CHICAGO—Ọgwụ ọgwụgwọ Neoadjuvant enweghị ike ịka mma ịwa ahụ tupu oge eruo maka ndụ maka ọrịa kansa pancreas a na-ewepụ, obere nnwale na-egosi.
N'ụzọ a na-atụghị anya ya, ndị ọrịa a wachara ahụ maka oge mbụ dịrị ndụ karịa ndị natara obere usoro ọgwụgwọ FOLFIRINOX chemotherapy tupu a wa ha ahụ. Nsonaazụ a dị oke egwu ebe ọ bụ na ọgwụgwọ neoadjuvant jikọtara ya na oke ọnụọgụ ịwa ahụ na-adịghị mma (R0) dị elu nakwa na ọtụtụ ndị ọrịa nọ n'ìgwè ọgwụgwọ ahụ nwetara ọnọdụ node-negative.
"Nsochi ndị ọzọ nwere ike ịkọwa mmetụta ogologo oge nke mmezi na R0 na N0 na otu neoadjuvant," ka Knut Jorgen Laborie, MD, Mahadum Oslo, Norway, nzukọ American Society of Clinical Oncology. ASCO) kwuru. "Nsonaazụ ndị a anaghị akwado iji neoadjuvant FOLFIRINOX dị ka ọgwụgwọ ọkọlọtọ maka kansa pancreatic a na-ewepụ."
Nsonaazụ a tụrụ Andrew H. Ko, MD, nke Mahadum California, San Francisco, n'anya, onye a kpọrọ òkù ka ọ bịa na mkparịta ụka ahụ, o kwetakwara na ha anaghị akwado FOLFIRINOX, ọgwụ ọhụrụ a na-akpọ neoadjuvant dị ka ihe ọzọ maka ịwa ahụ tupu oge eruo. Mana ha anaghịkwa ewepụ ohere a. N'ihi mmasị ụfọdụ n'ọmụmụ ihe ahụ, ọ gaghị ekwe omume ikwu okwu doro anya gbasara ọnọdụ FOLFIRINOX, ọgwụ ọhụrụ a na-akpọ neoadjuvant n'ọdịnihu.
Ko kwuru na ọ bụ naanị ọkara nke ndị ọrịa ahụ mechara usoro ọgwụgwọ neoadjuvant anọ, "nke dị ala karịa ihe m tụrụ anya ya maka otu ndị ọrịa a, ndị usoro ọgwụgwọ anọ anaghị esiri ike maka ha…..Nke abụọ, gịnị mere nsonaazụ ịwa ahụ na ọrịa [ọnọdụ R0, N0] ji ebute ihe na-aga n'ihu na nsonaazụ ka njọ na otu neoadjuvant? Ghọta ihe kpatara ya ma mechaa gbanwee gaa na usoro ọgwụgwọ dabere na gemcitabine."
"Ya mere, anyị enweghị ike ịchọta nkwubi okwu siri ike site na nnyocha a gbasara mmetụta kpọmkwem nke FOLFIRINOX n'oge ọrụ na nsonaazụ ndụ... FOLFIRINOX ka dị, ọtụtụ ọmụmụ ihe na-aga n'ihu ga-enyekwa aka n'igosi ike ya n'ịwa ahụ a na-ewepụ." Ọrịa.
Laborie kwuru na ịwa ahụ yana ọgwụgwọ sistemụ dị irè na-enye nsonaazụ kacha mma maka kansa pancreas a na-ewepụ. Dịka ọ dị na mbụ, usoro nlekọta gụnyere ịwa ahụ ozugbo na ọgwụgwọ adjuvant. Agbanyeghị, ọgwụgwọ neoadjuvant nke na-esochi ịwa ahụ na ọgwụgwọ adjuvant chemotherapy amalitela ịba ụba n'etiti ọtụtụ ndị ọkachamara n'ọrịa kansa.
Ọgwụgwọ Neoadjuvant na-enye ọtụtụ uru nwere ike ịba uru: njikwa ọrịa sistemu n'oge, nnyefe chemotherapy ka mma, na nsonaazụ histopathological ka mma (R0, N0). Agbanyeghị, ruo taa, ọ dịghị nnwale enweghị usoro egosila nke ọma uru dị na neoadjuvant chemotherapy.
Iji dozie enweghị data na nnwale ndị a na-eme n'usoro, ndị nchọpụta si ebe iri na abụọ dị na Norway, Sweden, Denmark na Finland kpọbatara ndị ọrịa nwere kansa isi pancreas nke a na-ewepụ. Ndị ọrịa a na-eme n'usoro tupu a wa ha ahụ natara usoro iri na abụọ nke FOLFIRINOX (mFOLFIRINOX) nke a gbanwere agbanwe (adjuvant). Ndị ọrịa a na-enye ọgwụgwọ neoadjuvant natara usoro anọ nke FOLFIRINOX wee mee ya ugboro ugboro na ịwa ahụ, wee soro usoro asatọ nke mFOLFIRINOX nke a na-enye ọgwụgwọ. Isi ihe dị mkpa bụ ndụ zuru oke (OS), a nyekwara ọmụmụ ihe ahụ ike igosi mmụba na ndụ ọnwa 18 site na 50% site na ịwa ahụ tupu oge eruo ruo 70% na neoadjuvant FOLFIRINOX.
