kalafo phetolo ea lefutso phetoho ea kankere ea matšoafo phekolo

Kalafo ea Phetoho ea Liphatsa tsa lefutso ho Kankere ea Matšoafo Ho utloisisa le ho Phekola Phetoho ea Liphatsa tsa lefutso ho Kankere ea Matšoafo: Tataiso e Feletseng Tataiso ena e fana ka kakaretso e akaretsang ea karolo ea tlhahlobo ea liphatsa tsa lefutso mofetšeng oa matšoafo, liphetoho tse tloaelehileng, le likhetho tse fumanehang tsa kalafo. E ikemiselitse ho matlafatsa bakuli le malapa a bona ka tsebo e hlokahalang ho tsamaea leetong lena le thata. Re tla hlahloba liphekolo tse shebiloeng, immunotherapy, le maano a mang a sebelisoang hajoale ho laola mofetše oa matšoafo o susumetsoang ke ho se tloaelehe ha lefutso.

Teko ea Liphatsa tsa lefutso ka Kankere ea Matšoafo

Bohlokoa ba Boitsebiso ba Limolek'hule

Pele ho qala kalafo phetolo ea lefutso phetoho ea kankere ea matšoafo phekolo, tlhahlobo ea liphatsa tsa lefutso ke ea bohlokoa. Ts'ebetso ena, eo hangata e bitsoang tlhahlobo ea limolek'hule kapa tlhahlobo ea biomarker, e supa liphetoho tse itseng tsa lefutso ka har'a lisele tsa tumor. Liphetoho tsena li ka ama liqeto tsa kalafo le ho bolela esale pele monyetla oa karabelo ea kalafo. Liphatsa tsa lefutso tse lekiloeng hangata li kenyelletsa EGFR, ALK, ROS1, BRAF, le KRAS. Ho tseba phetoho e khethehileng ea liphatsa tsa lefutso ho lumella li-oncologists ho etsa liphekolo ho latela mofetše oa mokuli ka mong. Liphetho tsa tlhahlobo ea liphatsa tsa lefutso li bohlokoa bakeng sa ho fumana mokhoa o nepahetseng oa ts'ebetso.

Mefuta ea Liteko tsa Liphatsa tsa lefutso

Ho na le mekhoa e mengata ea tlhahlobo ea liphatsa tsa lefutso, e 'ngoe le e 'ngoe e na le melemo le mathata a eona. Tsena li kenyelletsa tatellano ea moloko o latelang (NGS), e lumellang tlhahlobo ea nako e le 'ngoe ea liphatsa tsa lefutso tse ngata, le polymerase chain reaction (PCR), mokhoa o lebisitsoeng haholo o shebaneng le liphatsa tsa lefutso tse itseng. Khetho ea mokhoa o itšetlehile ka lintlha tse kang lisebelisoa tse teng le lipotso tse tobileng tsa kliniki tse ntseng li rarolloa. Ngaka ea hau ea oncologist e tla u tataisa ho khetha khetho e ntle ka ho fetisisa ea tlhahlobo e ipapisitseng le nyeoe ea hau.

Liphetoho tse Tloaelehileng tsa Liphatsa tsa lefutso ho Kankere ea Matšoafo le Liphekolo tsa Tsona

Liphetoho tsa EGFR

Liphetoho tsa EGFR li tloaelehile ho kankere e seng e nyane ea lisele tsa matšoafo (NSCLC), haholo-holo ho bakuli ba e-s'o tsube kapa ba nang le histori ea ho tsuba ha bobebe. Liphekolo tse lebisitsoeng, tse kang EGFR tyrosine kinase inhibitors (TKIs), li sebetsa haholo ho bakuli ba nang le liphetoho tsena. Li-inhibitors tsena li thibela tšebetso ea protheine ea EGFR e fetotsoeng, e sitisang ho hola ha hlahala. Mehlala e kenyelletsa gefitinib, erlotinib, le afatinib. Leha ho le joalo, ho hanyetsa lithethefatsi tsena ho ka ba teng ha nako e ntse e ea.

Litlhophiso tsa ALK

Litokiso tsa ALK ke phetoho e 'ngoe ea bohlokoa ea mokhanni ho NSCLC. Ho tšoana le liphetoho tsa EGFR, litlhophiso tsa ALK hangata li lebisitsoe ho li-TKI tse itseng. Criztinib le alectinib ke mehlala ea ALK inhibitors e ipakileng e sebetsa ho phekoleng bakuli ba mofetše oa matšoafo oa ALK-positive. Ho beha leihlo khafetsa ho bohlokoa ho tseba le ho laola khanyetso efe kapa efe e ka bang teng.

