ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu

Ukuqonda indima ye ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu ibalulekile ekulawulweni komdlavuza wamaphaphu komuntu siqu nangempumelelo. Lesi sihloko sihlola ukuthi ukuhlolwa kofuzo kwazisa kanjani izinqumo zokwelashwa, izinhlobo zokuguqulwa kwezakhi zofuzo ezivame ukutholakala kumdlavuza wamaphaphu, kanye nemithi yokwelapha eqondiswe kulezi zinguquko ezithile. ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu. Lezi zinguquko zingenzeka ezakhini zofuzo ezilawula ukukhula kwamangqamuzana, ukuhlukana nokulungisa. Ukuhlonza lezi zinguquko kubalulekile ngoba kungaqondisa amasu okwelapha futhi kuthuthukise imiphumela yesiguli. E-Shandong Baofa Cancer Research Institute, sibeka eqhulwini ukuqonda isimo sofuzo somdlavuza wamaphaphu wesiguli ngasinye.Kuyini Ukuguqulwa Kwezakhi Zofuzo?Ukwelashwa komdlavuza wamaphaphu ngokuguqulwa kofuzo yizinguquko ohlelweni lwe-DNA olungaholela ekuziphatheni kwamaseli okungavamile. Lezi zinguquko zingazuzwa njengefa noma zitholwe ngesikhathi sokuphila komuntu. Kumdlavuza wamaphaphu, ukuguqulwa kwezakhi zofuzo okutholiwe kuvame kakhulu futhi kuvame ukubangelwa izici zemvelo ezinjengokubhema noma ukuchayeka ezintweni ezingcolisayo. Lezi zinguquko zingaphazamisa izinqubo ezivamile zamangqamuzana, okuholela ekukhuleni okungalawuleki kanye nokwakheka kwezimila.Izinguquko Zofuzo Ezivamile Kumdlavuza WamaphaphuIzakhi zofuzo eziningi zivame ukuguqulwa kumdlavuza wamaphaphu. Ukuqonda lezi zinguquko kubalulekile ekukhetheni indlela yokwelapha efanele. Nazi ezinye ezivame kakhulu:I-EGFR (I-Epidermal Growth Factor Receptor): Ukuguqulwa kwezinguquko ku-EGFR kuvamile kumdlavuza wamaphaphu ongewona omncane (NSCLC), ikakhulukazi ku-adenocarcinomas. Lezi zinguquko zingenza amangqamuzana omdlavuza azwele kakhulu kwezinye izindlela zokwelapha ezihlosiwe.I-ALK (Anaplastic Lymphoma Kinase): Ukuhlelwa kabusha kwe-ALK kungolunye uguquko oluqondiwe olutholakala ku-NSCLC. Ama-ALK inhibitors abonise impumelelo enkulu ekwelapheni izimila ngalolu shintsho.I-ROS1: Ngokufana ne-ALK, ukuhlanganiswa kwe-ROS1 kungaqhuba ukukhula komdlavuza wamaphaphu. I-ROS1 inhibitor iyatholakala ezigulini ezine-ROS1-positive NSCLC.I-BRAF: Ukuguqulwa kwe-BRAF, ikakhulukazi ukuguqulwa kwe-V600E, kungatholakala ku-NSCLC. Ama-BRAF inhibitors angasetshenziswa ukukhomba lezi zinguquko.I-KRAS: Ukuguqulwa kwe-KRAS kuvamile ku-lung adenocarcinoma. Yize kunzima ngokomlando ukukhomba, zokwelapha ezintsha ziyavela ukwelapha umdlavuza wamaphaphu oguquliwe we-KRAS.I-PD-L1 (I-Death-Ligand 1 Ehleliwe): Nakuba kungekona ukuguqulwa kofuzo ngomqondo wendabuko, isisho se-PD-L1 siyi-biomarker engabikezela impendulo ku-immunotherapy. Inkulumo ephezulu ye-PD-L1 ingase ibonise ukuthi isiguli singazuza kakhulu ekwelashweni kwamasosha omzimba.Ukuhlolwa Kofuzo Komdlavuza WamaphaphuUkwelashwa komdlavuza wamaphaphu ngokuguqulwa kofuzo ikhonjwa ngokuhlolwa kofuzo okuphelele, okwaziwa nangokuthi ukuhlolwa kwe-biomarker noma iphrofayili yamangqamuzana. Lokhu kuhlola kuhlaziya izicubu zesimila noma, kwezinye izimo, amasampula egazi ukuze kutholakale izinguquko ezithile zofuzo eziqhuba ukukhula komdlavuza. Imiphumela yalezi