Yini i-Bevacizumab: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Bevacizumab iyikhambi lomdlavuza eliqondiwe elisiza ukunciphisa ukukhula kwesimila ngokuvimba ukwakheka kwemithambo yegazi. Lokhu kwelashwa okukhethekile kusebenza ngokuqeda ukuhlinzekwa kwegazi okudingwa yizimila ukuze zikhule futhi zisakazeke emzimbeni wakho wonke.

Njenge-monoclonal antibody, i-bevacizumab imelela indlela eqondile yokwelashwa komdlavuza uma iqhathaniswa ne-chemotherapy yendabuko. Udokotela wakho we-oncologist angase ancome lo muthi njengengxenye yohlelo lwakho olubanzi lokunakekelwa komdlavuza, ngokuvamile kanye nokunye ukwelashwa ukukunikeza umphumela ongcono kakhulu.

Yini i-Bevacizumab?

I-Bevacizumab iyiphrotheni eyenziwe e-laboratory elingisa ama-antibody emvelo omzimba wakho wokuzivikela. Iqondise ngqo iphrotheni ebizwa nge-VEGF (vascular endothelial growth factor) esetshenziswa yizimila ukudala imithambo yegazi emisha.

Cabanga nge-VEGF njengesiginali etshela umzimba wakho ukuthi wakhe imigwaqo emikhulu yokugeleza kwegazi. Amaseli omdlavuza athumela izimpawu eziningi zalezi ukuze athole izakhamzimba azidingayo ukuze akhule. I-Bevacizumab ivimba lezi zimpawu, empeleni iqeda ukuhlinzekwa kokudla kwesimila.

Lo muthi ungowesigaba esibizwa ngokuthi ama-angiogenesis inhibitors, okusho ukuthi ivimbela ukwakheka kwemithambo yegazi emisha. Ngokwenza lokhu, kungasiza ukunciphisa ukukhula komdlavuza futhi kwenze ezinye izindlela zokwelapha umdlavuza zisebenze ngempumelelo.

Yini i-Bevacizumab Esizenzelwe Yona?

I-Bevacizumab iphatha izinhlobo eziningana zomdlavuza othuthukile, ikakhulukazi uma usakazekile noma ubuyile ngemva kokwelashwa kokuqala. Udokotela wakho uyayibhala lapho amaseli omdlavuza esethuthukise amanethiwekhi awo okuhlinzekwa kwegazi.

Imidlavaza evame kakhulu ephathwa nge-bevacizumab ihlanganisa umdlavuza we-colorectal, umdlavuza wamaphaphu, umdlavuza wezinso, kanye nezimila ezithile zobuchopho ezibizwa ngokuthi ama-glioblastomas. Isetshenziselwa futhi eminye imidlavaza ye-gynecologic efana ne-ovarian kanye nomdlavuza womlomo wesibeletho.

Udaktela wakho we-oncologist uvame ukuhlanganisa i-bevacizumab ne-chemotherapy kunokuyisebenzisa yodwa. Le ndlela yokuhlanganisa ivame ukusebenza kangcono kunanoma yikuphi ukwelashwa ngokwako, inike umzimba wakho izindlela eziningi zokulwa nomdlavuza.

Kwezinye izimo, odokotela basebenzisa i-bevacizumab ezimweni zamehlo ezinjengokuguga okuhlobene ne-macular degeneration, nakuba lokhu kudinga ukwakheka okuhlukile kanye nohlelo lokulinganisa kunokwelashwa komdlavuza.

Isebenza Kanjani I-Bevacizumab?

I-Bevacizumab isebenza ngokubopha amaprotheni e-VEGF egazini lakho, iwavimbela ukuthi anamathele kuma-receptors kumaseli emithambo yegazi. Lokhu kuvimba isignali ebizotshela umzimba wakho ukuthi ukhulise imithambo emisha yegazi ngase-tumor.

Njengokwelashwa okuhloswe ngakho, i-bevacizumab ithathwa njengomuthi onamandla aphakathi nendawo osebenza ngendlela ehlukile kune-chemotherapy yendabuko. Esikhundleni sokubulala ngokuqondile amaseli omdlavuza, iwaqeda ngokunqamula ukuhlinzekwa kwawo kwegazi.

Umuthi ujikeleza egazini lakho amasonto amaningana ngemva kokufakwa ngakunye. Ngesikhathi lesi, iqhubeka ivimba amasignali e-VEGF, isiza ukujwayela amanethiwekhi emithambo yegazi angahlelekile adalwa ama-tumor.

