Pafupifupi-khansa / chithandizo / zoyeserera zamatenda / matenda / extragonadal-nyongolosi-zotupa / chithandizo

Chithandizo Chachipatala Pazovuta za Extragonadal Germ Cell Tumor

Mayesero azachipatala ndi maphunziro ofufuza omwe amakhudza anthu. Mayeso azachipatala pamndandandawu ndi omwe amachiritsidwa ndi chotupa cha majeremusi a extragonadal cell. Mayesero onse pamndandanda amathandizidwa ndi NCI.

Zambiri za NCI zokhudzana ndi mayesero azachipatala zimafotokozera mitundu ndi magawo am'mayesero ndi momwe amachitikira. Mayesero azachipatala amayang'ana njira zatsopano zotetezera, kuzindikira, kapena kuchiza matenda. Mungafune kuganizira zokhala ndi gawo pakuyesedwa kwachipatala. Lankhulani ndi dokotala wanu kuti akuthandizeni kusankha ngati mukuyenera.

Mayesero 1-7 pa 7

Kuyang'anitsitsa Mwakhama, Bleomycin, Carboplatin, Etoposide, kapena Cisplatin Pochiza Odwala ndi Achikulire Odwala omwe ali ndi Germ Cell Tumors

Gawo lachitatu lakuyesa limafufuza momwe kuyang'anira, bleomycin, carboplatin, etoposide, kapena cisplatin zimagwirira ntchito pochiza ana ndi achikulire omwe ali ndi zotupa zama cell. Kuyang'anitsitsa mwachidwi kumatha kuthandiza madotolo kuwunika anthu omwe ali ndi zotupa zochepa za majeremusi pambuyo poti chotupa chawo chachotsedwa. Mankhwala omwe amagwiritsidwa ntchito mu chemotherapy, monga bleomycin, carboplatin, etoposide, ndi cisplatin, amagwira ntchito m'njira zosiyanasiyana kuti achepetse kukula kwa maselo otupa, mwina popha ma cell, powalekanitsa kuti asagawike, kapena poletsa kufalikira.

Malo: malo 435

Mofulumira kapena Standard BEP Chemotherapy pochiza Odwala omwe ali ndi zotupa zapakatikati kapena zoopsa za Metastatic Germ Cell Tumors.

Kafukufuku woyeserera gawo lachitatu lino amafufuza momwe kuchuluka kwa magazi kwa bleomycin sulphate, etoposide phosphate, ndi cisplatin (BEP) chemotherapy kumagwirira ntchito poyerekeza ndi dongosolo la BEP chemotherapy pochiza odwala omwe ali ndi zotupa zapakati kapena zosavulaza zomwe zafalikira kwa ena malo m'thupi (metastatic). Mankhwala omwe amagwiritsidwa ntchito mu chemotherapy, monga bleomycin sulphate, etoposide phosphate, ndi cisplatin, amagwira ntchito m'njira zosiyanasiyana kuti achepetse kukula kwa maselo otupa, mwina popha ma cell, powalekanitsa kuti asagawike, kapena poletsa kufalikira. Kupatsa chemotherapy ya BEP mwachangu, kapena "kufulumizitsa" kumatha kugwira ntchito bwino ndi zovuta zochepa pochiza odwala omwe ali ndi zotupa zamagulu apakati kapena zoopsa poyerekeza ndi ndandanda yoyenera.

Malo: malo 126

Kuphatikiza Kwadongosolo Losakanikirana Chemotherapy kapena Kuphatikiza Kwakukulu Chemotherapy ndi Kuika Cell Cell Stem Pochiza Odwala Omwe Amabwereranso Kapena Amachita Zotupa Zam'magazi.

Kafukufukuyu adafufuza momwe mankhwala ogwiritsira ntchito mankhwala osakanikirana amagwiranso ntchito poyerekeza ndi kuchuluka kwa mankhwala ophatikizira chemotherapy komanso kupatsira ma cell a cell pochiza odwala omwe ali ndi zotupa zama cell omwe abwerera patatha nthawi yayitali kapena sanayankhe kuchipatala. Mankhwala omwe amagwiritsidwa ntchito mu chemotherapy, monga paclitaxel, ifosfamide, cisplatin, carboplatin, ndi etoposide, amagwira ntchito m'njira zosiyanasiyana kuti achepetse kukula kwa maselo otupa, mwina popha ma cell, powalekanitsa kuti asagawike, kapena kuwaletsa kuti asafalikire. Kupatsa chemotherapy kusamba kwa tsinde kumaletsa kukula kwa maselo a khansa poletsa kuti asawagawe kapena kuwapha. Kupereka zinthu zolimbikitsa, monga filgrastim kapena pegfilgrastim, ndi mankhwala ena a chemotherapy, Amathandiza maselo am'madzi kuchoka m'mafupa kupita kumwazi kuti athe kusonkhanitsidwa ndikusungidwa. Chemotherapy amapatsidwa kuti akonzekeretse mafupa ake kuti adutse. Maselowo amabwezeretsedwanso kwa wodwalayo kuti alowe m'malo mwa maselo omwe amapanga magazi omwe anawonongedwa ndi chemotherapy. Sizikudziwika ngati mankhwala ophatikizira a chemotherapy komanso ma cell a stem ndi othandiza kwambiri kuposa chemotherapy yomwe imagwiritsidwa ntchito pochiza odwala omwe ali ndi zotupa kapena majeremusi obwereranso.

