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

I-Osimertinib iyikhambi lomdlavuza eliqondiswe ngqo eliphatha izinhlobo ezithile zomdlavuza wamaphaphu. Ingaphansi kohlu lwemithi ebizwa ngokuthi ama-tyrosine kinase inhibitors, asebenza ngokuvimba amaprotheni athile asiza amaseli omdlavuza ukuthi akhule futhi asabalale.

Lo muthi uguqule ukwelashwa ezigulini ezinomdlavuza wamaphaphu ongawona amancane (NSCLC) onoshintsho oluthile lofuzo. Yenzelwe ukuthi iqonde ngqo kunemithi yamakhemikhali yendabuko, iqondise kuphela amaseli omdlavuza ngenkathi ngokuvamile ibangela imiphumela emibi embalwa.

Yini i-Osimertinib?

I-Osimertinib iyikhambi lomdlavuza elithathwa ngomlomo eliqondise izinguquko ezithile zofuzo kumaseli omdlavuza wamaphaphu. Yilokho odokotela abakubiza ngokuthi i-“third-generation” tyrosine kinase inhibitor, okusho ukuthi yakhelwe ukunqoba ukumelana okungase kuvele ngemithi endala efanayo.

Umuthi usebenza ngokuvimba iprotheni ebizwa nge-EGFR (epidermal growth factor receptor) eshintshile emdlavuzeni wamaphaphu othile. Lapho le protein ivinjelwe, amaseli omdlavuza awakwazi ukuthola izimpawu abazidingayo ukuze bakhule futhi bande, okusiza ukunciphisa noma ukumisa ukuqhubeka komdlavuza.

I-Osimertinib ithathwa njengamaphilisi kanye ngosuku, okwenza kube lula kunezinye izindlela zokwelapha umdlavuza ezidinga ukuvakashelwa esibhedlela ukuze kuthathwe imithi. Lokhu kuvumela iziguli eziningi ukuthi ziqhubeke nokwelashwa kwazo ekhaya ngenkathi zigcina okuningi kwemisebenzi yazo yansuku zonke.

Isetshenziselwani i-Osimertinib?

I-Osimertinib isetshenziswa ikakhulukazi ukwelapha umdlavuza wamaphaphu ongawona amancane (NSCLC) onoshintsho oluthile lwe-EGFR. Udokotela wakho uzohlola izicubu zakho zomdlavuza ukuze aqinisekise ukuthi lezi zinguquko zikhona ngaphambi kokunikeza lo muthi.

Umuthi uvunyelwe izimo ezimbili eziyinhloko. Okokuqala, usetshenziswa njengokwelashwa kokuqala kwabantu abasanda kutholakala benesifo esithuthukile se-NSCLC esinokuguqulwa okuthile kwe-EGFR. Lokhu kusho ukuthi kungaba ukwelashwa komdlavuza kokuqala okutholayo ngemuva kokuxilongwa, esikhundleni sokuqala ngamakhemikhali.

Okwesibili, i-osimertinib iphatha i-NSCLC esikwazile ukumelana nezinye izinto ezivimbela i-EGFR futhi inokuguqulwa okuthile okubizwa nge-T790M. Lokhu kuguqulwa kungavela ngokuhamba kwesikhathi njengoba amaseli omdlavuza ezivumela ukwelashwa kwangaphambilini, futhi i-osimertinib yakhelwe ngqo ukunqoba lokhu kumelana.

Lo muthi futhi usetshenziswa lapho umdlavuza wamaphaphu usabalale ebuchosheni, njengoba ungaweqa umgoqo wegazi-nobuchopho ngempumelelo kunezinye izindlela zokwelapha ezihlosiwe. Lokhu kwenza kube yigugu ikakhulukazi ezigulini ezinomdlavuza oye wanda ebuchosheni.

Isebenza Kanjani I-Osimertinib?

I-Osimertinib isebenza ngokuvimba amaprotheni e-EGFR aguquliwe asebenza njengamashintshi anezinkinga kumaseli omdlavuza. Kumaseli anempilo, amaprotheni e-EGFR asiza ukulawula ukukhula kwamaseli okuvamile, kodwa kumaseli omdlavuza, lawa maprotheni aba namandla ngokweqile futhi aqhube ukukhula okungalawuleki.

Cabanga ngakho njengokunqamula i-accelerator pedal eyaphukile emotweni enamathele endaweni ethi

I-Osimertinib ithathwa kanye ngosuku njengokhethekile, futhi kufanele uyithathe ngesikhathi esifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo emzimbeni wakho. Ungayithatha ngaphandle noma ngaphandle kokudla, kodwa zama ukuba qotho ekukhetheni kwakho ukusiza ukugcina ukumuncwa okuqhubekayo.