Le ndlela ingenza ama-tumor abe sengozini enkulu yokwelashwa okuhlukile okufana ne-chemotherapy noma imisebe, yingakho odokotela bevame ukusebenzisa i-bevacizumab njengengxenye yokwelashwa okuhlanganisiwe kunokuba yodwa.

Kufanele Ngiyithathe Kanjani I-Bevacizumab?

I-Bevacizumab inikezwa kuphela ngokufakwa kwe-intravenous (IV) esikhungweni sokwelashwa komdlavuza noma esibhedlela. Awukwazi ukuthatha lo muthi ngomlomo noma ukuzijova ekhaya.

Ukufakwa kwakho kokuqala kuvame ukuthatha imizuzu engaba ngu-90, okuvumela ithimba lakho lezokwelapha ukuthi liqaphe ukuthi umzimba wakho usabela kanjani. Uma ukubekezelela kahle, ukufakwa okulandelayo kungancishiswa kube imizuzu engu-60, futhi ekugcineni kube imizuzu engu-30.

Akudingeki ukuthi uzile ngaphambi kokwelashwa, kodwa ukudla ukudla okulula ngaphambi kwesikhathi kungakusiza ukuthi uzizwe ukhululekile ngesikhathi sokufakwa. Letha amanzi nokudla okulula, njengoba uzohlala isikhathi eside.

Umhlengikazi wakho wokufakwa uzohlola izimpawu zakho ezibalulekile njalo futhi aqaphele noma yiziphi izimpendulo ngokushesha. Umuthi uhlanganiswe nesixazululo se-saline futhi unikezwa kancane ngomugqa wakho we-IV ukuze kuncishiswe imiphumela emibi.

Kufanele Ngithathe Isikhathi Esingakanani I-Bevacizumab?

Ubude bokwelashwa nge-bevacizumab buhlukahluka kakhulu kuye ngohlobo lomdlavuza wakho, isigaba, nokuthi usabela kahle kangakanani ekwelashweni. Iziguli eziningi zithola ukufakwa njalo ngemva kwamasonto angu-2-3 izinyanga eziningana.

Udokotela wakho we-oncologist uzoqapha umdlavuza wakho ngokusebenzisa izithombe ezivamile nokuhlolwa kwegazi ukuze anqume ukuthi ukwelashwa kuyasebenza yini. Uma umdlavuza wakho usabela kahle futhi ukwazi ukumelana nomuthi, ukwelashwa kungaqhubeka izinyanga eziyi-6-12 noma ngaphezulu.

Ezinye iziguli ziqhubeka ne-bevacizumab njengokwelashwa kokugcinwa ngisho nangemva kokuba umdlavuza wabo ubonakala ulawulwa. Lokhu kwelashwa okuqhubekayo kusiza ekuvikeleni umdlavuza ekuthuthukiseni imithambo emisha yegazi futhi ekwazi ukukhula futhi.

Udokotela wakho uzoxoxa ngokuyeka ukwelashwa uma umdlavuza wakho uqhubeka naphezu kokwelashwa, uma uthola imiphumela emibi engathi sína, noma uma udinga ukuhlinzwa okudinga isikhathi sokuphola.

Yiziphi Imiphumela Emibi ye-Bevacizumab?

Ukuqonda imiphumela emibi engaba khona kukusiza ukuthi wazi ukuthi yini ongayilindela nokuthi ungaxhumana nini nethimba lakho lezempilo. Abantu abaningi bathola eminye imiphumela emibi, kodwa ngokuvamile iyaphathwa ngosekelo olufanele nokuqapha.

Imiphumela emibi evamile abantu abaningi abayitholayo ihlanganisa umfutho wegazi ophezulu, ukukhathala, nokopha emakhaleni. Ungase futhi uqaphele izinguquko ekunambithekeni kwakho, isicanucanu esincane, noma ukukhula kokulimala ngenxa yezigaxa ezincane.

