Chimiotherapie ya Neoadjuvant no kubagwa mbere na mbere kanseri ya pancreas ishobora kuvurwa.

CHICAGO—Igerageza rito ry’uburyo bwo kuvura kanseri ya Neoadjuvant ntirishobora kubagwa mbere kugira ngo umuntu arokoke kanseri ya pancreas ishobora kuvurwa, nk’uko bigaragara mu igerageza rito.
Mu buryo butunguranye, abarwayi babazwe bwa mbere babayeho igihe kirenga umwaka ugereranije n’abahawe imiti ya chimiotherapie ya FOLFIRINOX mbere yo kubagwa. Ibi bitangaje cyane bitewe nuko uburyo bwo kuvura bwa neoadjuvant bwajyanye n’igipimo cyo hejuru cy’imibare mibi yo kubagwa (R0) kandi ko abarwayi benshi mu itsinda ry’ubuvuzi bagize ikibazo cyo kubagwa kidahuye n’imibare.
“Indi kurikiranwa ishobora gusobanura neza ingaruka z’igihe kirekire zo kunoza R0 na N0 mu itsinda rya neoadjuvant,” ibi byatangajwe n’inama ya Knut Jorgen Laborie, MD, Kaminuza ya Oslo, Noruveje, Umuryango w’Abanyamerika w’Ubuvuzi bw’Imiti. ASCO. “Ibisubizo ntibishyigikira ikoreshwa rya neoadjuvant FOLFIRINOX nk’uburyo busanzwe bwo kuvura kanseri ya pancreas ishobora kuvurwa.”
Ibi byatunguye Andrew H. Ko, MD, wo muri Kaminuza ya California, i San Francisco, wari watumiwe muri icyo kiganiro, maze yemera ko badashyigikiye FOLFIRINOX y’abakiri bato nk'uburyo bwo kubaga mbere y'igihe. Ariko kandi ntibikuraho ibi bishoboka. Bitewe n'inyungu runaka muri ubu bushakashatsi, ntibishoboka gutanga ibisobanuro bihamye ku bijyanye n'uko FOLFIRINOX ihagaze mu gihe kizaza.
Ko yavuze ko kimwe cya kabiri cy'abarwayi ari bo bonyine barangije icyiciro cya kane cya chemotherapy ya neoadjuvant, “ibi bikaba biri hasi cyane ugereranyije n'ibyo nari niteze kuri iri tsinda ry'abarwayi, aho icyiciro cya kane cy'ubuvuzi muri rusange kitagorana cyane…. ..Icya kabiri, kuki ibisubizo byiza byo kubaga no kuvura indwara [R0, N0 status] bitera ingaruka mbi mu itsinda rya neoadjuvant? sobanukirwa impamvu hanyuma uhindukire ukoreshe imiti ishingiye kuri gemcitabine.”
“Kubera iyo mpamvu, ntabwo dushobora gufata umwanzuro uhamye dukurikije ubu bushakashatsi ku ngaruka zihariye za FOLFIRINOX nyuma yo kubagwa ku musaruro wo kubaho… FOLFIRINOX iracyahari, kandi ubushakashatsi bwinshi buri gukorwa buzagaragaza ubushobozi bwayo mu kubaga hakoreshejwe uburyo bwo gusimbuza.”
Laborie yavuze ko kubagwa hamwe n’ubuvuzi bwiza bw’umubiri bitanga umusaruro mwiza ku ndwara ya kanseri y’agakoko gatera kanseri. Ubusanzwe, uburyo bwo kwita ku ndwara bwagiye bukoreshwa mu kubaga mbere na chemotherapy y’inyongera. Ariko, ubuvuzi bwa neoadjuvant bukurikirwa no kubaga na chemotherapy y’inyongera bwatangiye gukundwa n’abaganga benshi ba kanseri.
Laborie yakomeje avuga ko uburyo bwo kuvura indwara za Neoadjuvant butanga inyungu nyinshi: kurwanya indwara z’umubiri hakiri kare, kunoza uburyo bwo gutanga imiti igabanya ubukana bw’indwara, no kunoza ibisubizo by’indwara zo mu maraso (R0, N0). Ariko, kugeza ubu, nta bushakashatsi bwigeze bugaragaza neza ko imiti igabanya ubukana bw’indwara za Neoadjuvant ishobora kurokoka.