Gwinya ithebhulethi yonke ngamanzi. Ungayigayi, uhlafune, noma uyiphule ithebhulethi, ngoba lokhu kungathinta indlela umuthi omuncwa ngayo futhi kubangele imiphumela emibi. Uma unenkinga yokugwinya amathebhulethi, khuluma nethimba lakho lezempilo ngezindlela ezingezinye zokuthatha umuthi wakho.

Uma udinga ukuthatha umuthi ngeshubhu lokudla, umhlinzeki wakho wezempilo angakukhombisa ukuthi ungayincibilikisa kanjani ithebhulethi emanzini ngokuphepha. Lokhu kufanele kwenziwe kuphela ngemva kwemiyalelo ethile evela eqenjini lakho lezokwelapha.

Kubalulekile ukuthatha i-osimertinib ngendlela eqondile njengoba kunqunyiwe, ngisho noma uzizwa ungcono. Imithi yomdlavuza isebenza kahle uma ithathwa ngokuqhubekayo, futhi ukweqa imithamo kungavumela amaseli omdlavuza ukuthi aqale ukukhula futhi.

Ngingayithatha isikhathi esingakanani i-Osimertinib?

Ngokuvamile uzoqhubeka nokuthatha i-osimertinib uma nje isebenza ukulawula umdlavuza wakho futhi uyayibekezelela kahle. Lokhu kungaba izinyanga noma iminyaka, kuye ngokuthi umdlavuza wakho usabela kanjani ekwelashweni.

Udokotela wakho uzoqapha inqubekela phambili yakho ngokuskena njalo nokuhlolwa kwegazi ukuze abone ukuthi umuthi usebenza kahle kangakanani. Lokhu kuhlolwa kusiza ukunquma ukuthi kufanele uqhubeke yini nokwelashwa okufanayo noma ngabe kudingeka izinguquko.

Ezinye iziguli zithatha i-osimertinib iminyaka eminingana uma iqhubeka isebenza. Abanye bangase badinge ukushintshela ekwelashweni okuhlukile uma umdlavuza wabo ukhula ukumelana nomuthi noma uma imiphumela emibi iba nzima kakhulu ukuyilawula.

Ungayeki ukuthatha i-osimertinib ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Noma ngabe uhlangabezana nemiphumela emibi, ithimba lakho lezempilo lingavame ukulungisa uhlelo lwakho lokwelapha ukukusiza ukuthi uqhubeke nokuzuza emuthini ngokuphepha.

Ziyini Imiphumela Eceleni ye-Osimertinib?

Ngenkathi i-osimertinib ngokuvamile ibangela imiphumela emibi embalwa kunezindlela zokwelapha eziqhelekile, isengabangela ezinye izimpawu ezingakhululeki. Imiphumela eminingi eceleni ingalawulwa ngokunakekelwa okufanele nokuqashwa okuvela eqenjini lakho lezempilo.

Imiphumela evame kakhulu eceleni ongase uyithole ihlanganisa isifo sohudo, ukuqubuka kwesikhumba, isikhumba esomile, izinguquko zezipikili, nokukhathala. Lezi zimpawu zivame ukuthuthuka ngokuhamba kwesikhathi njengoba umzimba wakho ujwayela umuthi, futhi iqembu lakho lezempilo linganikeza amasu okusiza ukuwalawula.

Nansi imiphumela evame kakhulu eceleni ukuthi iziguli zivame ukuyithola:

• Isifo sohudo, esivame ukulawulwa ngezinguquko zokudla kanye nemithi etholakala ngaphandle kwemvume kadokotela
• Ukuqubuka kwesikhumba nesikhumba esomile, ngokuvamile kuvela emasontweni ambalwa okuqala kokwelashwa
• Ushintsho ezipikilini zakho, okuhlanganisa ukuba buthaka noma izinguquko emibaleni
• Ukukhathala nokuzizwa ukhathele kunokujwayelekile
• Ukuncipha kwesifiso sokudla nokulahlekelwa isisindo okungenzeka
• Izilonda zomlomo noma i-stomatitis

Le miphumela ejwayelekile eceleni, ngenkathi ikhathaza, ivame ukuba mnene kuya esimweni esiphakathi nendawo futhi ingalawulwa ngokunakekelwa okusekelayo. Ithimba lakho lezempilo lizosebenza nawe ukunciphisa le miphumela futhi likusize ukuthi ugcine izinga lempilo yakho.

