Thaum koj paub tias koj muaj mob qog noj ntshav hauv lub mis , nws nyuaj rau piav qhia txog kev ntshai thiab kev poob siab uas koj xav. Koj muaj ntau lo lus nug hauv koj lub siab. Nws yog ib qho ib txwm muaj cov lus nug xws li, "Vim li cas qhov no thiaj tshwm sim rau kuv?", "Kuv yuav ua li cas tam sim no?", "Qhov no puas kho tau?". Hauv txoj kev no, kuv sim piav qhia tej yam yooj yim thiab hauv hom lus uas koj nkag siab tau. Kev paub meej tias koj muaj hom mob qog noj ntshav twg zoo li kev nkag siab tus yeeb ncuab ua ntej pib sib ntaus sib tua. Qhov ntawd yog thawj kauj ruam thiab tseem ceeb tshaj plaws hauv kev xaiv txoj kev kho mob uas yog rau koj.
Mob Cancer Mis Uas Muaj Hormone Receptor Zoo
Nov yog hom mob qog noj ntshav hauv lub mis uas feem ntau pom. Yog hais li ntawd, muaj li ntawm 80 ntawm txhua 100 tus mob qog noj ntshav hauv lub mis uas muaj feem cuam tshuam rau pawg no.
Yog li ntawd, lo lus "hormonal-dependent" no txhais li cas?
Xav txog nws xwb. Peb lub cev, tshwj xeeb tshaj yog lub cev ntawm cov poj niam, muaj ob hom tshuaj hormones uas tshwm sim los ntawm ntuj hu ua estrogen thiab progesterone . Cov no yog qhov tseem ceeb rau cov txheej txheem ib txwm muaj hauv peb lub cev. Txawm li cas los xij, qee cov cell mob qog noj ntshav "quav" rau cov tshuaj hormones no. Ntawd yog, ntawm qhov chaw ntawm cov cell mob qog noj ntshav no, muaj cov "receptors" me me lossis cov qhov rooj uas cov tshuaj hormones no tuaj yeem tuaj thiab lo rau. Thaum cov tshuaj estrogen tuaj thiab khob qhov rooj ntawd, cov cell mob qog noj ntshav tau txais kev noj haus los ntawm nws thiab pib loj hlob thiab faib. Ib yam li thaum koj ywg dej rau ib tsob nroj, nws loj hlob tuaj.
Yog tias koj daim ntawv kho mob hais tias 'ER-positive' (Estrogen Receptor-Positive), nws txhais tau tias koj cov qog nqaij hlav rhiab rau cov tshuaj hormones estrogen. Yog tias nws hais tias 'PR-positive' (Progesterone Receptor-Positive), nws txhais tau tias nws rhiab rau cov tshuaj hormones progesterone. Yog tias nws rhiab rau ib qho ntawm cov no, tus mob qog nqaij hlav hu ua mob qog nqaij hlav hormone receptor-positive .
Qhov no yeej yog xov xwm zoo tiag tiag. Vim tias yog peb paub tias mob qog noj ntshav siv dab tsi los loj hlob, peb tuaj yeem thaiv txoj kev ntawd thiab tswj tau mob qog noj ntshav. Qhov ntawd yog qhov "kev kho mob hormone" siv rau.
Kev kho mob hormone feem ntau yog muab tom qab phais mob, kho mob qog noj ntshav, lossis kho hluav taws xob kom tiv thaiv kab mob qog noj ntshav kom tsis txhob rov qab los. Cov tshuaj no ua haujlwm los ntawm kev kaw "qhov rooj" ntawm cov hlwb qog noj ntshav, lossis los ntawm kev tiv thaiv lub cev kom tsis txhob tsim cov tshuaj estrogen.
| Pawg kev kho mob | Cov lus piav qhia yooj yim thiab cov piv txwv |
|---|---|
| Cov SERMs (Cov Khoom Siv Xaiv ER) | Cov no thaiv lub receptor hormone ntawm lub cell mob qog noj ntshav, tiv thaiv cov hormone kom tsis txhob nkag mus. Piv txwv li: Tamoxifen, Toremifene . |
| Cov Tshuaj Selective Estrogen Receptor Degraders (SERDs) | Cov no tsis yog tsuas thaiv lub receptor xwb, tab sis kuj ua rau nws puas tsuaj. Piv txwv li: Fulvestrant (Faslodex), Elacestrant (Orserdu) . |
| Cov Tshuaj Aromatase Inhibitors | Cov no ua rau lub cev tsis tsim cov tshuaj hormone estrogen (feem ntau muab rau cov poj niam postmenopausal). Piv txwv li: Anastrozole (Arimidex), Letrozole (Femara) . |
| Cov tshuaj LHRH agonists | Cov no ua rau cov zes qe menyuam tsis tsim cov tshuaj estrogen ib ntus. Piv txwv li: Goserelin (Zoladex), Leuprolide (Lupron) . |
| Lwm Cov Kev Kho Mob Uas Tau Targeted | Lwm cov tshuaj uas ua rau kev kho mob hormone ua tau zoo dua. Piv txwv li: Palbociclib (Ibrance), Ribociclib (Kisqali), Alpelisib (Piqray) . |
HER2-Positive Mis Cancer
Tam sim no cia peb tham txog lwm hom. Qee cov qog nqaij hlav mis (kwv yees li 20% ntawm tag nrho cov qog nqaij hlav) tsim cov protein tshwj xeeb ntau dhau ntawm lawv qhov chaw hu ua HER2 (Human Epidermal growth factor Receptor 2) .