Kugira ngo hakemurwe ikibazo cy’ibura ry’amakuru mu bushakashatsi bwakozwe ku buryo butunguranye, abashakashatsi bo mu bigo 12 byo muri Noruveje, Suwede, Danemark na Finlande bakusanyije abarwayi ba kanseri y’umutwe wa pancreas ishobora kuvurwa. Abarwayi bakoreweho ubushakashatsi bwakozwe ku buryo butunguranye bahawe ingero 12 za FOLFIRINOX (mFOLFIRINOX) yahinduwe na adjuvant (mFOLFIRINOX). Abarwayi bahawe ubuvuzi bwa neoadjuvant bahawe ingero 4 za FOLFIRINOX, hakurikiraho gusubiramo icyiciro no kubagwa, hakurikiraho ingero 8 za mFOLFIRINOX. Intego nyamukuru ni ukubaho muri rusange (OS), kandi ubushakashatsi bwakozwe kugira ngo bugaragaze iterambere mu kubaho kw’amezi 18 kuva kuri 50% hamwe no kubagwa mbere kugeza kuri 70% hamwe na neoadjuvant FOLFIRINOX.
Amakuru yari akubiyemo abarwayi 140 batoranijwe bafite ECOG status 0 cyangwa 1. Mu itsinda rya mbere ryakoreweho kubaga, 56 muri 63 (89%) barabazwe naho 47 (75%) batangira guhabwa imiti ivura indwara ya kanseri. Mu barwayi 77 bahawe imiti ivura indwara ya kanseri, 64 (83%) batangiye kuyivura, 40 (52%) barangije kuyivura, 63 (82%) baciwe, naho 51 (66%) batangira kuyivura.
Ingaruka mbi zo mu cyiciro cya ≥3 (AEs) zagaragaye kuri 55.6% by'abarwayi bahabwaga imiti ya chimiotherapie ivura indwara ya kanseri, cyane cyane impiswi, isesemi no kuruka, na neutropenia. Mu gihe cyo guhabwa imiti ya chimiotherapie ivura indwara ya kanseri, abarwayi bagera kuri 40% muri buri tsinda ry'ubuvuzi bagaragaje ko bafite amanota ≥3 (AEs).
Mu isesengura ryakozwe hagamijwe kuvura, impuzandengo y'ubuzima rusange hakoreshejwe imiti ya neoadjuvant yari amezi 25.1 ugereranije n'amezi 38.5 iyo umuntu yabazwe mbere, naho imiti ya neoadjuvant yongera ibyago byo kubaho ku kigero cya 52% (95% CI 0.94–2.46, P=0.06). Igipimo cy'ubuzima bw'amezi 18 cyari 60% iyo umuntu yakozwe na neoadjuvant FOLFIRINOX na 73% iyo yabazwe mbere. Isuzuma rya buri mushinga ryatanze ibisubizo bisa.
Ibisubizo by’indwara z’amaso bigaragaza ko 56% by’abarwayi bageze kuri R0 ugereranije na 39% by’abarwayi babazwe mbere (P = 0.076) naho 29% bageze kuri N0 ugereranije na 14% by’abarwayi (P = 0.060). Isesengura rya buri gahunda ryagaragaje itandukaniro rikomeye mu mibare hagati ya FOLFIRINOX na neoadjuvant mu miterere ya R0 (59% ugereranyije na 33%, P = 0.011) na N0 (37% ugereranyije na 10%, P = 0.002).
Charles Bankhead ni umwanditsi mukuru w’inzobere mu kuvura kanseri, akaba anakora ku bijyanye n’indwara z’inkari, indwara z’uruhu n’indwara z’amaso. Yinjiye muri MedPage Today mu 2007.
Ubu bushakashatsi bwatewe inkunga n’Umuryango wita ku ndwara ya kanseri wo muri Noruveje, Ikigo gishinzwe ubuzima mu majyepfo y’uburasirazuba bwa Noruveje, Umuryango wa Sjoberg wo muri Suwede n’Ibitaro bya Kaminuza bya Helsinki.
Ko 披露了与 Amahitamo yo Kwita ku Buvuzi bw'Abaganga、Gerson Lehrman Group、Medscape、MJH Life Sciences、Ubushakashatsi bwo Gukoresha、AAdi、FibroGen、Genentech、GRAIL、Ipsen、Merus、Roche、AbGenomics、Apexigen、Astellas、BioMed Valley Vumbuye "Bristol Myers Squibb". Celgene, CrystalGenomics, Leap Therapeutics n'andi masosiyete.
Incamake: Labori KJ et al. “FOLFIRINOX yo mu gihe gito irwanya kanseri y’umutwe wa pancreas ishobora kuvurwa mbere: igerageza ryakozwe mu byiciro byinshi ku buryo butaziguye (NORPACT-1),” ASCO 2023; Incamake LBA4005.
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