CHICAGO—Ba za a iya daidaita tiyatar da aka yi wa tiyatar da ba ta da magani ba don tsira daga cutar kansar pancreas da za a iya cirewa, wani ƙaramin gwaji da aka yi bazuwar ya nuna.
Ba zato ba tsammani, marasa lafiya da aka yi musu tiyata a karon farko sun rayu fiye da shekara guda fiye da waɗanda aka yi musu gajeren magani na FOLFIRINOX kafin a yi musu tiyata. Wannan sakamakon abin mamaki ne musamman ganin cewa maganin neoadjuvant yana da alaƙa da mafi girman ƙimar tiyatar da ba ta da kyau (R0) kuma ƙarin marasa lafiya a cikin rukunin jiyya sun sami matsayin node-negative.
"Ƙarin bin diddigin zai iya yin bayani mafi kyau game da tasirin ci gaba a cikin R0 da N0 na dogon lokaci a cikin ƙungiyar neoadjuvant," in ji Knut Jorgen Laborie, MD, Jami'ar Oslo, Norway, taron American Society of Clinical Oncology. ASCO). "Sakamakon bai goyi bayan amfani da FOLFIRINOX na neoadjuvant a matsayin magani na yau da kullun don ciwon daji na pancreas da za a iya cirewa ba."
Wannan sakamakon ya ba Andrew H. Ko, MD, na Jami'ar California, San Francisco mamaki, wanda aka gayyace shi zuwa tattaunawar, kuma ya yarda cewa ba sa goyon bayan FOLFIRINOX, wani magani na neoadjuvant a madadin tiyatar da aka yi a gaba. Amma kuma ba sa ware wannan yiwuwar. Saboda sha'awar da aka nuna a binciken, ba zai yiwu a yi cikakken bayani game da matsayin FOLFIRINOX na gaba ba.
Ko ya lura cewa rabin marasa lafiya ne kawai suka kammala zagaye huɗu na maganin chemotherapy na neoadjuvant, "wanda ya yi ƙasa da abin da na yi tsammani ga wannan rukunin marasa lafiya, waɗanda zagaye huɗu na magani ba su da wahala sosai…..Na biyu, me yasa sakamakon tiyata da na cututtuka mafi kyau [matsayin R0, N0] ke haifar da yanayin zuwa mummunan sakamako a cikin ƙungiyar neoadjuvant? Ku fahimci dalilin kuma a ƙarshe ku canza zuwa tsarin da aka yi amfani da shi bisa ga gemcitabine."
"Saboda haka, ba za mu iya samun sakamako mai ƙarfi daga wannan binciken game da tasirin FOLFIRINOX na lokacin tiyata kan sakamakon rayuwa ba... FOLFIRINOX har yanzu yana nan, kuma da fatan za a yi nazari da dama kan yuwuwar sa a tiyatar da za a iya cirewa." Cututtuka.
Laborie ta lura cewa tiyata tare da ingantaccen maganin tsari yana samar da mafi kyawun sakamako ga ciwon daji na pancreas da za a iya cirewa. A al'ada, tsarin kulawa ya haɗa da tiyata a gaba da kuma maganin chemotherapy na adjuvant. Duk da haka, maganin neoadjuvant wanda ya biyo baya tare da tiyata da maganin chemotherapy na adjuvant ya fara samun karbuwa a tsakanin likitocin da yawa.
Maganin Neoadjuvant yana ba da fa'idodi da yawa: magance cututtukan da ke cikin jiki da wuri, inganta isar da maganin chemotherapy, da kuma ingantattun sakamakon binciken histopathological (R0, N0). Duk da haka, har zuwa yau, babu wani gwaji da aka yi bazuwar da ya nuna fa'idar rayuwa ta maganin neoadjuvant.
