Hana ʻo AASraw i nā pauka NMN a me NRC i ka nui!

Regorafenib

 

  1. He aha ka Regorafenib?
  2. No ke aha i ʻae ʻia ai ʻo Regorafenib e FDA?
  3. Pehea e hana ai ʻo Regorafenib?
  4. He aha ka mea e hoʻohana ai ʻo Regorafenib Main?
  5. He aha nā pono o Regorafenib i hōʻike ʻia i loko o nā haʻawina?
  6. He aha nā pōpilikia / hopena e lawe mai ai ʻo Regorafenib?
  7. Pehea wau e mālama ai a i ʻole e hoʻolei ai iā Regorafenib?
  8. Nā ʻaoʻao e hiki mai ana o Regorafenib
  9. Panina

 

He aha Regorafenib?

ʻO Regorafenib (CAS: 755037-03-7), kūʻai ʻia ma lalo o ka inoa ʻo Stivarga me nā mea ʻē aʻe, he waha ia. mea hoʻoheheʻe maha-kinase hoʻomohala ʻia e Bayer e kuhikuhi ana i angiogenic, stromal a me oncogenic receptor tyrosine kinase (RTK). Hōʻike ʻo Regorafenib i ka hana anti-angiogenike ma muli o kāna pāpā ʻo VEGFR2-TIE2 tyrosine kinase inhibition ʻelua. Mai ka makahiki 2009 ua aʻo ʻia ia ma ke ʻano he koho koho kūpono ma nā ʻano tumo he nui. Ma ka 2015 he ʻelua mau ʻāpono a ʻAmelika no nā maʻi ʻoi loa.

 

No ke aha ʻo Regorafenib Ua'āponoʻia na FDA

ka Ka Hui Kūloko Hema ua hoʻoholo ʻoi aku ka nui o nā pono o Regorafenib ma mua o kāna mau pilikia a koi ʻia e ʻae ʻia no ka hoʻohana ʻana i ka EU. Ua hoʻomaopopo ke Kōmike i ka maʻi ʻaʻai kala i nā pōmaikaʻi e pili ana i ka hoʻolōʻihi ʻana i ke ola hoʻomanawanui he akahai, akā noʻonoʻo ʻia ua ʻoi aku lākou i ka nui o nā pilikia i nā mea maʻi no ka mea ʻaʻohe koho i koe e koe. Eia nō naʻe, no ka hopena o ka hopena, ua manaʻo ka CHMP he mea nui e ʻimi i nā ala e ʻike ai i nā lālā o nā mea maʻi e pane paha iā Stivarga.

E pili ana iā GIST a me HCC, ua hoʻomaopopo ke Kōmike he maikaʻi ʻole ka nānā ʻana no nā mea maʻi i ʻoi aku ka maʻi ma muli o ka mālama mua ʻana. Ua hōʻike ʻia ʻo Stivarga e hoʻopaneʻe i ka hōʻino ʻana o ka maʻi i kēia mau maʻi. No nā mea maʻi me HCC, alakaʻi kēia i kahi hoʻomaikaʻi i ka lōʻihi o ka manawa e ola ai nā mea maʻi. Hiki ke mālama ʻia nā hopena ʻaoʻao o Stivarga.

 

Pehea Regorafenib Hana? 

ʻO Regorafenib kahi mea mole mole mole mole o nā kinase i hoʻopili ʻia a me nā intracellular i pili i nā hana cellular maʻamau a me nā hana pathologic e like me oncogenesis, tumor angiogenesis, a me ka mālama ʻana i ka microen environment tumor. I nā in vitro biochemical a i ʻole nā ​​kelepona paʻalima, regorafenib a i ʻole kāna metabolites hana nui kanaka M-2 a me M-5 i kāohi i ka hana o RET, VEGFR1, VEGFR2, VEGFR3, KIT, PDGFR-alpha, PDGFR-beta, FGFR1, FGFR2, TIE2, DDR2, TrkA, Ef2A, RAF-1, BRAF, BRAFV600E, SAPK2, PTK5, a me Abl ma nā kukulu o ka regorafenib i loaʻa i ke kauka. I loko o nā hiʻohiʻona vivo, ua hōʻike ʻo regorafenib i ka hana anti-angiogenic i loko o kahi ʻōnaehana tumo iole, a me ka pāpā ʻana i ka ulu ʻana o ka puʻupuʻu a me nā hana anti-metastatic i loko o kekahi mau kiʻina xenograft iole e like me kekahi no ka carcinoma kala kanaka.

