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

I-Durvalumab uhlobo lomuthi wokwelapha umdlavuza oqeda ukuzivikela emzimbeni okusiza amasosha akho omzimba ukuthi alwe nezinhlobo ezithile zomdlavuza ngempumelelo. Inikezwa nge-IV (intravenous) infusion, okusho ukuthi ingena ngqo emsingeni wakho wegazi ngomthambo engalweni yakho noma esifubeni.

Lo muthi ungowodwa ohlwini lwemithi ebizwa ngokuthi ama-checkpoint inhibitors, asebenza ngokususa “amabhuleki” amaseli omdlavuza awabeka ohlelweni lwakho lokuzivikela emzimbeni. Cabanga ngakho njengokusiza izivikelo zemvelo zomzimba wakho ukuthi zibone futhi zihlaselwe amaseli omdlavuza abecashe ngaphambilini ekutholakaleni.

Yini i-Durvalumab Esetshenziselwa Yona?

I-Durvalumab isetshenziselwa ikakhulukazi ukwelapha izinhlobo ezithile zomdlavuza wamaphaphu nomdlavuza wesinye. Udokotela wakho unquma lo muthi lapho ezinye izindlela zokwelapha zingasebenzanga noma lapho umdlavuza usabalalele kwezinye izingxenye zomzimba wakho.

Izimo eziyinhloko i-durvalumab eziphatha ngazo zihlanganisa umdlavuza wamaphaphu ongahlangani (NSCLC) ongazange usabalale kakhulu nezinhlobo ezithile zomdlavuza wesinye othuthukile. Ivame ukusetshenziswa ngemva kokuqeda ukwelashwa ngemisebe noma lapho umdlavuza ubuyile naphezu kokunye ukwelashwa.

Ngemdlavuza wamaphaphu, i-durvalumab ivame ukunikezwa lapho umdlavuza usesigabeni III, okusho ukuthi uthuthukiswe endaweni kodwa awuzange usabalalele ezingxenyeni ezikude zomzimba wakho. Ezimweni zomdlavuza wesinye, ngokuvamile igcinelwe izigaba ezithuthukile lapho umdlavuza usabalale ngaphandle kwesinye uqobo.

Isebenza Kanjani i-Durvalumab?

I-Durvalumab isebenza ngokuvimba iphrotheni ebizwa nge-PD-L1 esetshenziswa amaseli omdlavuza ukucasha ohlelweni lwakho lokuzivikela emzimbeni. Lapho le phrotheni ivalekile, amaseli akho omzimba angakwazi ukubona kangcono futhi ahlaselwe umdlavuza.

Uhlelo lwakho lokuzivikela emzimbeni lunama-checkpoints akhelwe ngaphakathi okuvimbela ukuthi lingahlaseli amaseli anempilo. Amaseli omdlavuza ngokuhlakanipha asebenzisa lawo ma-checkpoints ukuze azivikele. I-Durvalumab isusa lokhu kuvikela, ivumela uhlelo lwakho lokuzivikela emzimbeni ukuthi lwenze umsebenzi walo ngempumelelo.

Lo muthi uthathwa njengokwelashwa okuqondiwe kunokwelashwa ngamakhemikhali okwesintu. Ngokuvamile unomusa emzimbeni wakho kunokwelashwa komdlavuza okujwayelekile, nakuba kungase kubangele imiphumela emibi njengoba amasosha akho omzimba eba matasa.

Kufanele Ngiyithathe Kanjani I-Durvalumab?

I-Durvalumab inikezwa njenge-IV infusion esibhedlela noma esikhungweni sokwelashwa komdlavuza. Awukwazi ukuthatha lo muthi ekhaya noma ngomlomo - kufanele unikezwe ochwepheshe bezempilo abaqeqeshiwe.

I-infusion ngokuvamile ithatha imizuzu engaba ngu-60 ukuze iqede. Uzohlala kahle esihlalweni ngenkathi umuthi ugeleza ngomugqa we-IV ungena egazini lakho. Abantu abaningi bathola ukwelashwa njalo emavikini ama-2 kuya kwangu-4, kuye ngesimo sabo esithile.

Ngaphambi kwe-infusion ngayinye, ithimba lakho lezempilo lizohlola izimpawu zakho ezibalulekile futhi lingakunika imithi yokuvimbela ukusabela komzimba. Akudingeki ukuthi uzile ukudla ngaphambi kokwelashwa, futhi ungadla ngokujwayelekile ezinsukwini zokwelashwa. Ukuhlala unamanzi ngokwanele ngokuphuza amanzi amaningi kuyasiza.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Durvalumab?