Domin magance rashin bayanai a gwaje-gwajen da aka yi bazuwar, masu bincike daga cibiyoyi 12 a Norway, Sweden, Denmark da Finland sun ɗauki marasa lafiya da ke fama da cutar kansar kan pancreas da za a iya cirewa. Marasa lafiya da aka yi wa tiyata bazuwar an yi musu tiyata bazuwar FOLFIRINOX (mFOLFIRINOX) sau 12. Marasa lafiya da aka yi musu maganin neoadjuvant sun sami zagayowar FOLFIRINOX sau 4 sannan aka sake yin tiyata da kuma sake yin tiyata, sannan aka sake yin zagaye 8 na mFOLFIRINOX mai taimakawa. Babban abin da aka yi nazari a kai shi ne rayuwa gaba ɗaya (OS), kuma binciken ya ba da ƙarfin nuna ci gaba a rayuwa ta watanni 18 daga kashi 50% idan aka yi musu tiyata kafin a yi musu tiyata zuwa kashi 70% idan aka yi musu tiyatar neoadjuvant FOLFIRINOX.
Bayanan sun haɗa da marasa lafiya 140 da bazuwar suka kamu da cutar ECOG a matsayin 0 ko 1. A cikin rukunin farko na tiyata, an yi wa marasa lafiya 56 daga cikin 63 tiyata (89%) kuma 47 (75%) sun fara maganin chemotherapy na adjuvant. Daga cikin marasa lafiya 77 da aka ba wa maganin neoadjuvant, 64 (83%) sun fara magani, 40 (52%) sun kammala magani, 63 (82%) an yi musu tiyata, kuma 51 (66%) sun fara maganin adjuvant.
An lura da abubuwan da suka faru na rashin lafiya na aji ≥3 (AEs) a cikin kashi 55.6% na marasa lafiya da ke karɓar maganin neoadjuvant chemotherapy, galibi gudawa, tashin zuciya da amai, da kuma neutropenia. A lokacin maganin adjuvant chemotherapy, kusan kashi 40% na marasa lafiya a kowace rukunin jiyya sun sami matakin ≥3 AEs.
A cikin wani bincike da aka yi da nufin magance matsalar, matsakaicin rayuwa gaba ɗaya tare da maganin neoadjuvant shine watanni 25.1 idan aka kwatanta da watanni 38.5 tare da tiyata a gaba, kuma maganin neoadjuvant chemotherapy ya ƙara haɗarin rayuwa da kashi 52% (95% CI 0.94–2.46, P=0.06). Adadin rayuwa na watanni 18 shine kashi 60% tare da neoadjuvant FOLFIRINOX da kashi 73% tare da tiyata a gaba. Gwaje-gwajen kowace yarjejeniya sun samar da sakamako iri ɗaya.
Sakamakon binciken da aka yi kan cutar kansa ya fi dacewa da maganin cutar kansar da ba ta da magani, domin kashi 56% na marasa lafiya sun sami matsayin R0 idan aka kwatanta da kashi 39% na marasa lafiya da aka yi musu tiyata a gaba (P = 0.076) da kashi 29% sun sami matsayin N0 idan aka kwatanta da kashi 14% na marasa lafiya (P = 0.060). Binciken kowace yarjejeniya ya nuna bambance-bambance masu mahimmanci a kididdiga tare da FOLFIRINOX na neoadjuvant a matsayin R0 (59% vs. 33%, P = 0.011) da matsayin N0 (37% vs. 10%, P = 0.002).
Charles Bankhead babban editan cutar kansa ne kuma yana kula da ilimin fitsari, ilimin fata da kuma ilimin ido. Ya shiga MedPage Today a shekara ta 2007.
Ƙungiyar Kula da Cututtukan Daji ta ƙasar Norway, Hukumar Lafiya ta Yankin Kudu maso Gabashin Norway, Gidauniyar Sjoberg ta Sweden da Asibitin Jami'ar Helsinki ne suka tallafa wa wannan binciken.
Ko 披露了与 Clinical Care Options、Gerson Lehrman Group、Medscape、MJH Life Sciences、Research to Practice、AAdi、FibroGen、Genentech、GRAIL、Ipsen、Merus、Roche、AbGenomics、Apexigen、Astellas、BioMed Valley Discoveries “Bristol Myers Squibb” . Celgene, CrystalGenomics, Leap Therapeutics da sauran kamfanoni.
Ambato daga Tushe: Labori KJ da sauransu. “FOLFIRINOX na ɗan gajeren lokaci idan aka kwatanta da tiyatar da aka yi wa ciwon daji na pancreas: gwajin mataki na biyu na tsakiya da yawa (NORPACT-1),” ASCO 2023; Takaitaccen bayani game da LBA4005.
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Lokacin Saƙo: Satumba-22-2023