi ʻaʻai TNBC):
- ʻOiai ua kaohi ʻia ka maʻi kanesa o nā maʻi i lawe iā Trodelvy no 5.6 mau mahina me ka ʻole o ka ʻino ʻana, he 1.7 mahina wale nō ia no ka poʻe i lawe mau i ka lāʻau lapaʻau.
- ʻO ke ola holoʻokoʻa (OS) o nā maʻi i lawe iā Trodelvy ma kahi o 11.8 mau mahina , hoʻohālikelike ʻia me 6.9 mau mahina ma ka hui ʻē aʻe.
Haʻawina TROPiCS-02 (no nā maʻi ʻaʻai HR+/HER2-):
- ʻOiai ua kāohi ʻia ka maʻi kanesa no 5.5 mau mahina i nā maʻi i lawe iā Trodelvy me ka ʻole o ka laha ʻana, he 4 mau mahina ia no ka poʻe i lawe i ka lāʻau lapaʻau maʻamau.
- ʻO ka awelika o nā maʻi i lawe iā Trodelvy ua ola ʻo 3.2 mau mahina ma mua o nā poʻe ʻē aʻe (14.4 mau mahina vs 11.2 mau mahina).
- Ua ʻoi aku ke kiʻekiʻe o ka emi ʻana o ka puʻupuʻu i waena o ka poʻe i lawe iā Trodelvy (21% vs 14%).
I ka ʻōlelo maʻalahi, ua hōʻike nā haʻawina ʻelua ua ola lōʻihi nā maʻi i mālama ʻia me Trodelvy me ka kaohi ʻana i nā maʻi a ua ola lōʻihi ma mua o nā maʻi i mālama ʻia me ka chemotherapy maʻamau.
Nā hopena ʻaoʻao o ka lāʻau lapaʻau a pehea e hana ai me lākou
E like me nā lāʻau lapaʻau āpau, hiki iā Trodelvy ke loaʻa nā hopena ʻaoʻao. ʻO ka mea nui loa, ʻo ia ka makaʻala iā lākou a hana pū me kāu kauka e hoʻokele iā lākou. Eia nā hopena ʻaoʻao maʻamau a me nā mea hiki iā ʻoe ke hana e pili ana iā lākou.
| Hopena ʻaoʻao | Ka wehewehe a me ka hoʻokele |
|---|---|
| Ua emi nā hunaola koko keʻokeʻo (Neutropenia) | Hoʻonui kēia i ka pilikia o ka maʻi. E hoʻāʻo kāu kauka i kou koko. Inā loaʻa iā ʻoe ke kuni, he hōʻailona paha ia o ka maʻi, no laila e haʻi koke aku i kāu kauka . |
| Ka maʻi pākī | Nā ʻōpala palahalaha. E inu i nā wai he nui e like me ka wai a me ka wai momona. Inā koʻikoʻi ka maʻi kahe a mau paha no kekahi mau lā, e hōʻoia e haʻi i kāu kauka . |
| Ka luaʻi a me ka luaʻi | E noho mamao aku mai nā ʻala ikaika. E ʻai i nā meaʻai liʻiliʻi ma mua o nā meaʻai nui. E kuhikuhi ke kauka i ka lāʻau lapaʻau no ka nausea. |
| Luhi | He mea maʻamau ke manaʻo luhi loa. E hoʻomaha nui. E hoʻoikaika kino māmā me ka ʻae ʻia e kāu kauka. |
| Pohō lauoho | No kekahi manawa, e hāʻule paha kekahi a i ʻole kou lauoho āpau. He manawa pōkole kēia. Inā pono, hiki iā ʻoe ke hoʻohana i kahi wig a i ʻole ka uhi poʻo. |
| Ua emi nā hunaola koko ʻulaʻula (Anemia) | Hiki i kēia ke hana i kahi manaʻo o ka nāwaliwali a me ka luhi. E hoʻāʻo ke kauka i kou koko a kuhikuhi i ka lāʻau lapaʻau e pono ai. |
Ka ʻike kūikawā e pili ana i ka hāpai ʻana a me ka hānai waiū
ʻAʻole ʻōlelo ʻia ka lāʻau Trodelvy i ka wā hāpai . Hiki ke hōʻeha i kahi pēpē i hānau ʻole ʻia. No laila, he mea nui e hoʻohana i kahi ʻano kaohi hānau kūpono i ka wā o ka lāʻau a no 6 mau mahina ma hope o ka lāʻau hope loa. Pono nā makuahine hānai waiū e pale i ka hānai waiū i ka wā o ka lāʻau a no 1 mahina ma hope o ka lāʻau hope loa.
