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

I-Pembrolizumab iyindlela yokwelapha umdlavuza eqondiwe esiza amasosha akho omzimba ukuthi alwe namaseli omdlavuza ngempumelelo. Inikezwa nge-IV infusion futhi ingeyodwa yohlobo lwemithi ebizwa ngokuthi ama-immune checkpoint inhibitors, asebenza ngokususa "amabhuleki" amaseli omdlavuza abeka amasosha akho omzimba.

Lo muthi uguqule ukwelashwa komdlavuza ezigulini eziningi ngokusebenzisa amandla amasosha azo omzimba. Ngenkathi iyithuluzi elinamandla ekulweni imidlavaza ehlukahlukene, ukuqonda ukuthi isebenza kanjani nokuthi yini ongayilindela kungakusiza ukuthi uzizwe ulungiseleleke futhi uqiniseke ngohambo lwakho lokwelashwa.

Yini i-Pembrolizumab?

I-Pembrolizumab iyi-antibody eyenziwe e-laboratory evimba iphrotheni ebizwa nge-PD-1 kumasosha akho omzimba. Cabanga nge-PD-1 njengophawu "lokuma" oluvimbela amasosha akho omzimba ukuthi angahlaseli amaseli omdlavuza. Ngokuvimba le phrotheni, i-pembrolizumab ivumela amasosha akho omzimba ukuthi aqaphele futhi alwe nomdlavuza ngempumelelo.

Lo muthi waziwa nangegama lomkhiqizo elithi Keytruda. Uhlukaniswa njenge-monoclonal antibody, okusho ukuthi yakhelwe ukuthi iqondise iphrotheni eyodwa ethile emzimbeni wakho. Ngokungafani ne-chemotherapy yendabuko ehlasela ngokuqondile amaseli ahlukanisa ngokushesha, i-pembrolizumab isebenza ngokuthuthukisa izindlela zomzimba zakho zokuzivikela zemvelo.

Isetshenziselwani i-Pembrolizumab?

I-Pembrolizumab iphatha izinhlobo eziningana zomdlavuza ngokusiza amasosha akho omzimba ukuthi asebenze kangcono ngokumelene namaseli omdlavuza. Udokotela wakho cishe ukunikeze lo muthi ngoba uhlobo lwakho oluthile lomdlavuza luphendula kahle kule ndlela ye-immunotherapy.

Imidlavaza evame kakhulu ukwelatshwa nge-pembrolizumab ihlanganisa i-melanoma (umdlavuza wesikhumba), umdlavuza wamaphaphu, imidlavaza yekhanda nentamo, nezinhlobo ezithile zomdlavuza wezinso. Isetshenziselwa futhi i-Hodgkin lymphoma, umdlavuza wesinye, nomdlavuza wesisu ezimweni ezithile. Udokotela wakho we-oncologist uzoqaphela ukuthi uhlobo lwakho lomdlavuza nesigaba sakho kukwenza yini ukuthi ube ngumuntu ofanelekayo kule ndlela yokwelapha.

Ezinye izimo ezingavamile ezingelashwa nge-pembrolizumab zihlanganisa izinhlobo ezithile zomdlavuza wesibindi, umdlavuza wesisu, nomdlavuza we-endometrial. Isinqumo sokusebenzisa i-pembrolizumab sivame ukuncika kumamaki athile e-genetic ethumba lakho, njengamazinga okukhuluma e-PD-L1 noma isimo sokungazinzi kwe-microsatellite.

Isebenza Kanjani I-Pembrolizumab?

I-Pembrolizumab isebenza ngokuvimba indlela ye-PD-1, esetshenziswa amaseli omdlavuza ukuzifihla emzimbeni wakho wokuzivikela. Uma le ndlela ivalekile, ama-T-cells akho (amaseli okulwa nokuzivikela) angakwazi ukubona kangcono futhi ahlaselwe amaseli omdlavuza emzimbeni wakho wonke.

Lokhu kuthathwa njengomuthi oqinile womdlavuza, kodwa usebenza ngendlela ehlukile kunamakhemikhali endabuko. Esikhundleni sokubulala ngokuqondile amaseli omdlavuza, inika amandla uhlelo lwakho lokuzivikela ukuthi lwenze umsebenzi. Imiphumela ingahlala isikhathi eside ngoba uhlelo lwakho lokuzivikela lunenkumbulo futhi lungaqhubeka likuvikela ngisho nangemva kokuphela kokwelashwa.

Umuthi ngokuvamile uthatha amasonto amaningana kuya ezinyangeni ukukhombisa umphumela wawo ogcwele. Lokhu kungenxa yokuthi uhlelo lwakho lokuzivikela ludinga isikhathi sokuthi lwakhe impendulo esebenzayo ngomdlavuza. Ezinye iziguli zingase zibone imiphumela ngaphakathi kwemijikelezo yokuqala yokwelashwa, kanti ezinye zingase zidinge isikhathi eside ukuze zithole izinzuzo.

