Thaum peb paub tias peb muaj mob qog noj ntshav, peb txhua tus ntshai heev. Tib lub sijhawm, peb xav txog kev kho mob zoo li chemotherapy. Chemotherapy rhuav tshem cov cell uas faib sai sai. Txawm li cas los xij, nws kuj tseem tuaj yeem rhuav tshem tsis yog cov cell qog noj ntshav xwb, tab sis kuj tseem muaj cov cell noj qab haus huv hauv peb lub cev, piv txwv li, cov cell plaub hau, cov cell uas ua rau mob qhov ncauj, thiab cov cell hauv cov hnyuv. Yog vim li cas chemo ua rau cov plaub hau poob, mob qhov ncauj, thiab mob plab. Tab sis, xav txog ... nws yuav zoo npaum li cas yog tias muaj ib hom tshuaj uas tuaj yeem tsom mus rau cov cell qog noj ntshav xwb, zoo li rab phom sniper? Ntawd yog qhov peb yuav tham txog hnub no. Cov no hu ua Tyrosine Kinase Inhibitors , lossis TKIs luv luv.
Hais yooj yim xwb, cov TKIs no yog dab tsi?
TKIs yog ib hom kev kho mob uas siv rau kev kho mob qog noj ntshav. Lawv ua haujlwm los ntawm kev thaiv qee yam hauv cov qe ntshav qog noj ntshav uas pab lawv loj hlob thiab faib. Hauv lwm lo lus, cov qe ntshav qog noj ntshav muaj lub tshuab ceeb toom uas qhia lawv kom "loj hlob thiab faib." TKIs ua haujlwm los ntawm kev cuam tshuam nrog lub tshuab ceeb toom ntawd thiab nres nws.
Cov tshuaj no yuav tsis kho tau mob qog noj ntshav tag nrho, tab sis lawv tuaj yeem pab cov neeg mob tswj tau mob qog noj ntshav mus ntev (kom tsis txhob mob ntxiv lawm), lossis txawm tias ua neej zoo nrog mob qog noj ntshav.
Cov tshuaj no ua haujlwm li cas tiag? Cia peb saib ntxiv me ntsis.
Yuav kom nkag siab qhov no, peb yuav tsum xub paub me ntsis txog cov txheej txheem ib txwm ntawm kev faib cell hauv peb lub cev. Xav txog tias peb lub cev yog ib lub Hoobkas loj. Cov neeg ua haujlwm hauv lub Hoobkas no hu ua cell.
1. Cov yam tseem ceeb rau kev loj hlob: Cov no yog cov neeg xa xov los ntawm sab nraud lub Hoobkas uas coj cov lus "Pib tsim khoom tam sim no."
2. Tyrosine kinases: Cov no yog cov enzymes hauv cov cell uas coj cov lus thiab qhia rau lwm tus kom "OK, cia peb pib ua haujlwm."
Nov yog qhov tshwm sim hauv lub cell noj qab nyob zoo ib txwm muaj. Tus neeg xa xov (cov khoom loj hlob) tuaj thiab muab cov lus rau tus thawj tswj (tyrosine kinase). Tus thawj tswj txais cov lus ntawd thiab hais kom lub cell faib. Tom qab cov cell tau faib ntau npaum li lawv xav tau, tus thawj tswj kaw lub qhov hloov. Qhov no yog ib qho txheej txheem tswj tau zoo heev .
Tiam sis hauv cov hlwb qog noj ntshav, lub kaw lus no mus tsis zoo. Hauv qee hom mob qog noj ntshav, tshwj xeeb, cov thawj coj no (Tyrosine kinases) mus vwm. Lawv lub qhov hloov pauv yog qhib tas mus li. Lawv tsis xav tau cov lus los ntawm sab nraud, lawv tsuas yog hais kom cov hlwb "faib, faib, faib." Qhov kev faib hlwb tsis tswj hwm no yog qhov peb hu ua mob qog noj ntshav.
Qhov uas TKIs ua yog mus rau qhov chaw ua haujlwm vwm, 'nyob' tas mus li (Tyrosine kinase) tus thawj coj thiab cuam tshuam nws kom nws ua tsis tau nws txoj haujlwm. Tom qab ntawd lub cim "faib" tas li ntawd tsis ua haujlwm lawm. Cov qe ntshav qog tsis faib, thiab cov qog pib me dua.