Ubude bokwelashwa nge-durvalumab buhlukahluka kakhulu ngokuya ngohlobo lomdlavuza wakho oluthile nokuthi usabela kahle kangakanani emuthini. Abanye abantu bathola ukwelashwa izinyanga eziningana, kanti abanye bangase baqhubeke isikhathi esingaphezu konyaka.

Ukuze uthole umdlavuza wamaphaphu, ukwelashwa ngokuvamile kuqhubeka izinyanga eziyi-12 uma ukubekezelela kahle futhi umdlavuza wakho ungahambeli phambili. Ukuze uthole umdlavuza wesinye, ukwelashwa kungase kuqhubeke unomphela uma nje kusiza ukulawula umdlavuza wakho futhi kungabangeli imiphumela emibi kakhulu.

Udokotela wakho uzohlola njalo inqubekela phambili yakho ngokuskena nokuhlolwa kwegazi. Bazolungisa uhlelo lwakho lokwelashwa ngokusekelwe ekutheni umdlavuza wakho usabela kanjani nokuthi umzimba wakho ukusingatha kanjani umuthi. Umgomo uwukuqhubeka nokwelashwa uma nje kukuzuzisa ngaphandle kokubangela imiphumela emibi engamukeleki.

Yini Imiphumela Emiqoka Ye-Durvalumab?

I-Durvalumab ingabangela imiphumela emibi ngoba yenza ngcono amasosha akho omzimba, okwenzeka ukuthi ahlasela izicubu ezinempilo kanye namaseli omdlavuza. Imiphumela eminingi emibi iyalawuleka, kodwa eminye ingaba yingozi futhi idinga ukunakekelwa kwezokwelapha ngokushesha.

Nawa amanye emiphumela emibi evame kakhulu ongase uhlangabezane nayo ngesikhathi sokwelashwa:

• Ukukhathala nokuzizwa ukhathele kakhulu kunokujwayelekile
• Ukukhwehlela noma ukuphefumula kanzima
• Ukuqubuka kwesikhumba noma ukuluma
• Ukuqunjelwa noma izinguquko ekuhambeni kwamathumbu
• Ukuncipha kwesifiso sokudla
• Ubuhlungu bemisipha noma amalunga
• Isicanucanu

Le miphumela emibi ejwayelekile ngokuvamile ithuthuka kancane kancane futhi ingalawulwa ngokunakekelwa okusekelayo nemithi. Ithimba lakho lezempilo lizosebenza nawe ukunciphisa noma yikuphi ukungakhululeki.

Ngenkathi kungavamile, i-durvalumab ingabangela imiphumela emibi engathi sína edinga ukunakekelwa kwezokwelapha ngokushesha. Lokhu kwenzeka lapho amasosha akho omzimba asebenzayo ehlasela izitho ezinempilo emzimbeni wakho.

Imiphumela emibi engathi sína edinga ukunakekelwa okuphuthumayo ihlanganisa:

• Ukuvuvukala okukhulu kwamaphaphu (i-pneumonitis) okubangela ukukhwehlela okuqhubekayo noma ubunzima bokuphefumula
• Izinkinga zesibindi ezinemiphumela efana nesikhumba esiphuzi, umchamo omnyama, noma ubuhlungu obukhulu besisu
• Ukuqunjelwa okukhulu noma i-colitis enegazi esitulweni
• Izinkinga ze-thyroid ezibangela ukukhathala okukhulu, izinguquko zesibalo somzimba, noma ukushaya kwenhliziyo okusheshayo
• Izinkinga zezinso ezinokuncipha komchamo noma ukuvuvukala
• Ukuphendula kwesikhumba okukhulu ngokuqubuka okubanzi noma ukuvuvukala
• Izinkinga ze-adrenal gland ezibangela ukukhathala okukhulu, isiyezi, noma ukuquleka

Ithimba lakho lezokwelapha likuqapha eduze ngalezi zimo ngokuhlolwa kwegazi njalo nokuhlolwa komzimba. Imiphumela emibi eminingi engathi sína iyaguquleka ngokwelashwa okusheshayo, okuvame ukubandakanya imithi ethulisa amasosha akho omzimba.

Ubani Ongafanele Athole I-Durvalumab?

I-Durvalumab ayilungele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi iphephile yini kuwe ngaphambi kokuqala ukwelashwa. Ezinye izimo zezokwelapha nezimo zenza lo muthi ube yingozi.