Xav txog HER2 zoo li lub kav hlau txais xov me me uas qhia rau lub cell mob qog noj ntshav kom "loj hlob sai dua, faib sai dua." Lub cell ib txwm muaj tsuas yog ob peb lub kav hlau txais xov no xwb. Tab sis lub cell mob qog noj ntshav HER2-zoo muaj ntau lub kav hlau txais xov no. Yog vim li cas cov hom mob qog noj ntshav no thiaj li ua rau mob hnyav dua .
Tiam sis kuj muaj xov xwm zoo ntawm no thiab. Nrog kev nce qib hauv kev tshawb fawb, tam sim no muaj " kev kho mob tsom" uas tsom thiab rhuav tshem cov HER2 antennae no. Vim tias cov no tsuas pom thiab tawm tsam cov hlwb uas muaj HER2 ntau dhau, muaj kev puas tsuaj tsawg dua rau cov hlwb ib txwm muaj.
Cov tshuaj tseem ceeb thiab zoo tshaj plaws uas tau muab rau qhov no yog Trastuzumab (Herceptin) . Qhov no pab tau zoo heev rau kev tiv thaiv kom tus mob qog noj ntshav tsis txhob rov qab los. Txawm li cas los xij, muaj qee qhov kev pheej hmoo me me ntawm qee qhov teebmeem rau lub plawv lossis lub ntsws thaum noj cov tshuaj no. Tsis txhob txhawj txog qhov ntawd , koj tus kws kho mob yuav ib txwm kuaj xyuas nws.
| Lwm cov kev kho mob uas siv rau cov mob qog nqaij hlav HER2-positive | |
|---|---|
| Pertuzumab (Perjeta) | Ado-trastuzumab emtansine (Kadcyla) |
| Lapatinib (Tykerb) | Neratinib (Nerlynx) |
| Tucatinib (Tukysa) | Enhertu (Fam-trastuzumab deruxtecan-nxki) |
"Triple-Negative" Mob Cancer Mis
Nov yog hom mob qog noj ntshav thib peb. Kwv yees li ntawm 10% -20% ntawm cov mob qog noj ntshav hauv lub mis poob rau hauv hom no. Koj puas paub vim li cas nws thiaj hu ua "triple-negative" lossis "triple negative"?
Vim tias nyob rau hauv cov hlwb mob qog noj ntshav no,
1. Tsis muaj tshuaj estrogen receptor (ETU) .
2. Tsis muaj progesterone receptor (PR).
3. Tsis muaj ntau cov protein HER2 .
Vim tias cov hlwb qog nqaij hlav no tsis muaj peb lub hom phiaj tseem ceeb uas peb tau tham ua ntej, tsis yog kev kho mob hormone lossis kev kho mob HER2-targeted xws li Herceptin ua haujlwm rau lawv. Yog li kev kho lawv tuaj yeem nyuaj me ntsis.
Hom mob qog noj ntshav no feem ntau yog los ntawm BRCA1.Nws muaj feem cuam tshuam nrog kev hloov pauv hauv ib lub noob hu ua. Yog li ntawd, yog tias koj muaj mob qog noj ntshav peb zaug tsis zoo, koj tus kws kho mob kuj tseem yuav qhia kom kuaj noob caj noob ces.
Hom mob no feem ntau yog kho los ntawm kev phais, tshuaj kho mob qog noj ntshav, thiab kev siv hluav taws xob . Txawm li cas los xij, tam sim no muaj kev kho mob tshiab tshwj xeeb rau hom mob no.
- Cov Tshuaj PARP Inhibitors: Cov tshuaj xws li Olaparib (Lynparza) thiab Talazoparib (Talzenna) yog siv rau cov neeg uas muaj kev hloov pauv ntawm BRCA gene. Cov no thaiv cov hlwb qog nqaij hlav kom kho lawv tus kheej.
- Kev Kho Mob Tiv Thaiv Kab Mob: Cov tshuaj zoo li Atezolizumab (Tecentriq) pab tua cov hlwb qog noj ntshav los ntawm kev siv peb cov hlwb tiv thaiv kab mob.
Qhov no yuav zoo li nyuaj me ntsis. Qhov ntawd yog ib txwm muaj. Qhov tseem ceeb yog nco ntsoov tias txawm koj muaj hom mob qog noj ntshav twg los xij, niaj hnub no muaj kev kho mob uas haum rau nws. Koj tus kws kho mob thiab pab neeg kho mob yuav ua haujlwm nrog koj los tsim txoj kev npaj kho mob zoo tshaj plaws rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Mob qog noj ntshav hauv lub mis muab faib ua 3 hom tseem ceeb: Hormone Receptor-Positive, HER2-Positive, thiab Triple-Negative .
- Kev paub txog hom mob qog noj ntshav uas koj muaj yog qhov tseem ceeb rau kev npaj kho mob.
- Cov qog nqaij hlav uas muaj cov tshuaj hormones zoo teb tau zoo rau kev kho mob hormone.
- Txawm hais tias mob qog noj ntshav HER2-positive loj hlob sai heev, muaj cov kev kho mob zoo heev uas tau tsim tshwj xeeb rau lawv.
- Txawm hais tias kev kho mob qog nqaij hlav triple-negative yog qhov nyuaj, lawv tuaj yeem tawm tsam nrog kev siv tshuaj chemotherapy thiab cov kev kho mob tshiab.
- Yog koj muaj lus nug txog ib yam dab tsi hauv koj cov ntaub ntawv kho mob, tsis txhob ntshai nug . Nug koj tus kws kho mob kom piav qhia meej. Koj tsis yog tib tug xwb, thiab muaj ntau tus neeg uas tuaj yeem pab koj.
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