Aia kekahi mau pilina me nā lāʻau lapaʻau a me nā meaʻai ʻē aʻe?
ʻAʻohe pilina meaʻai kikoʻī i hōʻike ʻia no Trodelvy. Eia nō naʻe, ʻo ka inu ʻana i ka waiʻona e hoʻonui i ka pilikia o nā hopena ʻaoʻao.Hiki i nā hopena ʻaoʻao e like me ka nausea, ka diarrhea, a me ka luhi ke ʻoi aku ka koʻikoʻi.
Hiki ke launa pū me nā lāʻau lapaʻau ʻē aʻe. Hiki i kekahi mau lāʻau lapaʻau ke hōʻemi i nā hopena o Trodelvy, aʻo kekahi e hoʻonui i nā hopena o Trodelvy a hoʻonui i nā hopena ʻaoʻao.
No laila, e hōʻoia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai, inā paha he mau mea kūʻai ʻole ʻia, nā huaora, a i ʻole nā mea hoʻohui lāʻau. He mea nui loa kēia.
ʻO wai ka mea pono ʻole e hoʻohana i kēia lāʻau lapaʻau?
Mai hoʻohana i kēia lāʻau lapaʻau inā he maʻi ʻoe iā Trodelvy a i ʻole kekahi o kāna mau mea hoʻohui. Hiki i kekahi poʻe ke loaʻa i nā hopena maʻi koʻikoʻi. E makaʻala i nā hōʻailona e like me kēia:
- Paʻakikī ka hanu ʻana (wheezing)
- Ka pehu ʻana o ka maka, ka ʻāʻī
- Ke koko haʻahaʻa
- ʻO ka ʻili nui
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, he pilikia ia. E hele koke i ka haukapila kokoke loa i ka Emergency Department (ETU).
Nā mea e haʻi aku i kāu kauka ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau
- Maʻi akepaʻa: E haʻi i kāu kauka inā loaʻa iā ʻoe kekahi maʻi akepaʻa.
- Gene UGT1A1: Loaʻa i kekahi poʻe kahi ʻano like ʻole o kēia gene, kahi e hoʻonui ai iā lākou i ka pilikia o nā hopena ʻaoʻao e like me ka helu haʻahaʻa o nā cell koko keʻokeʻo. Hiki i kāu kauka ke hoʻāʻo no kēia inā pono.
- Ke hoʻolālā nei e hāpai: E haʻi i kāu kauka inā ʻoe a i ʻole kāu hoa e hoʻolālā nei e hāpai. Inā ke lawe nei ka hoa kāne i ka lāʻau lapaʻau, pono lākou e hoʻohana i kahi ʻano kaohi hānau, e like me nā condom, i ka wā o ka lāʻau lapaʻau a no 3 mau mahina ma hope o ka mahele hope loa.
Leka Lawe-Home
- He lāʻau lapaʻau i hoʻopili ʻia ʻo Trodelvy i hoʻohana ʻia no kekahi mau ʻano maʻi ʻaʻai umauma holomua.
- He ʻokoʻa kāna hana mai ka chemotherapy kuʻuna, e kuhikuhi pololei ana i nā hunaola kanesa.
- Hāʻawi ʻia kēia lāʻau lapaʻau ma o kahi aa koko ma ka haukapila.
- Hiki ke loaʻa nā hopena ʻaoʻao e like me ka maʻi kahe a me ka helu haʻahaʻa o nā kele koko keʻokeʻo, a he mea nui e hana pū me kāu kauka e mālama iā lākou.
- E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei, nā huaora, a me nā mea kanu kuʻuna āu e lawe nei.
- ʻAʻole palekana kēia lāʻau lapaʻau i ka wā hāpai a i ka wā hānai waiū.
- E ʻoluʻolu e kūkākūkā inā kūpono kēia lāʻau lapaʻau iā ʻoe a me nā hoʻoholo pili āpau me kāu kauka maʻi ʻōpū.
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