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

I-Selpercatinib iyikhambi lomdlavuza eliqondiswe ngqo elivimba amaprotheni athile asiza ukukhula kwamathumba athile. Lo muthi othathelwa ngomlomo umele intuthuko enkulu kubantu abanomdlavuza wamaphaphu nomdlavuza wendlala yegilo abanezinguquko ezithile zofuzo ezibizwa ngokuthi ukuguqulwa kwe-RET.

Uma udokotela wakho ekunikeze i-selpercatinib, kungenzeka ukuthi ubhekene nomdlavuza okhombise lezi zimakhi zofuzo ezithile. Lo muthi usebenza ngendlela ehlukile kunamakhemikhali endabuko ngokugxila kuphela kumaseli omdlavuza analezi zinguquko, okusho ukuthi imiphumela emincane eceleni kuwe.

Yini i-Selpercatinib?

I-Selpercatinib ingeyodwa yohlobo lwemithi ebizwa ngokuthi ama-RET inhibitors. Yenzelwe ukuvimba amaprotheni e-RET angajwayelekile akhuthaza ukukhula komdlavuza ezigulini ezithile.

Umuthi uza ngesimo samaphilisi owathatha ngomlomo. Yakhiwa ngqo ngocwaningo lwemithi eqondile, okusho ukuthi ososayensi bayidala ukuthi iqondise inkinga eqondile yama-molecular eqhuba uhlobo oluthile lomdlavuza wakho. Le ndlela eqondiswe ngqo ivame ukusebenza kangcono kunezindlela zokwelapha ezindala ezithinta amaseli anempilo futhi.

Cabanga nge-selpercatinib njengokhiye olungena kulokhiyi othile kakhulu. “Uklokhi” yiprotheni ye-RET kumaseli akho omdlavuza, futhi lo muthi wenzelwe ukuthi ungene kahle futhi umise umdlavuza ekukhuleni.

Isetshenziselwani i-Selpercatinib?

I-Selpercatinib iphatha izinhlobo ezithile zomdlavuza ezinoshintsho lofuzo lwe-RET. Udokotela wakho uzobe ehlolile ithumba lakho ukuze aqinisekise lezi zinguquko zofuzo ngaphambi kokukuyala lo muthi.

Umuthi usetshenziswa ikakhulukazi kumdlavuza wamaphaphu ongawona amancane (NSCLC) onama-RET gene fusions. Lokhu kuthatha cishe u-1-2% wayo yonke imidlava yomdlavuza wamaphaphu, kodwa ezigulini ezinalesi sifo esithile, i-selpercatinib ingasebenza ngempumelelo.

Iphinde ivunyelwe ngomdlavuza we-thyroid we-medullary kanye neminye imidlavuza ye-thyroid enoshintsho lwe-RET. Lokhu kumelela izinhlobo ezahlukene zomdlavuza we-thyroid ophendula kahle ekwelashweni okuhloswe ngayo i-RET.

Ngaphezu kwalokho, i-selpercatinib ingasetshenziswa kwezinye izimila eziqinile ezinoshintsho lwe-gene ye-RET. Udokotela wakho we-oncologist uzoqaphela ukuthi uhlobo lwakho oluthile lomdlavuza luyalufanelekela yini lolu hlobo lokwelashwa ngokusekelwe emiphumeleni yokuhlolwa kwezakhi zofuzo.

Isebenza Kanjani I-Selpercatinib?

I-Selpercatinib ivimba indlela ye-protein ye-RET esetshenziswa amaseli omdlavuza ukukhula nokuzala. Lapho amaprotheni e-RET eba angajwayelekile ngenxa yezinguquko zofuzo, athumela njalo amasignali "okukhula" kumaseli omdlavuza.