Kufanele Ngiyithathe Kanjani I-Pembrolizumab?

I-Pembrolizumab inikezwa kuphela nge-IV infusion esibhedlela noma esikhungweni sokwelashwa komdlavuza. Awukwazi ukuthatha lo muthi ekhaya, futhi ngaso sonke isikhathi unikezwa ochwepheshe bezempilo abaqeqeshiwe abakuqapha eduze ngesikhathi sokufakwa.

Ukufakwa ngokuvamile kuthatha imizuzu engaba ngu-30 ukuqedela. Uzohlala esihlalweni esinethezekile ngalesi sikhathi, futhi iziguli eziningi ziletha izincwadi, amaphilisi, noma amalungu omndeni ahlala nazo. Ngaphambi kokufakwa kwakho, ungase uthole imithi yangaphambi kokwelashwa ukusiza ukuvimbela ukusabela komzimba noma ukunciphisa imiphumela emibi.

Akudingeki ukuthi wenze izinguquko ezikhethekile ekudleni ngaphambi kokufakwa kwakho. Ungadla ngokujwayelekile futhi uthathe imithi yakho ejwayelekile ngaphandle uma udokotela wakho ekutshela ngokuqondile ngenye indlela. Ukuhlala unamanzi ngokwanele ngokuphuza amanzi amaningi ngaphambi nangemva kokwelashwa kungasiza umzimba wakho ukuthi usebenze imithi ngempumelelo.

Kufanele ngiyithathe isikhathi esingakanani i-Pembrolizumab?

Ubude bokwelashwa nge-pembrolizumab buhlukahluka kakhulu ngokuya ngohlobo lomdlavuza wakho oluthile nokuthi usabela kahle kangakanani emuthini. Iziguli eziningi zithola ukwelashwa kusukela ezinyangeni ezimbalwa kuya eminyakeni emibili, ngokufakwa okuvame ukunikezwa njalo emavikini amathathu ukuya kwamathandathu.

Udokotela wakho we-oncologist uzohlola njalo inqubekela phambili yakho ngokuskena, ukuhlolwa kwegazi, nokuhlolwa komzimba. Uma umdlavuza wakho usabela kahle futhi ukwazi ukubekezelela ukwelashwa, ungaqhubeka isikhathi esiphelele esinconyiwe. Kodwa-ke, uma uhlangabezana nemiphumela emibi ebalulekile noma umdlavuza wakho uqhubeka, udokotela wakho angase alungise noma amise ukwelashwa.

Ezinye iziguli zingase zikwazi ukuthatha amakhefu okwelashwa noma

Imiphumela emibi engathi sína kodwa engavamile ingathinta izitho ezihlukahlukene lapho amasosha omzimba wakho eseba matasa ngokweqile. Lokhu kungabandakanya ukuvuvukala kwamaphaphu (i-pneumonitis), izinkinga zesibindi, izifo ze-thyroid, noma izinkinga zezinso. Ithimba lakho lezokwelapha lizokuqapha ngokucophelela ngezivivinyo zegazi ezivamile kanye nezifundo zokucabanga ukuze kubanjwe noma yiziphi izinkinga zisasekuqaleni.

Imiphumela emibi engavamile kodwa engathi sína ingabandakanya ukusabela okukhulu okuhlobene nokuzivikela komzimba okuthinta inhliziyo, ubuchopho, noma ezinye izitho. Ngenkathi lezi zinkinga zingavamile, zidinga ukunakekelwa kwezokwelapha ngokushesha. Ithimba lakho lezempilo lizokufundisa izimpawu zokuxwayisa okufanele uzibheke futhi likunikeze imininingwane yokuxhumana ngezinkinga eziphuthumayo.

Ubani Ongafanele Athathe i-Pembrolizumab?

I-Pembrolizumab ayifanele wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Abantu abanezimo ezithile zokuzivikela komzimba kungenzeka bangabi ngabantu abafanelekayo ngoba umuthi ungenza isimo sabo esiyisisekelo sibe sibi kakhulu.

Uma unezifo ezisebenzayo zokuzivikela komzimba njenge-rheumatoid arthritis, i-lupus, noma isifo samathumbu esivuvukalayo, udokotela wakho uzohlola izingozi nezinzuzo ngokucophelela. Ungase ukwazi ukuthola i-pembrolizumab, kodwa uzodinga ukuqapha okwengeziwe futhi mhlawumbe nemithi eyengeziwe yokuphatha isimo sakho sokuzivikela komzimba.