Nansi imiphumela emibi ebikwa kaningi:

• Umfutho wegazi ophezulu odinga ukulungiswa kwemithi
• Ukukhathala nobuthakathaka obungase buqine ngokuhamba kwesikhathi
• Ukuphuma kwegazi emakhaleni noma ezinye izigameko ezincane zokuphuma kwegazi
• Amaprotheni emchameni wakho atholwe ngokuhlolwa okuvamile
• Ushintsho lokunambitheka oluthinta ukudla kwakho
• Ukucanuzela kwenhliziyo okuncane kuya kokulingene
• Ukuvuvukala okukhulu noma ukuphola kwamanxeba okuhamba kancane

Imiphumela emibi engathi sína idinga ukunakekelwa kwezokwelapha ngokushesha, nakuba yenzeka kaningi. Lezi zinkinga zingaba yingozi ekuphileni uma zingalungiswa ngokushesha yithimba lakho lezempilo.

Imiphumela emibi engavamile kodwa engathi sína ihlanganisa:

• Ukuphuma kwegazi okukhulu esiswini sakho, emaphashini, noma ebuchosheni
• Amaqhubu egazi emilenzeni yakho, emaphashini, noma enhliziyweni
• Izimbobo noma izinyembezi odongeni lwamathumbu akho (ukugqobhoza)
• Inkinga enkulu yomfutho wegazi ophezulu
• Izinkinga zenhliziyo ezihlanganisa ukwehluleka kwenhliziyo
• Umonakalo wezinso nokulahleka kwamaprotheni
• Ukungezwani komzimba okukhulu ngesikhathi sokufakwa

Ithimba lakho lezokwelapha liqapha lezi zinkinga ezingathi sína ngokuhlolwa kwegazi okuvamile, ukuhlolwa komfutho wegazi, nokuhlolwa komzimba. Ukutholwa kusenesikhathi nokwelashwa kwemiphumela emibi kungavimbela izinkinga eziningi ukuthi zingabi yingozi.

Ubani Ongafanele Athole i-Bevacizumab?

Ezinye izimo zezokwelapha nezimo zenza i-bevacizumab ingaphephile noma idinga izinyathelo zokuphepha ezikhethekile. Udokotela wakho we-oncologist uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuncoma lokhu kwelashwa.

Akufanele uthole i-bevacizumab uma ukhulelwe njengamanje noma uhlela ukukhulelwa, njengoba kungabangela ukukhubazeka okukhulu kokuzalwa. Abesifazane abaneminyaka yokuzala kufanele basebenzise izindlela zokuvimbela inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nezinyanga eziyisithupha ngemva kwalokho.

Abantu abahlinzwe ngemva kwesikhathi esifushane noma izinqubo zokuhlinzwa ezihleliwe ngokuvamile abakwazi ukuthola i-bevacizumab. Umuthi uphazamisa ukuphola kwamanxeba, ngakho-ke uzodinga ukuyeka ukwelashwa okungenani izinsuku ezingama-28 ngaphambi kwanoma yikuphi ukuhlinzwa okuhleliwe.

Ezinye izimo ezingase zivimbele ukusetshenziswa kwe-bevacizumab zihlanganisa:

• Umfutho wegazi ophezulu ongagadiwe ngaphandle kwemithi
• Umlando wakamuva wezigameko zokuphuma kwegazi ezinzima
• Izifo zamanje zokujiya kwegazi
• Isifo senhliziyo esibi noma ukuhlaselwa yinhliziyo kwakamuva
• Izifo ezisebenzayo ezingaphenduli emithini
• Isifo sezinso esibi ngokulahlekelwa amaprotheni
• Ukushaywa unhlangothi kwakamuva noma ukuphuma kwegazi ebuchosheni

Udokotela wakho uzoqondanisa izinzuzo ezingaba khona neziyingozi zalesi simo sakho esithile. Ngezikhathi ezithile ukuguqulwa kohlelo lwakho lokwelashwa noma ukuqapha okwengeziwe kungenza i-bevacizumab iphephe kubantu abanezimo ezithile.

Amagama Omkhiqizo we-Bevacizumab

I-Bevacizumab itholakala ngaphansi kwamagama amaningi omkhiqizo, i-Avastin iyona eyamukelwa kakhulu. Lolu hlobo lomkhiqizo luye lwasetshenziswa ekwelashweni komdlavuza iminyaka eminingi ngocwaningo oluningi olusekela ukusebenza kwayo.

Izinhlobo ze-biosimilar ze-bevacizumab manje ziyatholakala, zinikeza izinzuzo ezifanayo zokwelapha ngezindleko ezingase zibe ngaphansi. Lokhu kuhlanganisa i-Mvasi, i-Zirabev, ne-Alymsys, zonke ezivunyelwe njengezilingana ne-Avastin yasekuqaleni.