Piv txwv zoo tshaj plaws: Kab mob qog ntshav Chronic Myeloid Leukemia (CML)
Qhov no yog ib hom mob qog ntshav. Yav dhau los, thaum CML tshwm sim, nws yog ib yam kab mob uas ua rau tuag taus. Tab sis tom qab kev tshawb pom ntawm TKIs, CML tam sim no tau dhau los ua ib yam kab mob ntev uas tuaj yeem tswj tau nrog cov tshuaj xws li ntshav qab zib thiab ntshav siab.
Hauv cov hlwb pob txha ntawm cov neeg mob CML, cov enzyme Tyrosine kinase uas peb tau hais txog tau tsim tsis zoo, thiab nws lub qhov hloov pauv yog 'on' tas mus li. Yog li cov hlwb pob txha tsim cov qe ntshav dawb yam tsis muaj kev tswj hwm. Qhov no tiv thaiv kev tsim cov qe ntshav liab noj qab haus huv, cov qe ntshav dawb, thiab cov platelets. TKIs, xws li Imatinib (Gleevec®) , tsom mus rau cov enzyme tsis zoo ntawd thiab tig nws lub qhov hloov 'on' 'off'. Qhov no yog kev hloov pauv loj hauv keeb kwm ntawm kev kho mob qog noj ntshav.
Cov TKIs siv rau hom mob qog noj ntshav twg?
Txoj kev kho mob no tam sim no siv rau ntau hom mob qog noj ntshav. Nws tsis ua haujlwm rau txhua yam mob qog noj ntshav. Qhov no yog vim tsis yog txhua yam mob qog noj ntshav muaj Tyrosine kinase 'qhib'. Cov kws kho mob yuav kuaj cov qog noj ntshav thiab saib seb lawv puas muaj cov molecule uas tuaj yeem tsom tau no. Tsuas yog tias nws muaj, lawv thiaj li muab cov tshuaj no.
Hauv qab no yog qee hom mob qog noj ntshav tseem ceeb uas kho nrog TKIs.
| Hom mob qog noj ntshav | Kev piav qhia |
|---|---|
| Kab mob qog ntshav (Leukemia) | Cov hom mob xws li mob chronic myeloid leukemia (CML) thiab mob chronic lymphocytic leukemia (CLL). |
| Mob qog nqaij hlav ntsws | Tshwj xeeb tshaj yog rau cov neeg mob uas muaj mob qog nqaij hlav hauv lub ntsws uas tsis yog me me (NSCLC) thiab kev hloov pauv caj ces xws li EGFR thiab ALK. |
| Mob Cancer Mis | Rau cov hom mob tshwj xeeb xws li mob qog noj ntshav hauv lub mis HER2-positive. |
| Mob Cancer ntawm Txoj Hnyuv | Rau cov mob qog noj ntshav xws li cov qog nqaij hlav stromal gastrointestinal (GIST) uas tshwm sim hauv plab thiab txoj hnyuv. |
| Mob qog nqaij hlav raum | Tshwj xeeb tshaj yog rau cov mob qog nqaij hlav uas mob hnyav heev. |
| Mob qog nqaij hlav | Rau cov mob qog nqaij hlav ntawm daim tawv nqaij xws li melanoma nrog kev hloov pauv ntawm BRAF gene. |
Tam sim no, US FDA tau pom zoo ntau dua 50 TKIs los kho ntau yam mob qog noj ntshav. Cov tshuaj thawj zaug uas tau pom zoo, Imatinib (Gleevec®), yog siv los kho 7 hom mob qog noj ntshav.
Kuv yuav tau txais kev kho mob no li cas? Nws siv sijhawm ntev npaum li cas?
Qhov no yog lwm qhov yooj yim ntawm kev kho mob no. Feem ntau cov TKIs muaj cov tshuaj ntsiav lossis cov kua . Yog li koj tsis tas yuav nyob hauv tsev kho mob thiab txhaj tshuaj los ntawm cov kua ntsev. Koj tsuas yog yuav tsum noj ib lossis ob lub tshuaj tib lub sijhawm txhua hnub los ntawm tsev.