zivivinyo isiza odokotela be-oncologist ukwenza izinhlelo zokwelapha zibe ngezomuntu ukuze ziqondise izici ezihlukile zomdlavuza wesiguli ngasinye. I-Baofa Cancer Research Institute isebenzisa ubuchwepheshe besimanje bokuhlola izakhi zofuzo.Izinhlobo Zokuhlolwa Kwezakhi ZofuzoIzinhlobo eziningana zokuhlolwa kofuzo zisetshenziswa ekuxilongeni umdlavuza wamaphaphu nasekuhleleni ukwelashwa:I-Next-Generation Sequencing (NGS): I-NGS iyindlela yokuhlola ebanzi engahlaziya izakhi zofuzo eziningi ngesikhathi esisodwa. Lokhu kuvumela ukutholwa kohlu olubanzi lokuguquguquka nokunye ukuguqulwa kofuzo.I-Polymerase Chain Reaction (PCR): I-PCR iyindlela yokuhlola egxile kakhulu esetshenziselwa ukuthola ukuguqulwa okuthile noma ukuhlelwa kabusha kofuzo.I-Fluorescence In Situ Hybridization (INHLANZI): I-FISH isetshenziselwa ukuthola ukuhlelwa kabusha kofuzo, okufana nokuhlanganiswa kwe-ALK kanye ne-ROS1.I-Immunohistochemistry (IHC): I-IHC isetshenziselwa ukuthola ukusho kwamaprotheni, njenge-PD-L1, engasiza ukubikezela impendulo ku-immunotherapy. Kufanele Kwenziwe Nini Ukuhlolwa Kofuzo? Ukuhlolwa kofuzo kufanele kwenziwe kuzo zonke iziguli ezitholwe zine-NSCLC ethuthukisiwe. Ukuhlolwa kufanele kwenziwe ngokushesha ngangokunokwenzeka ohlelweni lokuhlela ukwelashwa ukuze izindlela zokwelapha ezihlosiwe zicatshangelwe zisuka nje. Kubalulekile futhi ukuthi uphinde uhlole uma umdlavuza uqhubeka noma uma izindlela ezintsha zokwelapha sezitholakala. Imithi Eqondiwe Yokwelapha Umdlavuza Wamaphaphu Imithi yokwelapha ehlosiwe yimithi eqondiswe ngokukhethekile kumangqamuzana omdlavuza. ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu. Lezi zindlela zokwelapha zenzelwe ukuphazamisa ukukhula, ukuhlukana, nokusabalala kwamangqamuzana omdlavuza kuyilapho kunciphisa umonakalo kumaseli avamile. Indlela yokwelapha yomuntu siqu yeSibhedlela i-Baofa isebenzisa izindlela zokwelapha eziqondisiwe ezithuthuke kakhulu.Ama-EGFR InhibitorsEGFR inhibitors asetshenziselwa ukwelapha umdlavuza wamaphaphu ngokushintshashintsha kwe-EGFR. Le mithi ivimba ukusebenza kwephrotheni ye-EGFR, evame ukusebenza ngokweqile kumaseli omdlavuza ngalezi zinguquko. I-EGFR inhibitors evamile ihlanganisa:I-Gefitinib (Iressa)I-Erlotinib (Tarceva)I-Afatinib (Gilotrif)I-Osimertinib (Tagrisso): Ngokuvamile ukwelashwa komugqa wokuqala kwe-EGFR-mutated NSCLC.ALK InhibitorsALK inhibitors isetshenziselwa ukwelapha umdlavuza wamaphaphu ngokuhlelwa kabusha kwe-ALK. Le mithi ivimba ukusebenza kwephrotheni ye-ALK, evame ukusebenza ngendlela engavamile kumaseli omdlavuza ngalokhu kuhlelwa kabusha. Ama-ALK inhibitors ajwayelekile afaka:I-Crizotinib (Xalkori)I-Alectinib (Alecensa)I-Ceritinib (Zykadia)I-Brigatinib (Alunbrig)I-Lorlatinib (Lorbrena)I-ROS1 InhibitorsROS1 inhibitors isetshenziselwa ukwelapha umdlavuza wamaphaphu ngokuhlanganisa kwe-ROS1. Le mithi ivimba ukusebenza kwephrotheni ye-ROS1, evame ukusebenza ngendlela engavamile kumaseli omdlavuza ngalokhu kuhlangana. I-ROS1 inhibitors evamile ihlanganisa:I-Crizotinib (Xalkori)I-Entrectinib (Rozlytrek)I-BRAF Inhibitors I-BRAF inhibitors isetshenziselwa ukwelapha umdlavuza wamaphaphu ngokushintshashintsha kwe-BRAF, ikakhulukazi ukuguqulwa kwe-V600E. Le mithi ivimba