Umshwalense wakho ungase uthonye ukuthi yiluphi uhlobo udokotela wakho alubhala, kodwa zonke izinhlobo ezivunyelwe ziqukethe isithako esifanayo esisebenzayo futhi zisebenza ngokufanayo emzimbeni wakho. Ukukhetha phakathi kwemikhiqizo kuvame ukuncika ekutholakaleni nasekubhekeni izindleko kunokwehluka kwezokwelapha.

Ezinye izindlela ze-Bevacizumab

Eminye imithi eminingi isebenza ngendlela efanayo ne-bevacizumab ngokugxila ekwakhekeni kwemithambo yegazi, nakuba ngalinye linobunjalo obuhlukile nokusetshenziswa okuvunyelwe. Udokotela wakho we-oncologist angase acabangele lezi ezinye izindlela ngokusekelwe ohlotsheni lwakho oluthile lomdlavuza nomlando wezokwelapha.

I-Ramucirumab (Cyramza) ngomunye umuthi oqondiswe ku-VEGF osetshenziswa ikakhulukazi emithanjeni yesisu namaphaphu. Isebenza ngendlela ehlukile kancane kodwa izuza imiphumela efanayo ekuvimbeleni ukukhula kwemithambo yegazi yomdlavuza.

Ezinye izinto ezivimbela i-angiogenesis zihlanganisa i-aflibercept (Zaltrap) yomdlavuza we-colorectal kanye ne-regorafenib (Stivarga) yomdlavuza we-colorectal nesibindi othuthukile. Le mithi inikeza izinketho zokuphathwa ngomlomo, okuyinto ezinye iziguli ezikhetha ukuyenza ngaphezu kokufakwa kwe-IV.

Ngeminye imidlavuza, imithi ye-immunotherapy efana ne-pembrolizumab (Keytruda) noma i-nivolumab (Opdivo) ingase icatshangelwe esikhundleni se-bevacizumab, noma ngasohlangothini lwayo, kuye ngezici ezithile zomdlavuza wakho kanye nama-biomarker.

Ingabe i-Bevacizumab Ingcono Kunezinye Izidakamizwa Ezifanayo?

I-Bevacizumab yaba ngumvimbeli wokuqala we-VEGF ovunyelwe futhi inemininingwane eminingi yocwaningo esekela ukusetshenziswa kwayo ezinhlotsheni eziningi zomdlavuza. Le rekhodi ende isiza odokotela ukuthi baqagele ukuthi ungasabela kanjani ekwelashweni.

Uma kuqhathaniswa nezinye izindlela ezintsha ezifana ne-ramucirumab, i-bevacizumab ivame ukuba nezinhlanganisela zokwelapha eziningi ezitholakalayo kanye nokuvunywa okubanzi kwezinhlobo ezahlukene zomdlavuza. Kodwa-ke, ukukhetha

I-Bevacizumab ingawuthinta umzimba wakho we-cardiovascular, ngakho-ke abantu abanezimo zenhliziyo ezikhona badinga ukuqapha okwengeziwe nezinyathelo zokuphepha. Udokotela wakho wenhliziyo kanye nodokotela we-oncologist bazosebenzisana ukunquma ukuthi izinzuzo zidlula izingozi.

Uma unesifo senhliziyo esithambile esilawulwa kahle, ungase ukwazi ukuthola i-bevacizumab ngokuqapha okwengeziwe kwenhliziyo. Lokhu kufaka phakathi ama-ECG avamile, ama-echocardiograms, nokuphathwa ngokucophelela komfutho wegazi ngesikhathi sokwelashwa.

Abantu abanenhliziyo ehlulekayo, ukuhlaselwa yinhliziyo kwakamuva, noma umfutho wegazi ophezulu ongagadiwe ngokuvamile abakwazi ukuthola i-bevacizumab ngokuphepha. Umuthi ungenza lezi zimo zibe zimbi futhi wandise ingozi yezinkinga ezinkulu ze-cardiovascular.

Kufanele Ngenzeni Uma Ngithola I-Bevacizumab Engaphezu Kakhulu Ngengozi?

Ukweqisa kwe-Bevacizumab akuvamile kakhulu ngoba inikezwa ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni zokunakekelwa kwezempilo ezilawulwayo. Umuthi ubhalwa ngokucophelela ngokuya ngesisindo somzimba wakho futhi unikezwa kancane kancane ngokufakwa kwe-IV okuqashwe.