Abesifazane abakhulelwe akufanele bathole i-pembrolizumab njengoba ingalimaza ingane esakhula. Uma uneminyaka yokuzala, uzodinga ukusebenzisa izindlela zokuvimbela inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nasezinyangeni ezimbalwa ngemva komthamo wakho wokugcina. Udokotela wakho uzoxoxa ngezinketho zokuhlela umndeni nesikhathi uma lokhu kuyikukhathaza kuwe.

Abantu abanezifo ezinzima zezinso noma zesibindi bangase badinge ukulungiswa komthamo noma bangabi ngabantu abafanelekayo bokwelashwa. Udokotela wakho uzobuyekeza ukusebenza kwezitho zakho ngezivivinyo zegazi ngaphambi kokuqala ukwelashwa futhi aqhubeke nokuqapha ngesikhathi sonke sokunakekelwa kwakho.

Igama Lomkhiqizo Le-Pembrolizumab

I-Pembrolizumab ithengiswa ngaphansi kwegama lomkhiqizo elithi Keytruda, elenziwa yi-Merck & Co. Ungase uzwe ithimba lakho lezempilo lisebenzisa noma yiliphi igama ngokushintshana, njengoba libhekisela emuthini ofanayo.

Uma uthola ukwelashwa kwakho, ibhodlela lomuthi lizobhalwa njenge-Keytruda, futhi yilokhu ozokubona emarekhodini akho ezokwelapha nasemapepheni omshwalense. Womabili la magama abhekisela esithakweni esisebenzayo esifanayo kanye nokwakheka.

Ezinye Izindlela Zokwelapha Nge-Pembrolizumab

Ezinye izindlela zokuvimbela amasosha omzimba zisebenza ngendlela efana ne-pembrolizumab, nakuba ukukhetha okungcono kuncike ohlotsheni lwakho oluthile lomdlavuza kanye nezimo zakho. Udokotela wakho we-oncologist uzokhetha inketho efanele kakhulu ngokusekelwe ebufakazini bomtholampilo kanye nesimo sakho esithile.

I-Nivolumab (Opdivo) ingenye i-PD-1 inhibitor esebenza ngendlela efana kakhulu ne-pembrolizumab. Kwezinye izinhlobo zomdlavuza, le mithi isebenza kahle ngokulinganayo, kanti kwezinye, enye ingase ithandwe ngokusekelwe ezifundweni zocwaningo. Udokotela wakho uzokuchazela ukuthi kungani bekhethe i-pembrolizumab ngqo ekwelashweni kwakho.

Ezinye izinketho ze-immunotherapy zihlanganisa i-ipilimumab (Yervoy), eqondiswe kwenye i-immune checkpoint ebizwa nge-CTLA-4, kanye nezinhlobo ezihlukahlukene ze-PD-L1 inhibitors njenge-atezolizumab (Tecentriq). Ngezinye izikhathi le mithi isetshenziswa ngokuhlanganyela ne-pembrolizumab ukuze kuthuthukiswe ukusebenza kahle.

Ukwelashwa kwendabuko okufana ne-chemotherapy, i-radiation therapy, noma imithi eqondiswe ekwelapheni kungase futhi kube ezinye izindlela noma kusetshenziswe kanye ne-pembrolizumab. Uhlelo lwakho lokwelashwa luzokwenziwa ngendlela oyifisayo ngokusekelwe ezintweni ezithile zomdlavuza wakho, impilo yakho yonke, kanye nemigomo yakho yokwelashwa.

Ingabe i-Pembrolizumab Ingcono Kune-Nivolumab?

Kokubili i-pembrolizumab ne-nivolumab ziyizinto ezinhle kakhulu ze-PD-1 inhibitors ezisebenza ngezindlela ezifanayo kakhulu, futhi akukho ngisho neyodwa 'engcono' kunenye. Ukukhetha phakathi kwazo kuvame ukuncika ohlotsheni lwakho oluthile lomdlavuza, ubufakazi bocwaningo obutholakalayo, futhi ngezinye izikhathi izinto ezingokoqobo njengeshejuli yokulinganisa.

Ngeminye iminyango yomdlavuza njenge-melanoma, yomibili imithi ikhombise ukusebenza kahle okufanayo ezivivinyweni zomtholampilo. Ngomdlavuza wamaphaphu, i-pembrolizumab ingase ithandwe njengokwelashwa kokuqala kwezinye izimo, kuyilapho i-nivolumab ingase ikhethwe kwezinye. Udokotela wakho we-oncologist uzosekela isinqumo sakhe ocwaningweni lwamanje lwesimo sakho esithile.

Amaphrofayili emiphumela emibi yomibili imithi iyafana kakhulu, nakuba ezinye iziguli zingase zikwazi ukubekezelela eyodwa kangcono kunenye. Uma uhlangabezana nemiphumela emibi ebalulekile ngomuthi owodwa, udokotela wakho angase acabange ukushintshela komunye uma kufanele uhlobo lwakho lomdlavuza.