Lo muthi usebenza njengesibonakaliso sokuma saleyo migomo yokukhula. Ngokuvimba i-protein ye-RET, i-selpercatinib inganciphisa noma imise ukuhlukaniswa kwamaseli omdlavuza, okungenzeka ukuthi inciphise izimila noma izivimbele ukuthi zingakhuli zibe zinkulu.

Lo muthi ubhekwa njenge-inhibitor ye-RET eqinile, ekhethekile kakhulu. Lokhu kusho ukuthi ilunge kakhulu ekushayeni okuhlosiwe kwayo ngenkathi ishiya ezinye izinqubo zeselula zingaphazamiseki. Lokhu kukhetha yikho okwenza ukuthi iziguli eziningi zibe nemiphumela emincane uma ziqhathaniswa ne-chemotherapy yendabuko.

Amaseli akho omdlavuza ancika kule migomo engajwayelekile ye-RET ukuze asinde. Lapho i-selpercatinib ivimba le migomo, amaseli omdlavuza avame ukufa noma ayeke ukukhula, yingakho lo muthi ungasebenza kahle kakhulu ezigulini ezifanele.

Kufanele Ngiyithathe Kanjani I-Selpercatinib?

Thatha i-selpercatinib ngendlela udokotela wakho ayala ngayo, ngokuvamile kabili ngosuku ngaphandle kokudla. Umthamo ojwayelekile wokuqala uyi-160 mg kabili ngosuku, kodwa udokotela wakho angalungisa lokhu ngokusekelwe ekuphenduleni kwakho kanye nanoma yimiphi imiphumela emibi.

Ungathatha amaphilisi ngamanzi, ubisi, noma ijusi. Akudingeki ukuthi ugweme ukudla lapho uthatha lo muthi, okwenza kube lula ukungena emsebenzini wakho wansuku zonke. Kodwa-ke, zama ukuyithatha ngezikhathi ezifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo ohlelweni lwakho.

Gwinya amaphilisi wonke ngaphandle kokuwavula, ukuwachoboza, noma ukuwahlafuna. Uma unzima ukugwinya amaphilisi, khuluma neqembu lakho lezempilo mayelana namasu angasiza, kodwa ungawashintshi amaphilisi ngokwakho.

Uma uhlanza ngemva kokuthatha umthamo, ungalithathi elinye ngokushesha. Linda kuze kube yisikhathi sakho somthamo olandelayo. Qhubeka nokuthatha imithi ngisho noma uqala ukuzizwa ungcono, njengoba imithi yomdlavuza isebenza kangcono uma ithathwa njalo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Selpercatinib?

Ngokuvamile uzothatha i-selpercatinib uma isasebenza futhi uyayibekezelela kahle. Lokhu kungaba izinyanga noma iminyaka, kuye ngokuthi umdlavuza wakho uphendula kanjani.

Udokotela wakho uzoqapha ukuqhubeka kwakho ngokuskena njalo nokuhlolwa kwegazi. Lokhu kuqokwa kusiza ukunquma ukuthi imithi iyazinciphisa yini izimila zakho noma izigcina zizinzile. Uma nje i-selpercatinib isiza ukulawula umdlavuza wakho ngaphandle kokubangela imiphumela emibi, cishe uzoqhubeka nokuyithatha.

Ezinye iziguli zithatha le mithi isikhathi eside ngempilo enhle. Ezinye zingase zidinge ukulungiswa komthamo noma ukuphumula uma imiphumela emibi iba yinselele. Udokotela wakho we-oncologist uzosebenza nawe ukuze athole ukulinganisela okulungile.

Ungayeki ukuthatha i-selpercatinib ngaphandle kokuxoxa ngayo nodokotela wakho kuqala. Noma ngabe uzizwa kahle, imithi ingase isasebenza ukulawula amaseli omdlavuza ongawaboni noma ongawazwa.

Yiziphi Imiphumela Emibi Ye-Selpercatinib?

Abantu abaningi abathatha i-selpercatinib bahlangabezana nemiphumela emibi ethile, kodwa ngokuvamile iyaphathwa ngosekelo olufanele. Izindaba ezinhle ukuthi imiphumela emibi engathí sina ayivamile njengoba kunjalo ngamakhemikhali endabuko.

Nansi imiphumela emibi evame kakhulu ongase uyithole, futhi kubalulekile ukwazi ukuthi iqembu lakho lezempilo lingasiza ukuphatha ngamunye walaba:

• Umlomo owomile uvela cishe kuma-60% eziguli kodwa ungalawulwa ngokuphuza amanzi njalo nokunakekela umlomo
• Ukuqunjelwa kuphazamisa cishe ingxenye yeziguli futhi kuvame ukusabela kahle ekushintsheni kokudla nasemithini
• Umfutho wegazi ophezulu uvela cishe kuma-40% eziguli futhi ungalawulwa ngemithi yomfutho wegazi
• Ukukhathala kuvamile futhi kuvame ukuthuthuka njengoba umzimba wakho ujwayela imithi
• Ukuvuvukala ezandleni, ezinyaweni, noma ebusweni kwenzeka cishe kuma-30% eziguli
• Ukuqubuka noma izinguquko zesikhumba zithinta ezinye iziguli kodwa ngokuvamile zithambile

Le miphumela emibi ayenzeki kuwo wonke umuntu, futhi uma yenzeka, ivame ukuba milde kuya phakathi nendawo. Ithimba lakho lokunakekelwa kwezempilo lizokuqapha ngokucophelela futhi lingashintsha uhlelo lwakho lokwelapha uma kudingeka.

Imiphumela emibi engavamile kodwa ebucayi ingabandakanya izinkinga zesibindi, izinguquko zesigqi senhliziyo, noma ukusabela okukhulu kwesikhumba. Udokotela wakho uzobheka lokhu ngezivivinyo zegazi ezivamile nokuhlolwa.

Ezinye izinkinga ezingavamile kodwa ezinzima zihlanganisa ukopha okukhulu, izinkinga zamaphaphu, noma ukusabela okukhulu komzimba. Ngenkathi lokhu kungavamile, kubalulekile ukuxhumana nethimba lakho lokunakekelwa kwezempilo ngokushesha uma uhlangabezana nezimpawu ezingavamile njengokuphefumula kanzima, ubuhlungu obukhulu besifuba, noma ukopha okungavamile.

Ubani Ongafanele Athole i-Selpercatinib?

I-Selpercatinib ayilungile kuwo wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi iphephile yini kuwe. Abantu abanezimo ezithile zenhliziyo noma izinkinga zesibindi bangase badinge ukuqashwa okukhethekile noma ukwelashwa okuhlukile.

Akufanele uthathe i-selpercatinib uma unokungezwani nayo noma yiziphi izithako zayo. Uma uke waba nokusabela okukhulu komzimba emithini efanayo, qiniseka ukuthi uxoxa ngalokhu nodokotela wakho we-oncologist.

Abesifazane abakhulelwe akufanele bathathe i-selpercatinib ngoba ingalimaza ingane esakhula. Uma uhlela ukukhulelwa, ungase ukhulelwe, noma uncelisa, xoxa ngalokhu nodokotela wakho ngaphambi kokuqala ukwelashwa.

Abantu abanezifo zesibindi ezinzima bangase badinge ukulungiswa komthamo noma ezinye izindlela zokwelapha. Udokotela wakho uzohlola ukusebenza kwesibindi sakho ngaphambi kokuqala i-selpercatinib futhi akubheke njalo ngesikhathi sokwelashwa.

Uma unomlando wezinkinga zesigqi senhliziyo, udokotela wakho uzohlola ukuthi ngabe izinzuzo zidlula izingozi. Ezinye iziguli zingase zidinge ukuqapha okwengeziwe kwenhliziyo ngenkathi zithatha lo muthi.

Igama Lomkhiqizo le-Selpercatinib

I-Selpercatinib ithengiswa ngaphansi kwegama lomkhiqizo elithi Retevmo. Ungase ubone elinye igama ebhodleleni lakho lemithi noma emarekhodi ezokwelapha.

I-Retevmo yenziwa yi-Eli Lilly and Company. Umuthi wagunyazwa yi-FDA ngonyaka ka-2020, okwenza kube yindlela yokwelapha entsha kodwa efundwe kahle.

Noma ngabe incwadi yakho kadokotela ithi selpercatinib noma Retevmo, uthola umuthi ofanayo. Ezinye izinkampani zomshuwalense noma amakhemisi angase asebenzise elinye igama noma elinye, kodwa isithako esisebenzayo nokusebenza kwaso kuyafana.

Ezinye Izindlela Zokwelapha ze-Selpercatinib

Uma i-selpercatinib ingakulungele, ezinye izindlela zokwelapha ziyatholakala ngokuya ngohlobo lwakho oluthile lomdlavuza kanye nephrofayili yezakhi zofuzo. Udokotela wakho we-oncologist uzosiza ekunqumeni indlela engcono kakhulu.

Ngesifo somdlavuza wamaphaphu we-RET-positive, ezinye izindlela zokwelapha eziqondiwe njenge-pralsetinib (Gavreto) zingaba yindlela. Lesi esinye isithiyo se-RET esisebenza ngendlela efanayo ne-selpercatinib kodwa singase sibe nephrofayili ehlukile yemiphumela emibi.

I-chemotherapy yendabuko iseyindlela yokwelapha iziguli eziningi, yize ngokuvamile inemiphumela emibi ebanzi. Imithi ye-Immunotherapy efana ne-pembrolizumab ingase icatshangelwe ngokuya ngezici zakho zomdlavuza.

Ngemidlavuza yegilo, ezinye izindlela zingabandakanya ezinye izindlela zokwelapha eziqondiwe njenge-cabozantinib noma i-vandetanib. Ukwelashwa ngemisebe ye-iodine kungaba yindlela yokwelapha izinhlobo ezithile zomdlavuza wegilo.

Uvivinyo lwezempilo luvame ukunikeza ukufinyelela ekwelashweni okusha okusavivinywa. Udokotela wakho we-oncologist angakusiza ukuthi uhlole ukuthi ngabe yikuphi ukuvivinywa kwamanje okungase kufaneleke esimweni sakho.

Ingabe i-Selpercatinib ingcono kunezinye izinto ezivimbela i-RET?

I-Selpercatinib ne-pralsetinib zombili ziyizinto ezivimbela i-RET eziphumelelayo, kodwa zinezinye izinto ezingenza enye ifaneleke kakhulu kuwe kunenye. Udokotela wakho uzocabangela isimo sakho esithile lapho ekhetha phakathi kwazo.

I-Selpercatinib yiyona nto yokuqala ekhethekile evimbela i-RET eyavunyelwa, ngakho odokotela banolwazi oluningi lokuyisebenzisa. Uvivinyo lwezempilo lubonise amazinga aphezulu okusabela, nabantu abaningi bebona amathumba abo encipha kakhulu.

Amaphrofayili emiphumela emibi ahlukile phakathi kwemithi emibili. Ezinye iziguli zikubekezelela kahle okunye kunokunye, okungaba yinto ebalulekile ezinqumweni zokwelashwa.

Zombili le mithi zibonise ukusebenza kahle okufanayo ekuvivinyweni kwemitholampilo, ngakho-ke ukukhetha kuvame ukwehla ezintweni zomuntu ngamunye njengezinye izimo zakho zempilo, ukusebenzisana okungenzeka kwemithi, nezintandokazi zomuntu siqu mayelana nemiphumela emibi.

Imibuzo Evame Ukubuzwa Mayelana ne-Selpercatinib

Ingabe i-Selpercatinib iphephile kubantu abanezifo zenhliziyo?

I-Selpercatinib ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqapha okucophelelayo. Imithi ngezinye izikhathi ingathinta ukushaya kwenhliziyo noma umfutho wegazi, ngakho-ke udokotela wakho we-cardiologist kanye ne-oncologist bazosebenzisana ukuze bakuqaphe eduze.

Uma unezinkinga zenhliziyo ezikhona, udokotela wakho cishe uzo-oda ezinye izivivinyo zenhliziyo ngaphambi kokuqala ukwelashwa futhi aqaphe ukusebenza kwenhliziyo yakho njalo. Iziguli eziningi ezinemibandela yenhliziyo zingathatha i-selpercatinib ngokuphepha ngaphansi kokuqondiswa okufanele kwezokwelapha.

Ngingenzani uma ngiphuthelwa ukuthatha i-Selpercatinib eningi kakhulu?

Uma ngabe uthathe i-selpercatinib eningi kunaleyo oyinikiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ungazami ukuzenza uhlanze ngaphandle uma uqondiswe ngqo ukuba wenze kanjalo ochwepheshe bezokwelapha.

Ukuthatha okuningi kungakhuphula ingozi yakho yemiphumela emibi, ikakhulukazi izinkinga zesigqi senhliziyo noma isifo sohudo esibi. Ithimba lakho lezempilo lizokweluleka ngokuthi yini okufanele uyibheke nokuthi ngabe udinga ukunakekelwa kwezempilo ngokushesha.

Kufanele Ngenzeni Uma Ngingaphuthelwa Umthamo We-Selpercatinib?

Uma uphuthelwa umthamo futhi sekudlule amahora angaphansi kwangu-6 kusukela ngesikhathi sakho esihleliwe, yithathe ngokushesha lapho ukhumbula. Uma sekudlule amahora angaphezu kwangu-6, weqa umthamo ophuthelwe bese uthatha umthamo wakho olandelayo ngesikhathi esijwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe. Lokhu kungakhuphula ingozi yakho yemiphumela emibi ngaphandle kokuhlinzeka ngomvuzo owengeziwe. Uma uvame ukukhohlwa imithamo, cabangela ukusetha izikhumbuzi zocingo noma ukusebenzisa umhleli wamaphilisi.

Ngingayeka Nini Ukuthatha I-Selpercatinib?

Kufanele uyeke kuphela ukuthatha i-selpercatinib lapho udokotela wakho ekuncoma. Lesi sinqumo ngokuvamile sisekelwe ekutheni umuthi usebenza kahle kangakanani nokuthi ngabe uhlangabezana nemiphumela emibi elawulekayo.

Udokotela wakho uzosebenzisa ukuskena okuvamile nokuhlolwa kwegazi ukuze aqaphele impendulo yakho ekwelashweni. Uma umdlavuza wakho uqhubeka ngaphandle kokwelashwa, noma uma imiphumela emibi iba yimbi kakhulu, udokotela wakho we-oncologist uzoxoxa ngokuyeka umuthi nokuhlola ezinye izinketho.

Ngingakwazi Ukuphuza Utywala Ngenkathi Ngithatha I-Selpercatinib?

Ukunywa kotshwala okulinganiselwe kuvamile ukwamukeleka ngenkathi kuthathwa i-selpercatinib, kodwa kungcono ukuxoxa ngalokhu nodokotela wakho. Utywala bungase buqhubekisele phambili eminye imiphumela emibi efana nokukhathala noma lithinte ukusebenza kwesibindi sakho.

Njengoba i-selpercatinib ingathinta isibindi sakho, futhi notshwala buyakwenza, udokotela wakho angase ancome ukukhawulela ukuthathwa kotshwala. Thembeka nethimba lakho lezempilo mayelana nemikhuba yakho yokuphuza ukuze bakwazi ukukunikeza iseluleko esiqondene nawe.