Litlhophiso tsa ROS1

Litokiso tsa ROS1 ha li na khafetsa ho feta EGFR kapa ALK rearrangements, empa li arolelana mekhoa e tšoanang ea kalafo. Bakuli ba nang le mofetše oa matšoafo oa ROS1-positive ba ka rua molemo liphekolong tse lebisitsoeng, tse kang crizotinib, lorlatinib, le entrectinib. Liphekolo tsena li bontšitse katleho ho lelefatsa ho phela le ho ntlafatsa boleng ba bophelo ho bakuli ba nang le phetoho ena.

Liphetoho Tse Ling

Liphetoho tse ling tse ngata tsa liphatsa tsa lefutso li ka kenya letsoho kholong ea mofetše oa matšoafo, ho kenyelletsa le liphetoho tsa BRAF, KRAS le HER2. Le hoja mekhoa ea phekolo e lebisitsoeng e le teng bakeng sa tse ling tsa liphetoho tsena, boemo ba phekolo bo ntse bo fetoha, ka lipatlisiso tse tsoelang pele ho hlahloba mekhoa e mecha le e ntlafalitsoeng. The Shandong Baofa Cancer Research Institute (https://www.baofahospital.com/) o ka pele-pele lipatlisisong tsena, a lula a hlahloba mekhoa e mecha ea phekolo ea kankere ea matšoafo.

Mekhoa ea Kalafo ka Ntle ho Therapy e Lebisitsoeng

Immunotherapy

Immunotherapy e sebelisa matla a sesole sa 'mele sa mokuli ho loantša mofetše. Li-inhibitors tsa ho hlahloba, tse kang pembrolizumab le nivolumab, li sebelisoa ho kalafo phetolo ea lefutso phetoho ea kankere ea matšoafo phekolo, ka linako tse ling hammoho le liphekolo tse lebisitsoeng kapa chemotherapy. Lithethefatsi tsena li thibela ho hlahlojoa ha 'mele, ho lumella sesole sa' mele ho lemoha le ho hlasela lisele tsa mofetše. Immunotherapy e ka sebetsa le maemong ao kalafo e lebisitsoeng ho eona e kanna ea se sebetse.

Chemotherapy

Chemotherapy e ntse e le khetho ea bohlokoa ea kalafo bakeng sa mofetše oa matšoafo, haholo-holo maemong ao liphekolo tse lebisitsoeng kapa immunotherapy li sa lokelang. Leha ho le joalo, chemotherapy hangata ha e lebisoe ho feta liphekolo tse ncha, 'me e ka ba le litlamorao tse kholo.

Phekolo ea Mahlaseli

Kalafo ea radiation e ka sebelisoa ho lebisa le ho senya lisele tsa mofetše. Hangata e sebelisetsoa ho fokotsa lihlahala, ho fokotsa bohloko, kapa ho fokotsa matšoao a mang. E ka sebelisoa e le mong kapa hammoho le litlhare tse ling.

Ho Tsamaisa Leeto la Kalafo

Mofuta oa Kalafo	Melemo	Mefokolo
Targeted Therapy	Tšebeliso e phahameng ea liphetoho tse itseng, litla-morao tse fokolang ho feta chemotherapy.	Khanyetso e ka hlaha, ha e sebetse bakeng sa liphetoho tsohle tsa liphatsa tsa lefutso.
Immunotherapy	Likarabo tse tšoarellang, li ka atleha esita le ka ho hanyetsa mekhoa e meng ea phekolo.	Monyetla oa liketsahalo tse mpe tse amanang le 'mele oa ho itšireletsa mafung.
Chemotherapy	E sebetsa mefuteng e mengata ea mofetše, e fumanehang hohle.	Litla-morao tse ngata ho feta phekolo e lebisitsoeng kapa immunotherapy, phekolo e sa lebelloang haholo.

Ho khetha se nepahetseng kalafo phetolo ea lefutso phetoho ea kankere ea matšoafo phekolo ke ts'ebetso e rarahaneng e hlokang tšebelisano e haufi pakeng tsa mokuli, oncologist ea bona, le litsebi tse ling tsa tlhokomelo ea bophelo. Ho bohlokoa ho botsa lipotso, ho utloisisa mekhoa ea kalafo, le ho nka karolo ka mafolofolo ho etsa liqeto. Hopola, tsoelo-pele ea lipatlisiso e lula e ntlafatsa mekhoa ea kalafo bakeng sa mofetše oa matšoafo. Lula u tseba, 'me u seke oa tsilatsila ho batla tšehetso ho tsoa ho lihlopha tsa bobuelli ba bakuli le marang-rang a ts'ehetso.Boitlhotlhollo: Litaba tsena ke tsa merero ea thuto feela,' me ha lia lokela ho nkoa e le keletso ea bongaka. Kamehla buisana le setsebi sa tlhokomelo ea bophelo bakeng sa mathata leha e le afe a bophelo bo botle kapa pele u etsa liqeto tse amanang le bophelo bo botle kapa phekolo ea hau.