Akufanele uthole i-durvalumab uma wazi ukuthi unokungezwani komzimba okukhulu kulo muthi noma izingxenye zawo. Udokotela wakho uzophinda aqaphele kakhulu uma unezifo ze-autoimmune ezisebenzayo lapho amasosha akho omzimba esehlasela izicubu ezinempilo.

Izimo ezidinga ukucatshangelwa okukhethekile zihlanganisa:

• Izifo ze-autoimmune ezisebenzayo njenge-rheumatoid arthritis, i-lupus, noma isifo samathumbu esivuvukalayo
• Umlando wemiphumela emibi ehlobene nokuzivikela komzimba evela kweminye imithi ye-immunotherapy
• Izifo ezisebenzayo ezilwelwa amasosha akho omzimba
• Abamukeli bezitho ezithathelwe ukwelashwa ngemithi ecindezela amasosha omzimba
• Ukukhulelwa noma ukuncelisa ibele
• Isifo esibi sesibindi noma sezinso

Udokotela wakho uzoqhathanisa izinzuzo ezingaba khona nezingozi esimweni sakho esithile. Ngezikhathi ezithile i-durvalumab ingasetshenziswa ngokuqapha okucophelelayo nezinyathelo zokuphepha ezengeziwe, noma ngabe unezinye zalezi zimo.

Amagama Omkhiqizo we-Durvalumab

I-Durvalumab ithengiswa ngaphansi kwegama lomkhiqizo elithi Imfinzi. Leli yigama lomkhiqizo elitholakalayo lalo muthi, njengoba lisavikelwe yi-patent ngumenzi wokuqala.

Lapho uthola ukwelashwa kwakho, uzobona i- "Imfinzi" kumalebula akho emithi kanye namarekhodi okwelashwa. Izinhlobo ezivamile ze-durvalumab azikatholakali, ngakho bonke iziguli zithola umuthi ofanayo onophawu ngaphandle komshuwalense wabo noma isikhungo sokwelashwa.

Ezinye izindlela ze-Durvalumab

Eminye imithi eminingi ye-checkpoint inhibitor isebenza ngendlela efanayo ne-durvalumab yokwelapha umdlavuza. Udokotela wakho angase acabangele lezi ezinye izindlela uma i-durvalumab ingakulungele noma uma umdlavuza wakho ungayiphenduli kahle.

Ezinye izindlela ezivamile zihlanganisa i-pembrolizumab (Keytruda), i-nivolumab (Opdivo), kanye ne-atezolizumab (Tecentriq). Le mithi isebenza ngokuvimba amaprotheni ahlukene e-checkpoint, okuvumela amasosha akho omzimba ukuthi alwe nomdlavuza ngempumelelo.

Ukukhetha phakathi kwale mithi kuncike ohlotsheni lomdlavuza wakho, ukwelashwa kwangaphambilini, kanye nezici zezempilo zomuntu ngamunye. Udokotela wakho we-oncologist uzoncoma inketho engcono kakhulu ngokusekelwe ocwaningweni lwamanje kanye nesimo sakho sezokwelapha esiyingqayizivele.

Ezinye izindlela zokwelapha zendabuko njenge-chemotherapy, i-radiation therapy, noma imithi yokwelapha eqondiwe nayo ingase icatshangelwe kuye ngezici zomdlavuza wakho nesigaba sawo.

Ingabe i-Durvalumab Ingcono Kune-Pembrolizumab?

I-Durvalumab ne-pembrolizumab zombili ziyizithiyo eziphumelelayo ze-checkpoint, kodwa zisebenza kahle kakhulu ezinhlotsheni ezahlukene zomdlavuza nasezimweni ezahlukene. Akukho muthi owodwa ovamile ukuthi “ungcono” - ukukhetha kuncike ohlotsheni lomdlavuza wakho kanye nomlando wokwelashwa.

I-Durvalumab ivunyelwe ngokuqondile ngeminyaka ethile yomdlavuza wamaphaphu nowesinye, kuyilapho i-pembrolizumab iphatha uhla olubanzi lwemidlavuza okuhlanganisa amaphaphu, isinye, isikhumba, neminye eminingi. Ngomdlavuza wamaphaphu, i-durvalumab ivame ukusetshenziswa ngemva kwe-radiation therapy, kuyilapho i-pembrolizumab ingase isetshenziswe njengokwelashwa komugqa wokuqala.