Uma usola ukuthi uthole umthamo ongalungile, yazisa umhlengikazi wakho wokufaka noma udokotela ngokushesha. Bangabuyekeza amarekhodi akho okwelashwa futhi bakuqaphe eduze nganoma yimiphi imiphumela engavamile.

Izimpawu ezingase zikhombise izinkinga zokulinganisa zifaka ikhanda elibuhlungu eliqinile, umfutho wegazi ophezulu kakhulu, ukuphuma kwegazi okungavamile, noma isicanucanu esiqinile. Ithimba lakho lokunakekelwa kwezempilo liyazi ukuthi lingazisingatha kanjani lezi zimo futhi lizohlinzeka ngokunakekelwa okufanele.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Bevacizumab?

Xhumana nethimba lakho le-oncology ngokushesha ngangokunokwenzeka uma uphuthelwa ukufakwa kwe-bevacizumab okuhleliwe. Bazokuhlela kabusha ngesikhathi esifanele kakhulu ukuze ugcine ukusebenza kokwelashwa kwakho.

Udktela wakho angase alungise uhlelo lwakho lokwelashwa kancane ukuze kulungelwe umthamo ongawutholanga, kodwa ungazami "ukulungisa" ngokuthola imithamo eseduze. Isikhathi phakathi kokufakwa kwemithi kuhlelwe ngokucophelela ukuze kulinganiswe ukusebenza kahle nokuphepha.

Ukwenza iphutha lomthamo owodwa ngokuvamile akuthinti kakhulu umphumela wakho wokwelashwa, ikakhulukazi uma uqala kabusha uhlelo lwakho olujwayelekile ngokushesha. Udktela wakho we-oncologist uzoqapha impendulo yakho futhi angase ancome ukuskena okwengeziwe ukuze aqinisekise ukuthi umdlavuza wakho usalawulwa.

Ngingayeka nini ukuthatha i-Bevacizumab?

Isinqumo sokuyeka i-bevacizumab sincike ezintweni eziningana okuhlanganisa ukusabela komdlavuza wakho ekwelashweni, imiphumela emibi oyitholayo, kanye nesimo sakho sempilo esiphelele. Udktela wakho we-oncologist uzoqondisa lesi sinqumo ngokusekelwe ekuqapheni njalo.

Ungase uyeke ukwelashwa uma umdlavuza wakho uqhubeka ngaphandle kokwelashwa, uma uthola imiphumela emibi engaphezu kwezinzuzo, noma uma udinga ukuhlinzwa okudinga ukuphola kahle kwamanxeba.

Ezinye iziguli ziyeka i-bevacizumab ngemva kokuqeda inkambo yokwelashwa ehleliwe, kanti ezinye ziqhubeka uma nje isiza ukulawula umdlavuza wazo futhi zikwazi ukuyibekezelela kahle. Akukho "suku lokuphela" oluqediwe kuwo wonke umuntu.

Ungalokothi uyeke i-bevacizumab ngokwakho ngaphandle kokuxoxa ngayo nodktela wakho we-oncologist kuqala. Ukuyeka kungazelelwe ngeke kubangele izimpawu zokuhoxisa eziyingozi, kodwa kungase kuvumele umdlavuza wakho ukuthi uqhubeke ngokushesha kunokulindelekile.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Bevacizumab?

Ukuphuza utshwala ngokulinganisela kuvamile ukwamukeleka ngenkathi uthola i-bevacizumab, kodwa kufanele uxoxe ngemikhuba yakho yokuphuza nodktela wakho we-oncologist. Utshwala bungasebenzisana neminye imithi oyithathayo futhi bungase luqhubekisele phambili imiphumela emibi ethile.

Njengoba i-bevacizumab ingathinta umfutho wegazi lakho futhi ikhulise ingozi yokopha, utshwala bungase luqhubekisele phambili le miphumela. Uma ukhetha ukuphuza, zilinganisele esiphuzweni esisodwa ngosuku futhi ugweme utshwala eduze kwezinsuku zakho zokufakwa kwemithi.

Qaphela ukuthi utshwala bukulimaza kanjani ngesikhathi sokwelashwa, njengoba imithi yomdlavuza ingashintsha ukubekezelelana kwakho. Ezinye iziguli zithola ukuthi zizwa imiphumela yotshwala ngamandla noma zithola ukukhathala okwandayo uma zikuhlanganisa ne-bevacizumab.