ʻO AASraw ka mea hana ʻoihana o Regorafenib.

E ʻoluʻolu e kaomi ma aneʻi no ka ʻike ʻōlelo. Hana iā mākou

 

He aha Regorafenib Hoʻohana ʻia no ka?

ʻO Regorafenib kahi lāʻau lapaʻau i loaʻa i ka lāʻau i hana regorafenib ka lehu. Hoʻohana ʻia iā ia iho e mālama i nā maʻi maʻi aʻe:

① Ka maʻi maʻi ʻaʻai kala (cancer of the bowel and rectum) i palahalaha aʻe i nā ʻāpana ʻē aʻe o ke kino;

Tumor Gastrointestinal stromal tumor (GIST, kahi maʻi ʻaʻai o ka ʻōpū a me ka ʻōpū) ua palahalaha a ʻaʻole hiki ke wehe ʻia i kahi ʻokiʻoki.

③ Hepatocellular carcinoma (HCC, kahi maʻi ʻaʻai o ke ake).

Hoʻohana ʻia ʻo Regorafenib i nā mea maʻi i mālama mua ʻia me, a i ʻole hiki ʻole ke hāʻawi ʻia, i nā lāʻau lapaʻau ʻē aʻe i loaʻa. No ka maʻi ʻaʻai kala, nā chemotherapy e pili ana i nā lāʻau i kapa ʻia fluoropyrimidines a me nā lāʻau me nā mea ʻē aʻe Ka maʻi 'aʻai nā lāʻau i ʻike ʻia ma ke ʻano he anti ‑ VEGF a me anti ‑ EGFR therapies. ʻO nā mea maʻi me GIST e hoʻāʻo e mālama me imatinib a me sunitinib a ʻo nā mea maʻi me HCC e hoʻāʻo i ka sorafenib ma mua o ka hoʻomaka ʻana me ka Regorafenib.

 

Regorafenib

 

He aha nā pono o Regorafenib i hōʻike ʻia i loko o Haʻawina?

 ʻO ka maʻi maʻamau

I loko o kahi noiʻi nui e pili ana i nā maʻi 760 me ka maʻi ʻaʻai kala metastatic i holomua ma hope o ka maʻamau maʻamau, ua hoʻohālikelike ʻia ʻo Regorafenib me kahi placebo (kahi mālama dummy) a ʻo ke ana nui o ka maikaʻi ke ola holoʻokoʻa (ka lōʻihi o ka manawa e ola ai nā mea maʻi). Ua loaʻa i nā maʻi āpau ke kōkua kākoʻo, e like me nā lāʻau ʻeha a me ka mālama ʻana no nā maʻi. Ua hōʻike ka noiʻi ua hoʻomaikaʻi ʻo Regorafenib i ke ola ʻana, me nā mea maʻi i mālama ʻia e noho ana no 6.4 mau mahina ma ka awelika, hoʻohālikelike ʻia me 5 mau mahina no kēlā mau placebo i hāʻawi ʻia.

 

 GIST(Nā Tumors Gastrointestinal Stromal Kūlana kiʻekiʻe)

Ma kahi noiʻi nui ʻē aʻe, ua hoʻohālikelike ʻia ʻo Regorafenib me kahi placebo ma 199 mau mea maʻi me GIST i pālahalaha ʻia a i ʻole hiki ʻole ke hoʻohana a hāʻawi ʻia hoʻi i ka mālama kākoʻo maikaʻi loa. Mālama nā kākoʻo me nā mālama ʻana e like me ke kōkua ʻana i ka ʻeha, nā antibiotic, a me nā transfusions o ke koko e kōkua ai i ka mea maʻi akā me ka ʻole o ka mālama ʻana i ka Ka maʻi 'aʻai. Ua hōʻike ʻia ka noiʻi ua maikaʻi ʻo Regorafenib me ke kākoʻo kākoʻo i ka hoʻolōʻihi ʻana i ka lōʻihi o ka manawa o ka poʻe maʻi me ka ʻole o ka maʻi e ʻino ai. ʻO nā maʻi i mālama ʻia me Regorafenib i noho ma ka awelika no 4.8 mau mahina me ka ʻole o ko lākou maʻi e ʻino ana ke hoʻohālikelike ʻia me nā mahina 0.9 no nā mea maʻi e lawe ana i ka placebo a me ke kākoʻo kōkua.

 

 HCC(Advanced Hepatocellular Carcinoma)

I loko o kahi noiʻi nui e pili ana i nā maʻi 573 me HCC i ʻoi aku ka maikaʻi ma hope o ka mālama ʻana me sorafenib, Regorafenib ua hoʻohālikelike ʻia me placebo a me ke ana nui o ka pono ke ola holoʻokoʻa. Ua loaʻa i nā maʻi āpau ke kōkua kākoʻo. Ua hōʻike ka noiʻi ua hoʻonui ʻo Stivarga i ka lōʻihi o ke ola ʻana o nā mea maʻi, me nā mea maʻi i mālama ʻia me Regorafenib e noho nei no 10.6 mau mahina ma ka awelika, hoʻohālikelike ʻia me 7.8 mau mahina no kēlā mau placebo i hāʻawi ʻia.

 

He aha nā pōpilikia / hopena i hana ai Regorafenib Hiki mai paha?

Infection. Hiki i ke Regorafenib ke alakaʻi i kahi kiʻekiʻe o nā maʻi a ʻoi loa o ka mimi, ihu, ʻāʻī a me ka akemāmā. Hiki i ke Regorafenib ke alakaʻi i kahi kiʻekiʻe o nā maʻi fungal o ka membrane mucous, ʻili a i ʻole ke kino. E haʻi koke aku i kāu kauka inā loaʻa ʻoe i ke kuni, kū ka maʻi me a me ka ʻole o ka hoʻonui ʻana o ka mucus (sputum), ka ʻehaʻeha nui, ka hanu ʻana, ka ʻeha a ʻeha paha i ka wā he mimi, hemo a he huhū paha ka ʻula, ʻulaʻula, pehu a ʻeha paha. i kēlā me kēia ʻāpana o ke kino

Skahe loa ʻana Hiki i ka Regorafenib ke hana i ke kahe o ke koko, i hiki ke koʻikoʻi a i kekahi manawa e alakaʻi i ka make. E haʻi i kāu kauka inā loaʻa nā hōʻailona o ke kahe ʻana i ka wā e lawe ana iā Regorafenib, e like me: ka luaʻi ʻana i ke koko a i ʻole inā like kou luaʻi me ka wai kope, ʻāpala a ʻeleʻele ʻeleʻele, ʻulaʻula a ʻeleʻele (e like me ka ʻākeʻakeʻa). ʻo ke kahe o ka menstrual ka mea ʻoi aku ke kaumaha ma mua o ka maʻamau, kahe ʻole o ka maʻi hepē, kahe o ka ihu e hana pinepine ʻia, palu a me ka ʻālohilohi.

A waimaka i loko o kou ʻōpū a i ʻole ka paia o kou ʻōpū (hāhā o ka ʻōpū). Hoʻokumu paha ʻo Regorafenib i kahi waimaka i loko o kou ʻōpū a i ʻole ka paia o kou ʻōpū i hiki ke koʻikoʻi a i kekahi manawa e alakaʻi i ka make. E kāhea koke aku i kāu kauka inā ʻike ʻoe i nā ʻeha nui a i ʻole ka pehu ʻana i kāu wahi o kou ʻōpū (ʻōpū), ke kuni, ka haʻalulu, kahoʻi, ka luaʻi, a i ʻole ka make wai.

A pilikia ʻili i kapa ʻia ka ʻili o ka wāwae wawae a me ka ʻeha o ka ʻili. Kūleʻa ka hopena o ka ʻili wāwae wāwae a i kekahi manawa hiki ke koʻikoʻi. E haʻi koke aku i kāu kauka inā loaʻa ʻoe i ka ʻulaʻula, ʻeha, palu, kahe ʻana o ke koko, a i ʻole ka pehu ʻana ma nā poho o kou mau lima a me nā wāwae o kou mau wāwae, a i ʻole ka ʻāwīwī koʻikoʻi.

