Kizibu okussa mu bigambo okutya n’okweraliikirira omuntu kw’awulira ng’azuuliddwa nti alina kookolo. Naye olw’okukulaakulana kwa ssaayansi w’obusawo, leero waliwo enkola ez’omulembe ennyo era ezikola obulungi ez’okujjanjaba kookolo. Okwawukanako n’edda, kati waliwo obujjanjabi obw’enjawulo obugenderera n’okulumba obutoffaali bwa kookolo bwokka. Leero, twogera ku nkola enkulu ennyo ey’obujjanjabi ekozesebwa ku kookolo w’olubuto n’omumwa gwa nnabaana. Okwo kwe kujjanjaba obutoffaali obuziyiza endwadde (Monoclonal Antibody Therapy).
Antibodies zino eza Monoclonal Antibodies ze ziruwa?
Kino nga tetunnakitegeera, katutunuulire enkola y’omubiri gwaffe ey’obutonde ey’okwekuuma. Omuntu ow’ebweru, gamba ng’akawuka oba akawuka, bwe kayingira mu mubiri gwaffe, abaserikale baffe abaziyiza endwadde bakola puloteyina ez’enjawulo okuzizuula n’okuzisaanyaawo. Zino tuziyita antibodies. Kiringa eggye erikuuma eggwanga.
Kati teebereza nti eggye lino lirina "tiimu y'amagye ag'enjawulo" etendekeddwa mu ngeri ey'enjawulo era ng'emanyi okulumba ekigendererwa kimu kyokka. Monoclonal Antibodies kintu nga ekyo. Zino ze antibodies ezenjawulo ezitondebwa mu ngeri ey’ekikugu mu laboratory. Zikoleddwa okunoonya ekigendererwa kimu, okukikwatako, n’okukisaanyaawo. Mu mbeera eno, ekigendererwa ekyo ye katoffaali ka kookolo.
Ekirungi ekisinga obunene mu bujjanjabi buno kwe kuba nti butuufu . Eddagala ly’ekinnansi liringa bbomu. Wadde atta obutoffaali bwa kookolo, naye era asobola okwonoona obutoffaali obulamu mu mubiri gwaffe. Y’ensonga lwaki eddagala eriweweeza ku bulwadde buleeta ebizibu ng’enviiri okugwa n’okukoowa. Naye obujjanjabi bwa Monoclonal Antibody bulinga "mizayiro elungamizibwa." Kigenda butereevu mu katoffaali ka kookolo. N’olwekyo, osobola okusuubira ebizibu ebitono.
Eddagala erikomya "obulamu" bwa kookolo
Kookolo si kibinja kya butoffaali bwokka. Kiringa ekkolero ettono. Kyetaaga ebiriisa okukula, okukula. Okusobola okufuna ekiriisa kino, obutoffaali bwa kookolo bwe bukola emisuwa emipya. Mu busawo, enkola eno tugiyita angiogenesis . Okuyita mu misuwa gino kookolo w’afuna ebiriisa bye yeetaaga okusobola okuwangaala.
Kale, antibodies ezimu eza monoclonal kye zikola kwe kuyimiriza okutondebwa kw’emisuwa egyo. Kiba ng'okusalako "supply" y'amafuta eri kookolo. Eddagala erisinga mu kiraasi eno ye Bevacizumab (Avastin) .
Avastin ekola etya?
Obutoffaali bwa kookolo bufulumya akabonero ak’enjawulo akayitibwa Vascular Endothelial Growth Factor (VEGF) . Akabonero kano bwe kafunibwa, omubiri gutandika okukola emisuwa emipya. Eddagala lya Avastin likola nga liziyiza akabonero ako aka VEGF. Kino kiremesa kookolo okukola emisuwa emipya. Olwo, nga tewali mmere ya kookolo, okukula kwa kookolo kukendeera oba kuyimirira.
Avastin ddagala erikkirizibwa eriwonya kookolo w’olubuto olunene eyasaasaana (metastasized) mu bitundu by’omubiri ebirala. Wadde nga tawonya kookolo mu bujjuvu, okunoonyereza kulaga nti Avastin bwe yaweebwa n’eddagala eriweweeza ku bulwadde, yayongera ku budde bw’abalwadde okuwangaala emyezi nga etaano.
Ezimu ku ddagala eppya mu kiraasi eno mulimu `Fruquintinib (Fruzaqla), `ramucirumab (Cyramza)` ne `ziv-aflibercept (Zaltrap).` Lino era likola nga liyingirira enkola y'obubonero bwa VEGF.
Engeri Avastin gy’aweebwamu n’ebizibu ebivaamu
Avastin ddagala eriweebwa mu misuwa oba IV. Butera kuweebwa buli luvannyuma lwa wiiki bbiri oba ssatu wamu n’obujjanjabi bw’eddagala. Ekikulu okujjukira nti eddagala lino lyongera ku bikolwa by’obujjanjabi bw’eddagala, naye teriragiddwa nti likola bulungi nga liweebwa lyokka mu balwadde ba kookolo w’olubuto olunene.
Kikulu nnyo okwogera mu lwatu n’omusawo wo ku buzibu bwonna bw’oyinza okufuna nga tonnatandika bujjanjabi buno n’okubufuna.
| Ebizibu ebiyinza okuva mu Bevacizumab (Avastin) . | |
|---|---|
| Ebizibu ebitera okuvaamu ebitera okulabibwa | |
| Okuwulira ng’okooye era nga tolina bulamu | Okulumizibwa omutwe |
| Puleesa eri waggulu | Endya |
| Ekiddukano (okulumwa olubuto) . | |
| Ebizibu eby’amaanyi ebirina okuloopebwa eri omusawo mu bwangu | |
| Okukutula ekituli ky’ekyenda ekinene (kiyinza okwetaagisa okulongoosebwa) . | Okwonooneka kw’ekibumba n’okweyongera kwa puloteyina mu musulo |
| Omutima okulwala oba okulumwa mu kifuba | Okukendeeza ku kuwona kw’ebiwundu (n’olwekyo tekulina kukozesebwa mangu nga omaze okulongoosebwa) . |
| Okuvaamu omusaayi ekisusse oba obuzibu mu kuzimba omusaayi | |
Eddagala eriggyako "growth switch" mu butoffaali bwa kookolo
Ka twogere ku kika ekirala ekya monoclonal antibody. Bino tebikola mu ngeri gye twayogeddeko emabegako. Eddagala lino litunuulira butereevu puloteyina eyeetongodde ku ngulu w’obutoffaali bwa kookolo. Kiyitibwa ekirungo ekiyitibwa Epidermal Growth Factor Receptor (EGFR) .
Mu ngeri ennyangu, EGFR eno eringa "switch" egamba obutoffaali bwa kookolo "okukula, okukula." Ebitundu nga 75% ku kookolo w’olubuto olunene alina puloteyina eno eya EGFR.
Eddagala lya cetuximab (Erbitux) ne panitumumab (Vectibix) likola nga likwata ku "switch" eyo eyitibwa EGFR ne ligiggyako. Kino kiremesa akabonero ak’obutonde akagamba obutoffaali okukula okukwatagana ne switch. N’ekyavaamu, obutoffaali bwa kookolo bulekera awo okukula.
Erbitux ne Vectibix zikozesebwa ani?
Eddagala lino lyombi likkirizibwa ku kookolo w’olubuto olunene eyasaasaana (metastasized) mu bitundu by’omubiri ebirala. Naye waliwo ekintu kimu ekikulu ennyo . Nga tonnatandika bujjanjabi buno, olina okukebera obuzaale obw’enjawulo (`genetic mutation test`) ku butoffaali bwo obwa kookolo. Okukebera okwo kwe kusalawo oba eddagala lino linaakola ku kookolo wo oba nedda. Kino tekisaanira buli muntu.
Erbitux aweebwa mu misuwa omulundi gumu mu wiiki. Kiweebwa kyokka oba n’eddagala eriweweeza ku ddagala erya irinotecan (Camptosar). Vectibix eweebwa buli luvannyuma lwa wiiki bbiri, ebiseera ebisinga ng’agigatta n’eddagala eddala eriwerako erijjanjaba eddagala.
| Ebizibu ebiyinza okuva mu Erbitux ne Vectibix | |
|---|---|
| Ebizibu by’olususu: ebizimba ebiringa embalabe, ebizimba ku lususu, olususu olukalu. (Jjukira nti oluusi ebikolwa bino eby’olususu biyinza okuba akabonero akalaga nti eddagala lino likola ku kookolo!) | Omusujja |
| Okuwulira ng’okooye era nga tolina bulamu | Obuteeyabya |
| Obulumi mu lubuto | Allergy ng’okukaluubirirwa okussa ne puleesa okukka |
| Ebikolwa ebibaawo ng’eddagala liweereddwa omubiri | |
Obujjanjabi buno bwonna buba bwa njawulo nnyo. Omusawo wo yekka y’asobola okusalawo obujjanjabi obusinga obulungi gy’oli okusinziira ku kika kya kookolo n’obulamu bwo. Tosalawo nga osinziira ku by’osoma ku yintaneeti oba omuntu omulala by’ayogedde.
Obubaka Obutwala Awaka
- Monoclonal Antibody bujjanjabi obw’enjawulo obukoleddwa mu laboratory obugenderera n’okulumba obutoffaali bwa kookolo bwokka.
- Waliwo engeri zino ez’enjawulo gye zikolamu. Eddagala erimu liziyiza omusaayi okutuuka ku kookolo, ate eddala liyimiriza obubonero obutoffaali bwa kookolo bwe bufulumya okukula.
- Enzijanjaba zino si ze zimu eri buli muntu. Nga eddagala erimu terinnaweebwa, kiyinza okwetaagisa okukebera obuzaale obw’enjawulo olabe oba eddagala lino linaakola ku kookolo wo.
- Okufaananako n’eddagala lyonna, lino lirina ebizibu ebivaamu. Tozitya, wabula yogerako n’omusawo wo mu ngeri etegeerekeka obulungi nga tonnatandika kujjanjaba.
- Omusawo akujjanjaba yekka y’asobola okukuwa amagezi n’obulagirizi obusinga obulungi ku bikwata ku bujjanjabi bwa kookolo, n’olwekyo kikulu nnyo okugoberera ebiragiro byabwe.
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