Koj yuav tsum tau kho mob ntev npaum li cas nyob ntawm seb koj muaj hom mob qog noj ntshav, theem ntawm tus kab mob, thiab koj lub cev teb li cas rau cov tshuaj. Piv txwv li, yog tias koj muaj CML, koj yuav tsum tau noj cov tshuaj no mus tas koj lub neej. Rau lwm hom mob qog noj ntshav, koj tus kws kho mob yuav txiav txim siab tsis txhob noj cov tshuaj thaum tus mob qog noj ntshav tswj tau lawm.
Cia peb kuj paub txog cov kev mob tshwm sim.
Vim tias TKIs yog cov kev kho mob uas tsom mus rau tus neeg mob, feem ntau lawv muaj tsawg dua cov kev mob tshwm sim dua li kev kho mob chemotherapy. Qhov no yog vim lawv ua rau muaj kev puas tsuaj tsawg kawg nkaus rau cov hlwb noj qab haus huv. Tab sis nws tsis tuaj yeem hais tias lawv "tsis muaj kev mob tshwm sim hlo li." Qhov no yog vim tias cov molecule uas lawv tsom mus rau, hu ua Tyrosine kinase, tsis yog tsuas yog muaj nyob rau hauv cov hlwb mob qog noj ntshav xwb, tab sis kuj muaj me me hauv qee cov hlwb noj qab haus huv. Yog li ntawd cov hlwb ntawd kuj tseem yuav raug cuam tshuam.
Cov kev mob tshwm sim sib txawv ntawm ib tus neeg mus rau ib tus neeg thiab kuj nyob ntawm cov tshuaj TKI siv.
Cov kev mob tshwm sim feem ntau:
- Qaug zog: Qhov no yog ib qho mob uas ntau tus neeg ntsib.
- Mob raws plab: Tej zaum yuav yog vim muaj kev puas tsuaj rau cov hlwb hauv txoj hnyuv.
- Xeev siab thiab ntuav: Qee tus neeg yuav muaj tus mob no.
- Cov tawv nqaij ua pob: Cov tawv nqaij ua pob, qhuav, thiab khaus yog ib qho uas tshwm sim.
- Kev ntshaw thiab qhov hnyav hloov pauv: Ib txhia neeg poob phaus, thaum lwm tus yuav nce phaus vim yog o.
- Ua npaws
Tej zaum yuav muaj cov kev mob tshwm sim loj heev:
Qee cov TKIs tuaj yeem ua rau muaj kev phiv rau lub plawv, daim siab, lossis lub ntsws. Lawv kuj tuaj yeem ua rau muaj mob tawv nqaij loj heev, txawm tias ua rau tuag taus, xws li Stevens-Johnson syndrome , uas cuam tshuam rau daim tawv nqaij. Tab sis cov no tsis tshua muaj. Ntshav siab (ntshav siab) yog lwm qhov kev txhawj xeeb.
Qhov tseem ceeb tshaj plaws yog nug koj tus kws kho mob txog cov kev mob tshwm sim ntawm cov tshuaj uas koj noj ua ntej pib kho mob. Yog tias koj muaj cov tsos mob txawv txawv, tsis txhob tsis quav ntsej lawv thiab qhia rau koj tus kws kho mob tam sim ntawd.
Kuv ua tau dab tsi los pab kom qhov kev kho mob no yooj yim dua rau kuv?
Kev kho mob qog noj ntshav tuaj yeem yog lub sijhawm nyuaj, ob qho tib si lub cev thiab lub hlwb. Muaj ob peb yam koj tuaj yeem ua tau los ua kom lub sijhawm no yooj yim dua me ntsis.
1. So: Kev qaug zog yog ib qho teeb meem loj heev. Yog li ntawd, pw tsaug zog ntau li ntau tau, so me ntsis thaum nruab hnub, thiab mloog koj lub cev.
2. Kev Noj Haus: Kev noj mov yuav nyuaj vim muaj tej yam xws li tsis xav noj mov thiab xeev siab. Sim noj me me ob peb zaug hauv ib hnub. Haus dej ntau ntau xws li dej, kua txiv hmab txiv ntoo, porridge, thiab kua zaub. Yog tias koj poob phaus lossis nce phaus yam tsis tsim nyog, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev qhia los ntawm tus kws noj haus.
3. Kev tswj cov kev mob tshwm sim: Yog tias koj raws plab, noj cov khoom xws li roj, tsis txhob ntsim heev, zaub steamed, mov, thiab txiv tsawb. Haus dej haus zoo li Jeevani zoo heev. Yog tias koj daim tawv nqaij khaus, siv cov tshuaj pleev uas tsis muaj xab npum, tsis muaj ntxhiab. Tham nrog koj tus kws kho mob txog qhov no thiab nrhiav cov tshuaj zoo.