Hke kahe o ke koko. Pono e nānā i kou kaomi koko i kēlā me kēia pule no nā pule 6 mua o ka hoʻomaka ʻana o Regorafenib. Pono e nānā pinepine i kou kaomi koko a mālama ʻia i ke koko kiʻekiʻe ke loaʻa iā Regorafenib. E haʻi i kāu kauka inā loaʻa ʻoe i ka ʻeha o ke poʻo, ke poʻo māmā, a i ʻole nā ​​loli i kāu hihiʻo.

Dke kahe o ke koko i ka puʻuwai a me ka puʻuwai. E loaʻa i ke kōkua pilikia inā loaʻa iā ʻoe ka ʻeha o ka umauma, loaʻa ka hanu liʻiliʻi, poniuniu, a manaʻo paha e hele i waho.

A ʻO ke ʻano i kapa ʻia ʻo leukoencephalopathy syndrome hope (RPLS). Kāhea koke aku i kāu kauka inā loaʻa ʻoe i ka ʻeha o ke poʻo, hopu, hilahila, hoʻololi i ka hihiʻo, a i ʻole nā ​​pilikia e noʻonoʻo nei

Risk o nā pilikia hoʻōla hōʻeha. ʻAʻole hiki ke hoʻōla pono nā ʻeha i ka wā Regorafenib lapaʻau. E haʻi i kāu kauka inā ʻoe e hoʻolālā e hana i kahi ʻoki ma mua o ka hoʻomaka ʻana a i ʻole i ka wā o ka mālama ʻana me Regorafenib.

▪ E hoʻōki ʻoe i ka lawe ʻana iā Regorafenib ma kahi o 2 mau pule ma mua o ka hoʻolālā ʻana i ke ʻoki.

▪ Pono e haʻi aku kāu kauka iā ʻoe ke hoʻomaka hou ʻoe e lawe iā Regorafenib ma hope o ke kahakaha ʻana.

ʻO nā hopena ʻaoʻao maʻamau me Regorafenib e pili ana i ka ʻeha me ka ʻōpū-ʻāpana (ʻōpū); luhi, nāwaliwali, māluhiluhi. diarrhea (neʻe pinepine a wehe paha i nā ʻōpū); hoʻemi i ka makemake; maʻi maʻi; hoʻololi leo a kani paha; hoʻonui i kekahi mau ho'āʻo hana ate; kuni; pehu, ʻeha, a ʻulaʻula o ka uhi ʻana i kou waha, ʻāʻī, ʻōpū, a me kou ʻōpū (mucositis); a me ka pohō kaumaha.

ʻO AASraw ka mea hana ʻoihana o Regorafenib.

E ʻoluʻolu e kaomi ma aneʻi no ka ʻike ʻōlelo. Hana iā mākou

 

Pehea wau e mālama ai a i ʻole e hoʻolei ai iā Regorafenib?

♦ E mālama i nā papa i ka ipu kumu i ka mahana o ka lumi. E hoʻopaʻa paʻa loa i ka pāpale. Mai lawe i ka pahu antimoisture a i ʻole ka pūʻolo.

♦ E hoʻolei i kahi ʻāpana i hoʻohana ʻole ʻia i 7 mau pule ma hope o ka wehe ʻana o ka ʻōmole.

♦ Hale kūʻai i kahi maloʻo. Mai mālama i loko o ka lua.

♦ E mālama i nā lāʻau āpau i kahi palekana. E mālama i nā lāʻau āpau mai kahi e hiki ai i nā keiki a me nā holoholona.

♦ Kiola i nā lāʻau i hoʻohana ʻole ʻia a make ʻole paha. Mai holoi i ka lua i lalo a ninini paha i kahi kahawai ke ʻole ʻoe e haʻi ʻia pēlā. E nīnau me kāu kauka lāʻau inā he mau nīnau kāu e pili ana i ke ala maikaʻi loa e hoʻolei ai i nā lāʻau. Aia paha he mau papahana hoʻihoʻi lāʻau i kou wahi.