Imibuzo Evame Ukubuzwa Mayelana ne-Pembrolizumab

Ingabe i-Pembrolizumab iphephile kubantu abanesifo sikashukela?

I-Pembrolizumab ingasetshenziswa ngokuphepha kubantu abanesifo sikashukela, kodwa idinga ukuqapha ngokucophelela ngoba umuthi ngezinye izikhathi ungathinta amazinga kashukela egazini. Ithimba lakho lokuphatha isifo sikashukela lizosebenza eduze nethimba lakho le-oncology ukuqinisekisa ukuthi ushukela wakho wegazi uhlala ulawulwa kahle ngesikhathi sokwelashwa.

Ezimweni ezingavamile, i-pembrolizumab ingabangela ukuthi isifo sikashukela sohlobo 1 sithuthuke, ngisho nakubantu abangakaze babe nesifo sikashukela ngaphambili. Ithimba lakho lezempilo lizogada amazinga kashukela wakho wegazi njalo futhi liqaphele izimpawu ezinjengokwanda komzwelo wokoma, ukuvama ukuchama, noma ukuncipha kwesisindo okungachazeki.

Ngingenzani uma ngiphuthelwa ngengozi umthamo we-Pembrolizumab?

Uma uphuthelwa ukufakwa kwe-pembrolizumab okuhleliwe, xhumana nethimba lakho le-oncology ngokushesha ngangokunokwenzeka ukuze ulungiselele kabusha. Njengoba lo muthi unikezwa ngeshejuli ethile, kubalulekile ukugcina isikhathi esiqhubekayo ukuze uthole imiphumela engcono kakhulu.

Udokotela wakho uzonquma indlela engcono kakhulu yokubuyela emgqeni ngeshejuli yakho yokwelashwa. Ezimweni eziningi, uzomane uthole umthamo wakho olandelayo ngokushesha nje lapho ungalungiswa, bese uqhubeka neshejuli yakho ejwayelekile kusukela ngaleso sikhathi.

Ngingenzani uma ngihlangabezana nemiphumela emibi emibi?

Uma uhlangabezana nemiphumela emibi kakhulu efana nobunzima bokuphefumula, ubuhlungu besifuba, isifo sohudo esibi, noma ukukhathala okungajwayelekile, xhumana nethimba lakho lezempilo ngokushesha noma uye egumbini eliphuthumayo. Lokhu kungaba yizimpawu zemiphumela emibi ehlobene nokuzivikela komzimba edinga ukunakwa ngokushesha.

Ithimba lakho le-oncology lizokunikeza imihlahlandlela ethile mayelana nokuthi yiziphi izimpawu ezidinga ukunakekelwa kwezokwelapha ngokushesha kanye nolwazi lokuxhumana oluphuthumayo. Imiphumela eminingi emibi ingalawulwa ngempumelelo uma itholwe kusenesikhathi, ngakho unganqikazi ukuxhumana uma ukhathazekile.

Ngingayeka nini ukuthatha i-Pembrolizumab?

Isinqumo sokuyeka ukwelashwa nge-pembrolizumab sincike ezintweni eziningana, okuhlanganisa ukuthi umdlavuza wakho uphendula kahle kangakanani, yimiphi imiphumela emibi oyitholayo, kanye nesimo sakho sempilo esiphelele. Udokotela wakho we-oncologist uzokwenza lesi sinqumo ngokusekelwe ekuqapheni njalo nasekuhloleni.

Ezinye iziguli ziqeda inkambo yazo yokwelashwa ehleliwe futhi zingayeka ngemva kokuthola imiphumela emihle. Abanye bangase badinge ukuyeka ngaphambi kwesikhathi ngenxa yemiphumela emibi noma ukuqhubeka komdlavuza. Udokotela wakho uzoxoxa ngesikhathi nezizathu zokuyeka ukwelashwa kusenesikhathi ukuze ukwazi ukulungiselela isigaba esilandelayo sokunakekelwa kwakho.

Ngingathatha eminye imithi ngenkathi ngise-Pembrolizumab?

Ngokuvamile ungaqhubeka nokuthatha imithi yakho evamile ngenkathi uthola i-pembrolizumab, kodwa kubalulekile ukugcina ithimba lakho le-oncology linolwazi ngakho konke okuthathayo. Eminye imithi, ikakhulukazi imithi ecindezela ukuzivikela komzimba, ingase idinge ukulungiswa noma ukugadwa eduze.

Njalo hlola nethimba lakho lezempilo ngaphambi kokuqala noma iyiphi imithi emisha, okuhlanganisa imithi etholakala ngaphandle kwekhawunta, izithasiselo, noma imithi yezitshalo. Bangakuncoma nganoma yikuphi ukusebenzisana okungaba khona futhi baqinisekise ukuthi ukwelashwa kwakho kuhlala kuphephile futhi kuphumelela.