4. Npaj kom zoo: Sau koj cov tsos mob thiab cov kev mob tshwm sim rau hauv koj phau ntawv sau txhua hnub. Qhia rau koj tus kws kho mob thaum koj mus ntsib nws. Nco ntsoov noj koj cov tshuaj raws li lub sijhawm uas koj xav tau.
5. Kev noj qab haus huv ntawm lub hlwb: Nws yog ib qho tseem ceeb heev uas yuav tsum muaj lub hlwb ruaj khov thaum lub sijhawm no. Tham nrog tsev neeg thiab cov phooj ywg. Qhia koj cov teeb meem. Yog tias tsim nyog, nrhiav kev pab tswv yim.
6. Kev Kho Mob Rau Lub Sijhawm Ntev: Qhov no tsis tau txhais hais tias tus kab mob no kho tsis tau. Nov yog ib pab pawg kws tshwj xeeb uas pab koj nyob kaj siab dua los ntawm kev tswj cov tsos mob xws li mob, xeev siab, thiab qaug zog uas los nrog kev kho mob qog noj ntshav. Koj tuaj yeem tham nrog koj tus kws kho mob txog qhov kev pabcuam no.
Cov kev pheej hmoo ntawm kev kho mob no yog dab tsi?
Txawm hais tias TKIs ua haujlwm zoo rau ntau yam mob qog noj ntshav, qee zaum teeb meem tuaj yeem tshwm sim raws sijhawm. Qhov tseem ceeb tshaj plaws yog kev txhim kho kev tiv thaiv .
Hais yooj yim xwb, cov hlwb mob qog noj ntshav yog cov hlwb ntse heev. Thaum muab cov tshuaj tib yam rau lub sijhawm, lawv tuaj yeem hloov pauv kom tiv taus cov tshuaj ntawd. Ib yam li cov kab mob me me tiv taus cov tshuaj tua kab mob. Thaum qhov ntawd tshwm sim, cov tshuaj TKI uas ua haujlwm zoo thaum xub thawj yuav tsis ua haujlwm lawm.
Tiamsis nws tsis yog qhov kawg ntawm lub ntiaj teb. Vim tias cov kws tshawb fawb paub qhov no, tam sim no muaj "tiam ob" thiab "tiam peb" TKIs uas tuaj yeem muab thaum muaj kev tiv thaiv. Yog li ntawd, yog tias ib yam tshuaj tsis ua haujlwm, koj tus kws kho mob yuav hloov koj mus rau lwm TKI.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Tyrosine Kinase Inhibitors (TKIs) yog ib hom tshuaj tshwj xeeb uas tsom mus rau thiab thaiv lub cev ua haujlwm uas ua kom muaj kev loj hlob thiab kev faib ntawm cov hlwb qog noj ntshav.
- Vim tias cov no yog cov kev kho mob uas tsom mus rau ib tus neeg, lawv ua rau muaj kev puas tsuaj tsawg dua rau cov hlwb noj qab haus huv thiab muaj cov kev phiv tsawg dua li cov tshuaj kho mob ib txwm muaj.
- Vim tias cov tshuaj no muaj nyob rau hauv daim ntawv tshuaj ntsiav lossis kua, nws yooj yim heev uas yuav tau txais kev kho mob los ntawm tsev.
- Txawm tias cov mob qog noj ntshav uas tuag taus xws li CML tam sim no tau dhau los ua cov kab mob ntev uas tuaj yeem tswj tau ua tsaug rau cov tshuaj no.
- Tej zaum yuav muaj tej yam tshwm sim xws li qaug zog, raws plab, thiab tawv nqaij ua pob. Qhia tej yam tsos mob txawv txawv rau koj tus kws kho mob tam sim ntawd.
- Raws li lub sijhawm dhau mus, cov qog nqaij hlav tuaj yeem tiv taus cov tshuaj, tab sis muaj cov TKIs tshiab dua rau cov xwm txheej zoo li no.
- Txawm hais tias cov tshuaj no tsis kho tau mob qog noj ntshav tag nrho los xij, lawv tuaj yeem pab tib neeg tswj tau tus kab mob thiab nyob ntev dua nrog lub neej zoo.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus