Chiyembekezo chatsopano cha khansa ya m'mawere: Tiyeni tiphunzire za PI3K Inhibitors m'njira yosavuta (PI3K Inhibitors for ER+ Breast Cancer)

Tikamva mawu akuti khansa ya m'mawere, ambiri aife timaopa. Koma chofunika kwambiri chomwe tiyenera kumvetsetsa ndichakuti si khansa zonse za m'mawere zomwe zili zofanana. Pali mitundu yosiyanasiyana ya khansa. Mtundu umodzi wodziwika kwambiri ndi 'estrogen receptor positive' kapena monga momwe timatchulira azachipatala , khansa ya m'mawere ya ER+ (Estrogen-Receptor-Positive) . Ndipotu, 80% yokha ya khansa ya m'mawere yomwe yapezeka ndi ya mtundu uwu. Chifukwa chake lero tikambirana za mankhwala atsopano komanso opambana omwe apezeka kuti amachiza khansa ya m'mawere ya ER+.

Choyamba, tiyeni tiwone, kodi khansa ya m'mawere ya ER+ ndi chiyani?

Mwachidule, hormone ya estrogen m'thupi lathu imathandiza maselo a khansa kukula. Tangoganizani kuti maselo a khansa awa ali ndi 'maloko' apadera (ma receptor) pamwamba pawo omwe hormone ya estrogen imatha kumamatirako. Pamene 'kiyi' yotchedwa estrogen hormone ilowa mu 'maloko' awa, maselo a khansa amalandira 'chizindikiro' choti agawane ndikukula.

Ichi ndichifukwa chake madokotala nthawi zambiri amapereka chithandizo cha mahomoni pochiza khansa ya ER+. Mankhwalawa amaletsa 'key' (estrogen) kuti isagwirizane ndi 'lock' (receptors). Koma nthawi zina, makamaka khansa ikafalikira m'thupi lonse (yomwe yafalikira kwambiri), maselo a khansa awa amakhala achinyengo kwambiri. Amakhala osagonja ku mankhwala awa a mahomoni, zomwe zikutanthauza kuti sayankha bwino chithandizo. Apa ndi pamene timafunikira mankhwala atsopano komanso ogwira mtima.

'Kusintha kwa kukula' kwa maselo a khansa - majini a PI3K ndi PIK3CA

Pamene madokotala ndi asayansi ankafufuza zomwe zimayambitsa khansa imeneyi yosagonjetsedwa ndi mahomoni, adapeza china chake chapadera: vuto mu njira ya PI3K (Phosphatidylinositol-3-Kinase) , njira yofunika kwambiri yolumikizirana yomwe imayang'anira kukula, kugawikana, ndi kupulumuka kwa maselo m'thupi lathu.

Ganizirani njira iyi ya PI3K ngati 'switchboard' yayikulu mu selo. Imalamulira zisankho zokhudza ngati selo liyenera kukula kapena kugawikana. Limodzi mwa majini akuluakulu omwe amalamulira switchboard iyi ndi jini ya PIK3CA .

Mwa odwala ena a khansa, jini iyi ya PIK3CA imakhala ndi kusintha kwa majini , kutanthauza kusintha kapena chilema. Zili ngati kusintha kwa 'kukula' pa switchboard kumamatira ndipo nthawi zonse 'kumayaka'. Kenako maselo amayamba kugawikana ndikukula mosalamulirika. Ichi ndiye chifukwa chachikulu cha khansa. Kafukufuku wapeza kuti pafupifupi 40% ya odwala omwe ali ndi khansa ya m'mawere ya ER+ ali ndi kusintha kwa majini a PIK3CA.

Ndiye kodi ma PI3K Inhibitors awa ndi chiyani?

Pano, monga yankho la vutoli, gulu la mankhwala otchedwa PI3K inhibitors likuyambitsidwa. Chinthu chosavuta chomwe mankhwalawa amachita ndikuletsa bwino 'kusintha kwa kukula' (njira ya PI3K) yomwe ndatchula kale yomwe imayikidwa 'pa'.

Mankhwalawa nthawi zambiri amabwera ngati mankhwala omwa. Nthawi zambiri, mankhwalawa amaperekedwa kwa odwala pamodzi ndi mankhwala a mahomoni omwe atchulidwa kale (estrogen blocker).

Ndingadziwe bwanji ngati chithandizochi chili choyenera kwa ine?

Funso ili ndi lofunika kwambiri. Si odwala onse a khansa ya m'mawere omwe amapatsidwa PI3K inhibitors. Amapangidwira makamaka kuti:

• Kwa amayi omwe asiya kusamba ndi odwala amuna.
• Khansa iyenera kukhala HR+ (Hormone-Receptor-Positive) ndi HER2-Negative .
• Chofunika kwambiri: Maselo a khansa ayenera kukhala ndi kusintha kwa majini a PIK3CA .

Kuti adziwe ngati khansa yanu ili ndi kusintha kwa majini kumeneku, dokotala wanu adzachita mayeso apadera. Izi nthawi zambiri zimaphatikizapo kuyezetsa magazi kapena kachidutswa kakang'ono ka minofu (biopsy) kotengedwa kuchokera ku chotupacho. Zotsatira za mayesowo zidzatsimikizira ngati chithandizochi chili choyenera kwa inu.

Kodi mankhwala awa angayambitse zotsatirapo zotani?

Monga mankhwala ena aliwonse a khansa, mankhwala oletsa PI3K angayambitse zotsatira zina zoyipa. Komabe, izi sizimachitika kwa aliyense mofanana. Komanso, tsopano pali njira zothanirana ndi zotsatira zoyipazi.

Zina mwa zotsatira zoyipa kwambiri ndi izi:

• Kusanza ndi kusanza
• Kutaya chilakolako cha chakudya ndi kuchepetsa thupi
• Zilonda pakamwa
• Kutaya tsitsi
• Zotsatira zilizonse pa ntchito ya impso, chiwindi, kapena kapamba
• Ziphuphu pakhungu, nthawi zina zoopsa kwambiri, zimatha kuchitika, zomwe zimapangitsa kuti khungu lizituluka kapena kutuluka matuza.
• Shuga Wambiri M'magazi: Izi ndi zotsatira zoyipa zomwe zimachitika kawirikawiri pagulu la mankhwala awa, chifukwa njira ya PI3K imakhudzidwa ndi kagayidwe ka shuga m'thupi lathu.

Musachite mantha ndi zotsatirapo izi. Dokotala wanu adzakuyang'anirani nthawi zonse kuti aone ngati pali izi. Ngati pakufunika kutero, adzachepetsa mlingo wa mankhwalawo, adzasiya kumwa kwa kanthawi (nthawi ya tchuthi cha mankhwala), kapena kukupatsani mankhwala ena kuti muchepetse zotsatirapo zake. Musasiye kumwa mankhwala anu kapena kusintha mlingo popanda kufunsa dokotala wanu.

Kafukufuku wasonyeza kuti kumwa mankhwala a shuga kuti muchepetse shuga m'magazi kapena kutsatira zakudya zokhala ndi mafuta ochepa ( ketogenic diet ) kungathandize kuti mankhwalawa agwire bwino ntchito. Komabe, ndikofunikira kulankhula ndi dokotala wanu musanasinthe zakudya.

Kodi chithandizochi chilidi chothandiza?

Inde. Ichi ndiye chinthu chofunikira kwambiri. Mayesero ambiri azachipatala asonyeza kuti odwala omwe ali ndi khansa ya m'mawere ya ER+ omwe ali ndi kusintha kwa PIK3CA angapindule ndi mankhwala oletsa PI3K pamodzi ndi mankhwala a mahomoni.

Kafukufuku wina wamkulu adapeza kuti odwala omwe adalandira mankhwalawa anali ndi moyo wopanda kupitirira kwa miyezi pafupifupi 11. Izi zinali zosakwana miyezi 6 kwa odwala omwe ali ndi majini omwewo omwe sanalandire zoletsa za PI3K. Uku ndi kusintha kwakukulu komanso chiyembekezo chachikulu. Chifukwa cha kupambana kumeneku, mankhwala atsopano mu gulu ili la mankhwala akupangidwa tsopano.