ukusebenza kwephrotheni ye-BRAF, evame ukusebenza ngokweqile kumaseli omdlavuza ngalezi zinguquko. Ama-inhibitors e-BRAF ajwayelekile afaka:I-Dabrafenib (Tafinlar)I-Trametinib (i-Mekinist): Okuvame ukusetshenziswa ngokuhlanganiswa ne-dabrafenib.KRAS G12C InhibitorsI-Sotorasib (Lumakras) kanye ne-Adagrasib (Krazati) ziyizibonelo zama-KRAS G12C inhibitors asetshenziselwa ukwelapha umdlavuza wamaphaphu ngalokhu kuguquka kwe-KRAS okuqondile. Asebenza ngokuvimbela ukusebenza kweprotein ye-KRAS eguquliwe.I-Immunotherapy kanye ne-Genetic MutationsImmunotherapy uhlobo lokwelapha umdlavuza olusiza amasosha omzimba ukulwa nomdlavuza. Nakuba i-immunotherapy ingaqondile ngokuqondile ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu, ukuguqulwa okuthile kofuzo kanye nama-biomarker, njenge-PD-L1 expression kanye ne-tumor mutational burden (TMB), angabikezela impendulo ku-immunotherapy. Iziguli ezinenkulumo ephezulu ye-PD-L1 noma i-TMB ephezulu zingase zibe mathubeni amaningi okuzuza ku-immunotherapy. E-Shandong Baofa Cancer Research Institute, sihlanganisa i-immunotherapy nezinye izindlela zokwelapha ukuze kube nendlela ebanzi.Ikusasa Lokwelapha Umdlavuza WamaphaphuUmkhakha wokwelashwa komdlavuza wamaphaphu uthuthuka ngokushesha. Izindlela zokwelapha ezihlosiwe ezintsha kanye nama-immunotherapies ayathuthukiswa futhi ahlolwe ezivivinyweni zomtholampilo. Abacwaningi nabo basebenzela ukuhlonza okusha ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu okungabhekiselwa kukho ngemithi yokwelapha eyinoveli. Njengoba ukuqonda kwethu ngezakhi zofuzo zomdlavuza wamaphaphu kuba ngcono, singalindela ukubona izinketho zokwelashwa ezenzelwe umuntu siqu nezisebenza ngempumelelo ezigulini. I-Shandong Baofa Cancer Research Institute izimisele ngokuhlala ihamba phambili kulezi ntuthuko.Ithebula Elibonisayo: Izindlela zokwelapha ezihlosiwe ezisekelwe ekuguquguqukeni kwezindlela zokwelapha ezihlosiweIncazeloEGFROsimertinib, i-Gefitinib, i-Erlotinib, i-AfatinibVimbela umsebenzi wamaprotheni we-EGFRALKAlectinib, Crizotinib, Brilagabtinib, i-Ceritinib, Iphrotheni umsebenziROS1Crizotinib, EntrectinibVimba ROS1 umsebenzi wamaprotheniBRAF V600EDabrafenib (imvamisa eneTrametinib)Vimba umsebenzi wamaprotheni e-BRAFKRAS G12CSotorasib, AdagrasibVimba oguqule umsebenzi wamaprotheni we-KRASIsiphethoUkuqonda indima ye ukuguqulwa kofuzo ukwelashwa komdlavuza wamaphaphu kubalulekile ekwenzeni ngcono imiphumela yeziguli ezinomdlavuza wamaphaphu. Ukuhlolwa kofuzo kungasiza ekuhlonzeni ukuguqulwa okuthile okungakhonjwa indlela yokwelapha yomuntu siqu. Njengoba ukuqonda kwethu ngezakhi zofuzo zomdlavuza wamaphaphu kuqhubeka kukhula, singalindela ukubona izindlela zokwelapha ezisebenza ngempumelelo nezihlosiwe zalesi sifo esibhubhisayo. Vakashela I-Shandong Baofa Cancer Research Institute ukuze ufunde kabanzi mayelana nendlela yethu ebanzi yokunakekelwa komdlavuza wamaphaphu.Umshwana wokuzihlangula: Lolu lwazi ngelezinjongo zokufundisa kuphela futhi akufanele luthathwe njengeseluleko sezokwelapha. Hlala uthintana nochwepheshe bezempilo abaqeqeshiwe ukuze baxilongwe futhi belashwe izimo zezokwelapha.ReferencesNational Cancer Institute. www.cancer.govI-American Cancer Society. www.cancer.org