Kukhona nemiphumela emibi embalwa kodwa ebucayi edinga ukunakekelwa kwezempilo ngokushesha. Ngenkathi lokhu kwenzeka ezigulini ezimbalwa, kubalulekile ukuyazi ukuze ukwazi ukufuna usizo ngokushesha uma kudingeka.

Imiphumela emibi kakhulu edinga ukunakekelwa kwezempilo ngokushesha ihlanganisa:

• Izinkinga zamaphaphu, okuhlanganisa ukuvuvukala kwamaphaphu (i-pneumonitis), okungabangela ukuphefumula kanzima noma ukukhwehlela
• Izinkinga zenhliziyo, okuhlanganisa izinguquko kumgqigqo wenhliziyo noma ukwehla komsebenzi wenhliziyo
• Ukuphendula okukhulu kwesikhumba okuhlanganisa izindawo ezinkulu zomzimba wakho
• Izinkinga zamehlo, okuhlanganisa izinguquko embonweni noma ubuhlungu obukhulu emehlweni
• Izinkinga zokujiya kwegazi, okungabangela ukuvuvukala noma ubuhlungu emilenzeni yakho

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezinzima, xhumana nodokotela wakho ngokushesha. Ukutholwa kwangaphambi kwesikhathi nokwelashwa kwale miphumela emibi kungasiza ekuvikeleni izinkinga ezingathi sína.

Ubani Ongafanele Athatha i-Osimertinib?

I-Osimertinib ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ngabe ukwelashwa okulungile yini lesi simo sakho esithile. Umuthi usebenza kuphela emalini enezinguquko ezithile ze-EGFR, ngakho ukuhlolwa kwezakhi zofuzo kubalulekile ngaphambi kokuqala ukwelashwa.

Akufanele uthathe i-osimertinib uma unokungezwani komzimba nomuthi noma yiziphi izithako zawo. Xhumana nodokotela wakho mayelana nanoma yiziphi izimphendulo zangaphambilini zokungezwani komzimba nemithi, ikakhulukazi ezinye izindlela zokwelapha umdlavuza noma ama-tyrosine kinase inhibitors.

Abesifazane abakhulelwe akufanele bathathe i-osimertinib njengoba ingalimaza ingane esakhula. Uma ungumuntu wesifazane osemqoka, uzodinga ukusebenzisa izindlela zokulawula inzalo ngesikhathi sokwelashwa kanye okungenani amasonto ayisithupha ngemuva komthamo wakho wokugcina.

Amadoda athatha i-osimertinib kufanele futhi asebenzise izindlela zokulawula inzalo ngesikhathi sokwelashwa kanye okungenani izinyanga ezine ngemuva komthamo wokugcina, njengoba umuthi ungathinta isidoda futhi ungalimaza ingane esakhula.

Abantu abanezimo ezithile zenhliziyo, izinkinga ezinzima zezinso, noma isifo esinzima sesibindi bangase badinge ukuqapha okukhethekile noma ukulungiswa komthamo. Udokotela wakho uzobukeza umlando wakho wezokwelapha ophelele ukuze anqume ukuthi i-osimertinib iphephile yini kuwe.

Amagama Omkhiqizo we-Osimertinib

I-Osimertinib ivame kakhulu ngaphansi kwegama layo lomkhiqizo elithi Tagrisso, elikhiqizwa yi-AstraZeneca. Leli yigama ozolijwayela ukulibona ebhodleleni lakho lemithi kanye nokupakishwa kwemithi yakho.

Kwamanye amazwe, i-osimertinib ingase itholakale ngaphansi kwamanye amagama omkhiqizo noma njengomuthi ojwayelekile. Kodwa-ke, i-Tagrisso isahlala iyona fomu eyaziwa kakhulu futhi etholakalayo yalo muthi emhlabeni jikelele.

Njalo qiniseka ukuthi uthola umuthi olungile ngokuhlola kokubili igama elijwayelekile (osimertinib) negama lomkhiqizo (Tagrisso) kumkhemisi wakho. Lokhu kusiza ekuqinisekiseni ukuthi uthola ukwelashwa okulungile kanye nomthamo ofanele.

Ezinye Izindlela Zokwelapha Nge-Osimertinib

Uma i-osimertinib ingakulungele noma iyeka ukusebenza ngempumelelo, kunezindlela eziningi zokwelapha ezingenye ezitholakalayo zomdlavuza wamaphaphu oguqulwe yi-EGFR. Udokotela wakho uzocabangela izici ezithile zomdlavuza wakho kanye nomlando wokwelashwa lapho encoma ezinye izindlela zokwelapha.