Data ahụ gụnyere ndị ọrịa 140 a na-enyeghị ọgwụgwọ nke nwere ọnọdụ ECOG 0 ma ọ bụ 1. N'ime otu ịwa ahụ mbụ, a wara mmadụ 56 n'ime ndị ọrịa 63 (89%) ahụ, ebe mmadụ 47 (75%) malitere ọgwụgwọ adjuvant. N'ime ndị ọrịa 77 e kenyere ọgwụgwọ neoadjuvant, mmadụ 64 (83%) malitere ọgwụgwọ, mmadụ 40 (52%) mechara ọgwụgwọ, mmadụ 63 (82%) ewepụchara ọgwụgwọ ahụ, mmadụ 51 (66%) malitere ọgwụgwọ adjuvant.
A hụrụ ihe ndị na-adịghị mma nke ọkwa ≥3 (AEs) n'ime 55.6% nke ndị ọrịa na-anata ọgwụgwọ neoadjuvant, ọkachasị afọ ọsịsa, ọgbụgbọ na agbọ agbọ, na neutropenia. N'oge ọgwụgwọ adjuvant chemotherapy, ihe dị ka 40% nke ndị ọrịa nọ n'otu ọgwụgwọ ọ bụla nwetara ọkwa ≥3 AEs.
N'ime nyocha ebumnuche ịgwọ ọrịa, ọnụọgụ ndụ zuru oke site na ọgwụgwọ neoadjuvant bụ ọnwa 25.1 ma e jiri ya tụnyere ọnwa 38.5 site na ịwa ahụ tupu oge eruo, chemotherapy neoadjuvant mụbara ohere nke ndụ site na 52% (95% CI 0.94–2.46, P=0.06). Ọnụọgụ ndụ nke ọnwa 18 bụ 60% site na neoadjuvant FOLFIRINOX na 73% site na ịwa ahụ tupu oge eruo. Nnwale kwa usoro ahụ nwetara nsonaazụ yiri nke ahụ.
Nsonaazụ nke ọrịa histopathological na-akwado neoadjuvant chemotherapy ebe 56% nke ndị ọrịa nwetara ọnọdụ R0 ma e jiri ya tụnyere 39% nke ndị ọrịa tupu ịwa ahụ (P = 0.076) na 29% nwetara ọnọdụ N0 ma e jiri ya tụnyere 14% nke ndị ọrịa (P = 0.060). Nyocha nke usoro kwa-protocol gosiri ọdịiche dị mkpa na neoadjuvant FOLFIRINOX na ọnọdụ R0 (59% vs. 33%, P = 0.011) na ọnọdụ N0 (37% vs. 10%, P = 0.002).
Charles Bankhead bụ onye nchịkọta akụkọ ọrịa kansa dị elu ma na-akọkwa gbasara urology, dermatology na ophthalmology. Ọ sonyeere MedPage Today na 2007.
Òtù Na-ahụ Maka Ọrịa Kansa nke Norway, Òtù Na-ahụ Maka Ahụike Mpaghara nke Ndịda Ọwụwa Anyanwụ Norway, Ntọala Sjoberg nke Sweden na Ụlọ Ọgwụ Mahadum Helsinki kwadoro nnyocha a.
Ọ bụ nhọrọ nlekọta ahụike, 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 na ụlọ ọrụ ndị ọzọ.
Isi mmalite nke ihe e dere: Labori KJ na ndị otu ya. “Ịwa ahụ FOLFIRINOX dị mkpirikpi ma e jiri ya tụnyere ịwa ahụ mbụ maka kansa isi pancreas nke a na-ewepụ: nnwale nke usoro nke abụọ nke etiti na-enweghị usoro (NORPACT-1),” ASCO 2023; Nchịkọta LBA4005.
Ihe ndị dị na weebụsaịtị a bụ maka ebumnuche ozi naanị, e meghịkwa ya iji dochie ndụmọdụ ahụike, nchọpụta, ma ọ bụ ọgwụgwọ sitere n'aka onye na-ahụ maka ahụike ruru eru. © 2005-2023 MedPage Today, LLC, ụlọ ọrụ Ziff Davis. Ikike niile echekwabara. Medpage Today bụ ụghalaahịa edebanyere aha nke MedPage Today, LLC, ndị ọzọ agaghịkwa eji ya na-enweghị ikike doro anya.
Oge ozi: Sep-22-2023