 

Regorafenib

 

Nā kuhikuhi mua of Regorafenib

ʻElima mau makahiki ma hope o kona ʻae ʻia, noho mau ʻo regorafenib i lāʻau lapaʻau me ka lawelawe ʻana i nā lāʻau lapaʻau palena. Hoʻohana ʻia i ka maʻi ʻaʻai kala, GIST a me HCC no ka maʻi metastatic holomua wale nō. Hoʻohui ʻia me ke kumu kūʻai kiʻekiʻe, ʻaʻohe keu pono o ka maʻi i kēia manawa. Eia kekahi, ke mālama ʻia nei nā hoʻokolohua ʻokoʻa i mea e wehewehe ʻia ai ma ke ʻano he koho lapaʻau hou. ʻO nā kuhikuhi e hiki mai ana no kēia lāʻau lapaʻau me ka mālama ʻana i ka osteosarcoma. Ua hōʻike ʻia kahi placebo-kāohi ʻia, hoʻokolohua makapō makapō ʻelua ma Palani i ka hoʻonui ʻana o ke ola manuahi o ka holomua e kahi mea o 3 i nā maʻi me ka osteosarcoma metastatic i kūleʻa ʻole i kēlā me kēia laina lapaʻau. Hoʻoikaika, hōʻike kēia mau ʻike hou i ka pōmaikaʻi ma ka maʻi metastatic holomua ma ke ʻano he hopena hope loa, e like me nā hoʻohana i ʻae ʻia i kēia manawa.

Hōʻike nā ʻikepili i kēia manawa i ka hopena synergic hiki ma waena o regorafenib a me nā mea pale pale pale pale pale pale, e like me ia i hōʻike ʻia i ka hoʻokolokolo REGONIVO. (38% i ka maʻi ʻaʻai ʻōpū a me 44% i ka maʻi ʻaʻai kala) a me kahi ʻaoʻao hopena ʻae ʻia i ka hui hui. Ma muli paha o ka hōʻemi ʻana o nā macrophages e pili ana i ka tumo e regorafenib, e hoʻonui ana i ka ʻike o ka tumour i ka nivolumab. I kēia manawa, ke hoʻomaka nei ka hoʻokolokolo REGONIVO pae II a hiki koke ke hōʻoia i kēia kuhiakau. Hoʻohui ʻia, ua hōʻike kahi hoʻokolohua hoʻokolohua pae hope II i ka regorafenib ʻoi aku ma mua o ka lomustine i ka glioblastoma holomua a hoʻi hou. ʻO ka hoʻokolokolo REGOMA, ma Italia, ua hōʻike i kahi hoʻomaikaʻi nui i ke ola holoʻokoʻa (ka lākiō hiʻohiʻona 36; 0.50% ka manawa hilinaʻi 95-0.33; log-rank p = 0.75) ke hoʻohālikelike ʻia me ka lomustine therapy.

Ua mālama ʻia nā noiʻi REVERSE me regorafenib a me cetuximab i ka mālama ʻana i ka maʻi ʻaʻai kala metastatic colorectal. ʻO nā hopena i loaʻa ma ke kaʻina o ka hoʻohana ʻana o ia ʻano lāʻau i ka mālama ʻana i kēia maʻi ʻaʻai e hōʻike ana ʻo ke kauoha kūpono ke alakaʻi mua o regorafenib ukali ʻia e cetuximab, ʻokoʻa i ka protocol maʻamau i hoʻohana ʻia i kēia manawa. Ua hōʻike ʻia nā hopena i ke ola holoʻokoʻa o nā mea maʻi a ʻo ka pōmaikaʻi e like me ka hoʻoulu ʻia e ka hana nui o cetuximab ma mua o regorafenib ma ke ʻano ʻo ka lua o ka lāʻau.