Ezinye izinto ezivimbela i-EGFR zihlanganisa i-erlotinib (Tarceva) kanye ne-afatinib (Gilotrif), ezivame ukusetshenziswa njengokwelashwa komugqa wokuqala. Le mithi isebenza ngendlela efana ne-osimertinib kodwa ingase ilungele kangcono izinhlobo ezithile zokuguqulwa kwe-EGFR noma izimo zesiguli.

Ezikhathini ezigulini ezinomdlavuza oqhubeke ekwelashweni okuningi okuqondiwe, ukwelashwa okuhlanganisiwe kungase kunconywe. Lokhu kungabandakanya i-osimertinib ehlanganiswe ne-chemotherapy noma ezinye izidakamizwa eziqondiwe, kuye ngezici ezithile zomdlavuza wakho.

I-chemotherapy yendabuko isahlala iyindlela ebalulekile, ikakhulukazi ezigulini ezinomdlavuza ezingenawo ukuguqulwa okungaqondiwe noma eziye zakha ukumelana nokwelashwa okuningi okuqondiwe. Udokotela wakho we-oncologist uzosiza ekunqumeni ukulandelana kokwelashwa okungcono kakhulu esimweni sakho.

Ingabe i-Osimertinib Ingcono Kune-Erlotinib?

I-Osimertinib kanye ne-erlotinib zombili ziyizithiyo ze-EGFR ezisebenzayo, kodwa zisebenza kahle ezimweni ezingafani. I-Osimertinib ngokuvamile ithathwa njengesephumelela kakhulu ekwelashweni kokuqala komdlavuza wamaphaphu oshintshwe yi-EGFR futhi ibonise imiphumela engcono ezivivinyweni zemitholampilo.

Ucwaningo lubonise ukuthi i-osimertinib ngokuvamile inikeza ukusinda okude ngaphandle kokuqhubeka uma kuqhathaniswa ne-erlotinib uma isetshenziswa njengokwelashwa kokuqala. Lokhu kusho ukuthi iziguli zivame ukuhlala isikhathi eside ngaphambi kokuba umdlavuza wazo uqale ukukhula futhi uma zithathwa nge-osimertinib kuqala.

I-Osimertinib nayo inokungena okungcono ebuchosheni, okuyenza isebenze kahle ekuvikeleni noma ekwelapheni ama-metastases obuchopho. Lokhu kubaluleke kakhulu ngoba umdlavuza wamaphaphu uvame ukusabalala ebuchosheni.

Nokho, i-erlotinib ingase isathandwe kwezinye izimo, njengalapho izindleko ziyisici esikhulu noma lapho isiguli sinemiphumela ethile engenza i-osimertinib ingafaneleki. Udokotela wakho uzocabangela zonke lezi zici lapho encoma ukwelashwa okungcono kakhulu esimweni sakho esithile.

Imibuzo Evame Ukubuzwa Mayelana ne-Osimertinib

Ingabe i-Osimertinib iphephile kubantu abanezifo zenhliziyo?

I-Osimertinib ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqapha ngokucophelela futhi mhlawumbe ukulungiswa komthamo. Umuthi ngezinye izikhathi ungase uthinte isigqi senhliziyo noma ukusebenza, ngakho udokotela wakho uzohlola impilo yenhliziyo yakho ngaphambi kokuqala ukwelashwa.

Uma unomlando wezinkinga zenhliziyo, udokotela wakho cishe uzo-oda izivivinyo zenhliziyo eziyisisekelo, okuhlanganisa i-electrocardiogram (ECG) futhi mhlawumbe i-echocardiogram. Lezi zivivinyo zisiza ukusungula ukusebenza kwenhliziyo yakho yamanje futhi zinikeze isisekelo sokuqapha ngesikhathi sokwelashwa.

Ngesikhathi sokwelashwa, uzoba nokuhlolwa okuvamile ukuqapha ukusebenza kwenhliziyo yakho. Uma kuthuthuka noma yimiphumela emibi ehlobene nenhliziyo, udokotela wakho angalungisa umthamo wakho noma anikeze ukwelashwa okwengeziwe ukuvikela inhliziyo yakho ngenkathi eqhubeka nokwelashwa komdlavuza wakho.

Kumele Ngenzeni Uma Ngithathe I-Osimertinib Eningi Ngengozi?

Uma ngengozi uthatha i-osimertinib eningi kunaleyo oyinikiwe, xhumana nomhlinzeki wakho wezempilo noma isikhungo sokulawula ubuthi ngokushesha. Ungalindi ukubona ukuthi ngabe izimpawu ziyavela yini, ngoba ukuthola iseluleko sezokwelapha ngokushesha kubalulekile ekuphepheni kwakho.

Ukuthatha i-osimertinib eningi kungakhuphula ingozi yakho yemiphumela emibi engathi sína, ikakhulukazi lezo ezithinta inhliziyo yakho, amaphaphu, noma isikhumba. Abahlinzeki bezempilo bangakuqapha eduze futhi banikeze ukunakekelwa okusekelayo uma kudingeka.

Letha ibhodlela lakho lemithi nawe uma udinga ukufuna ukunakekelwa kwezempilo, ngoba lokhu kusiza abahlinzeki bezempilo ukuthi baqonde kahle ukuthi yini nokuthi ungakanani okuthathile. Ungalokothi uzame ukuthi "ukulungisa" ukweqisa ngokweqa imithamo yesikhathi esizayo.

Kumele Ngenzeni Uma Ngiphuthelwa Umthamo We-Osimertinib?

Uma uphuthelwa umthamo we-osimertinib, uyithathe ngokushesha lapho ukhumbula, ngaphandle kokuthi sekuseduze nesikhathi somthamo wakho olandelayo ohleliwe. Kuleso simo, weqa umthamo ophuthelwe bese uqhubeka nohlelo lwakho olujwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe, ngoba lokhu kungakhuphula ingozi yakho yemiphumela emibi. Uma ungaqiniseki ngesikhathi, xhumana nomhlinzeki wakho wezempilo noma usokhemisi ukuze uthole isiqondiso.

Ukuze usize ukukhumbula umthamo wakho wansuku zonke, cabanga ukusetha i-alamu yefoni noma usebenzise umhleli wamaphilisi. Ukuthatha imithi yakho ngesikhathi esifanayo nsuku zonke kusiza ukugcina amazinga aqhubekayo emzimbeni wakho futhi kuthuthukisa ukusebenza kahle kokwelashwa.

Ngingayeka Nini Ukuthatha I-Osimertinib?

Kufanele uyeke kuphela ukuthatha i-osimertinib ngaphansi kokuqondiswa okuqondile kwe-oncologist yakho. Isinqumo sokuyeka ukwelashwa sisekelwe ezintweni eziningana, okuhlanganisa ukuthi imithi ilawula kahle kangakanani umdlavuza wakho nokuthi ukubekezelela kahle kangakanani noma yimiphumela emibi.

Udkt wakho uzosebenzisa izithwebulo ezivamile kanye nokuhlolwa kwegazi ukuqapha ukuthi umdlavuza wakho usabela kanjani emithini. Uma izithwebulo zikhombisa ukuthi umdlavuza wakho ukhula naphezu kokwelashwa, noma uma uba nemiphumela emibi engalawuleki, udkt wakho angase ancome ukuyeka i-osimertinib.

Ezinye iziguli ziqhubeka nokuthatha i-osimertinib iminyaka eminingi uma ilawula ngempumelelo umdlavuza wazo ngemiphumela emibi elawulekayo. Ezinye zingase zidingeke ukuthi zishintshele kwezinye izindlela zokwelapha uma umdlavuza wazo uba nokumelana noma uma imiphumela emibi iba yinselele kakhulu.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Osimertinib?

Akukho ukusebenzisana okuqondile phakathi kwe-osimertinib notshwala, kodwa kuvamile ukunconywa ukuthi unciphise ukusetshenziswa kotshwala ngesikhathi sokwelashwa komdlavuza. Utshwala bungenza kube kubi eminye imiphumela emibi efana nokukhathala, isicanucanu, nezinkinga zokugaya ukudla.

Uma ukhetha ukuphuza utshwala ngezikhathi ezithile, kwenze ngokulinganisela futhi unake indlela umzimba wakho osabela ngayo. Ezinye iziguli zithola ukuthi utshwala buzithinta ngokuqinile ngenkathi zithatha imithi yomdlavuza, ngisho nangamanani amancane.

Njalo xoxa ngokusebenzisa utshwala neqembu lakho lezempilo, ikakhulukazi uma uthatha eminye imithi kanye ne-osimertinib. Bangakunikeza iseluleko esiqondene nawe ngokusekelwe ohlelweni lwakho lokwelashwa oluphelele kanye nesimo sempilo yakho esiphelele.