Amaphrofayili emiphumela emibi afana kakhulu phakathi kwale mithi, nakuba abantu ngabanye bengase bayibekezelele enye kangcono kunenye. Udokotela wakho we-oncologist uzokhetha ngokusekelwe ekutheni imuphi umuthi onobufakazi obuqinile bohlotsheni lomdlavuza wakho nesigaba sakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Durvalumab

Ingabe i-Durvalumab iphephile kubantu abanezifo zenhliziyo?

I-Durvalumab ngokuvamile ingasetshenziswa ngokuphepha kubantu abanezifo zenhliziyo ezinzile, kodwa idinga ukuqapha ngokucophelela. Umuthi ngezinye izikhathi ungabangela imiphumela emibi ehlobene nenhliziyo, okuhlanganisa ukuvuvukala kwemisipha yenhliziyo (myocarditis), nakuba lokhu kungavamile.

Udktela wakho uzohlola impilo yenhliziyo yakho ngaphambi kokuqala ukwelashwa futhi akuqaphele eduze ngaso sonke isikhathi sokwelashwa. Uma unomlando wezinkinga zenhliziyo, cishe uzodinga izivivinyo ezijwayelekile zomsebenzi wenhliziyo nokuxhumana eduze phakathi kwe-oncologist yakho kanye ne-cardiologist.

Kufanele ngenzeni uma ngiphuthelwa ngengozi umthamo we-Durvalumab?

Uma uphuthelwa ukufakwa kwe-durvalumab okuhleliwe, xhumana nethimba lakho lezempilo ngokushesha ukuze lihlehlise. Ungazami "ukubamba" ngokuhlela imithamo eduze - lokhu kungandisa ingozi yakho yemiphumela emibi.

Udktela wakho uzoqoka isikhathi esingcono kakhulu somthamo wakho olandelayo ngokusekelwe ukuthi sekudlule isikhathi esingakanani kusukela ekwelashweni kwakho kokugcina. Ezimweni eziningi, uzoqhubeka nje nohlelo lwakho olujwayelekile kusukela osukwini olusha lokuqokwa.

Ngingayeka nini ukuthatha i-Durvalumab?

Kufanele uyeke kuphela ukwelashwa nge-durvalumab ngemva kokuxoxa ngakho ngokucophelela ne-oncologist yakho. Isinqumo sincike ekutheni umdlavuza wakho uphendula kahle kangakanani, yimiphumela emibi oyitholayo, nesimo sakho sempilo esiphelele.

Izizathu ezivamile zokuyeka zihlanganisa ukuqhubeka komdlavuza naphezu kokwelashwa, imiphumela emibi engathuthuki ngokuphathwa, noma ukuqeda ubude bokwelashwa obuhleliwe. Udktela wakho uzosebenzisa izithombe kanye nezivivinyo zegazi ukusiza ukwenza lesi sinqumo esibalulekile.

Ngingakwazi yini ukuthola imithi yokugoma ngenkathi ngithatha i-Durvalumab?

Imithi yokugoma ephilayo kufanele igwenywe ngenkathi kuthathwa i-durvalumab ngoba amasosha akho omzimba asebenzisiwe angase asabele ngendlela engabikezelwa. Kodwa-ke, imithi yokugoma engasebenzi (njengomjovo womkhuhlane) ngokuvamile iphephile futhi ivame ukunconywa ukukuvikela ezifweni.

Njalo yazisa abahlinzeki bakho bezempilo ukuthi uthola i-durvalumab ngaphambi kokuthola noma yimiphi imithi yokugoma. Bangakuncoma ngesikhathi esingcono kakhulu nokuthi yimiphi imithi yokugoma efanele isimo sakho.

Ingabe i-Durvalumab izothinta ukuzala kwami?

I-Durvalumab ingase ithinte inzalo kubo bobabili abesilisa nabesifazane, nakuba umthelela oqondile ungaqondakali ngokugcwele. Uma uhlela ukuba nezingane, xoxa ngezinketho zokulondoloza inzalo nodokotela wakho ngaphambi kokuqala ukwelashwa.

Umuthi ungalimaza nezingane ezisakhula, ngakho-ke ukuvimbela ukukhulelwa okusebenzayo kubalulekile ngesikhathi sokwelashwa kanye nezinyanga eziningana ngemuva komthamo wakho wokugcina. Ithimba lakho lokunakekelwa kwezempilo lizohlinzeka ngesiqondiso esiqondile mayelana nokuhlela umndeni ngesikhathi sokwelashwa kwakho.