KA INTEGRATE hoʻokolokolo o regorafenib Ua hōʻike maikaʻi ʻia ka monotherapy i ka maʻi ʻaʻai gastric ua ʻae maikaʻi ʻia kēia lāʻau lapaʻau a ʻaʻohe mea i hōʻino ʻia i ke ola o nā mea maʻi i hoʻohālikelike ʻia i ka poʻe i loaʻa kahi placebo a ʻaʻole i loaʻa ka hopena maikaʻi ʻole i kēlā mau palena mai ka ʻona. Ua hōʻike ʻia nā papahana noiʻi i nā pae pae o ka ʻeha, ka makemake, ka paʻa paʻa ʻana, a me ka hana ʻana i ke kino i mea nui prognostic no ke ola. Eia kekahi, ua hōʻike kēia hoʻokolohua i ka nui o ka hana a ka regorafenib i ka hopena ola mua ʻole o ka holomua. Eia hou, ka pae II Hana ʻia ka hoʻāʻo REDOS mai 2015-2018 a ua hōʻike nā mea kākau i kahi papa hana hoʻonui escalation no regorafenib kahi mea hiki ke loaʻa i ka papa hana dode regorafenib maʻamau o 160 mg / lā, keu hoʻi i nā mea maʻi me ka maʻi ʻaʻai metastatic colorectal. Ua ʻike ʻia ʻo nā mea maʻi i mālama ʻia me ka piʻi ʻana o ka lāʻau i ʻoi aku ka kiʻekiʻe o ka lāʻau ma hope o ka holomua a me ka helu i ʻoi aku ka lōʻihi o ke ola.

E pili ana i ka hoʻomanawanui ʻana i ka regorafenib ke hoʻohana ʻia e mālama i ka maʻi ʻaʻai kala, hiki ke loaʻa nā ʻike palena no ka hoʻomanawanui ʻana i ka heluna kanaka hoʻomanawanui, a pono e hoʻoholo ʻia e pili ana i ka pōmaikaʻi e ola ai a me ka ʻikepili o ka ʻawahia. Ke noʻonoʻo nei i kēia lāʻau i ka lawelawe HCC, hoʻolahalaha nā papahana noiʻi aia kahi ʻike ʻae ʻia a me ka hāʻawi ʻana o regorafenib i kahi pōmaikaʻi ola. Lapaʻau GIST, ʻōlelo kekahi mau mea kākau e ʻae maikaʻi ʻia ka regorafenib me ka loaʻa ʻole o nā mea ʻino i manaʻo ʻole ʻia.

Pono e noiʻi hou e hoʻoholo i nā mea maʻi e hiki ke loaʻa ka pōmaikaʻi nui mai kēia lāʻau. E like me ka 2019, ke hoʻāʻo nei nā hoʻokolohua inā Regorafenib hiki ke hoʻomaikaʻi i nā hopena i nā sarcomas nā mea palupalu, e like me ka osteogenic sarcoma, liposarcoma, Ewing sarcoma a me rhabdomyosarcoma.

 

Panina

ʻOiai ʻo 5 mau makahiki o ka ʻae a me nā lāʻau lapaʻau i hoʻohiki ʻia, ua hōʻike ʻo regorafenib i ka palena, akā nui ka helu, ke kōkua no nā ʻano tumole paʻa. ʻO nā hōʻailona i hōʻailona ʻia i loko o ka maʻi ʻaʻai kala, GIST a me HCC. Ua hōʻike ʻia nā hoʻokolohua pae holomua ʻoi loa i nā hoʻomaikaʻi nui ʻana i ke ola ʻana no ka maʻi ʻaʻai gastric, glioblastoma a me ka osteosarcoma, kahi e hōʻike ai i ka hoʻopili ʻia o ka wā e hiki mai ana i nā hōʻailona hōʻailona.

Hōʻike ʻia ka hoʻohuihui hoʻohui ʻia ʻana me nā mea hoʻopale nānā check immune i mea maikaʻi ma nā hoʻokolohua pae I, a ke hana ʻia nei nā hoʻokolohua pae II. I kēia manawa, ʻimi ʻia ʻo regorafenib no nā maʻi ʻē aʻe pū kekahi. Hiki ke hoʻohana ʻia i nā hopena ʻaoʻao āpau e like me nā māka no nā hopena maikaʻi me ka lāʻau. I waena o kēlā mau mea, ʻo ka maʻi lima-wāwae a me ka hypothyroidism ka mea i pili loa i ke ola ʻana. I ka hōʻuluʻulu ʻana, ua hōʻike ʻia nā noiʻi e hiki i ka regorafenib ke hoʻomaikaʻi i ke ola me ka ʻae ʻana me ka ʻae ʻana i nā tumors paʻa.

ʻO AASraw ka mea hana ʻoihana o Regorafenib.

E ʻoluʻolu e kaomi ma aneʻi no ka ʻike ʻōlelo. Hana iā mākou

 

Reference

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