Malo: malo 54

Durvalumab ndi Tremelimumab pochiza odwala omwe ali ndi kachilombo koyambitsa matenda kapena kachilombo koyambitsa matenda

Gawo ili lachiwiri limawunika momwe durvalumab ndi tremelimumab zimagwirira ntchito pochiza odwala omwe ali ndi zotupa zamagulu omwe abwerera pambuyo poti asintha kapena samvera chithandizo. Immunotherapy yokhala ndi ma monoclonal antibodies, monga durvalumab ndi tremelimumab, imatha kuthandizira chitetezo chamthupi kulimbana ndi khansa, ndipo imatha kusokoneza kuthekera kwa maselo otupa kukula ndikufalikira.

Malo: Malo 7

Autologous Peripheral Magazi Amaika Ma cell Am'mimba Am'mimba

Njira zochiritsira odwala omwe abwereranso kapena omwe ali ndi zotupa zamagulu (GCT) ndizochepa. Chemotherapy yamphamvu kwambiri yopulumutsa ma cell cell (autologous stem cell transplant), ikaperekedwa motsatana, yawonetsa kuti kagawo ka odwala kangachiritsidwe. Mankhwala abwino kwambiri a chemotherapy regimen, komabe, sakudziwika. Poyeseraku, tidzagwiritsa ntchito zopangira ma autologous omwe ali ndi maimidwe osagwiritsa ntchito njira zochizira odwala omwe abwereranso / obwezeretsa ma GCT.

Kumalo: University of Minnesota / Masonic Cancer Center, Minneapolis, Minnesota

Melphalan, Carboplatin, Mannitol, ndi Sodium Thiosulfate pochiza Odwala omwe ali ndi CNS Embryonal kapena Germ Cell Tumors Yaposachedwa kapena Yopita Patsogolo.

Gawoli I / II limayesa zotsatira zoyipa ndi kuchuluka kwa melphalan mukamaperekedwa limodzi ndi carboplatin, mannitol, ndi sodium thiosulfate, ndikuwona momwe amagwirira ntchito pochiza odwala omwe ali ndi ubongo kapena kachilombo koyambitsa matenda (CNS) kamene kamakhala ndi mazira kapena majeremusi. zotupa zama cell. Mankhwala omwe amagwiritsidwa ntchito mu chemotherapy, monga melphalan ndi carboplatin, amagwira ntchito m'njira zosiyanasiyana kuti achepetse kukula kwa zotupa, mwina popha ma cell, powalekanitsa kuti asagawane, kapena poletsa kufalikira. Osmotic magazi-ubongo chotchinga kusokoneza (BBBD) amagwiritsa ntchito mannitol kutsegula mitsempha mozungulira ubongo ndikuloleza zinthu zopha khansa kuti zizinyamulidwa kupita kuubongo. Sodium thiosulfate ingathandize kuchepetsa kapena kupewa kutaya makutu ndi poizoni mwa odwala omwe amalandira chemotherapy ndi carboplatin ndi BBBD.

Malo: malo awiri

Katemera wa Adjuvant Tumor Lysate ndi Iscomatrix Wokhala kapena Wopanda Metronomic Oral Cyclophosphamide ndi Celecoxib mwa Odwala Omwe Amachita Malignancies Amakhudzana ndi Mapapo, Esophagus, Pleura, kapena Mediastinum

Chiyambi: M'zaka zaposachedwa, ma antigen a khansa-testis (CT) (CTA), makamaka omwe amaphatikizidwa ndi majini a X chromosome (CT-X genes), akhala ngati zolinga zabwino za khansa ya immunotherapy. Pomwe zovuta zoyipa zamankhwala osiyanasiyana zimafotokoza ma CTA osiyanasiyana, mayankho amthupi mwa mapuloteniwa amawoneka achilendo kwa odwala khansa, mwina chifukwa cha kuchepa kwa antigen, komanso ma cell a T omwe amapezeka m'malo otupa komanso kufalikira kwa anthuwa. . Zachidziwikire, katemera wa odwala khansa omwe ali ndi chotupa chomwe chimafotokoza kuchuluka kwa ma CTA kuphatikiza ma regimens omwe amawononga kapena kuletsa ma cell olamulira a T aziteteza ku antigen. Pofuna kuwunika nkhaniyi, odwala omwe ali ndi khansa yoyamba yam'mapapo ndi m'mimba, pleural mesotheliomas, thoracic sarcomas, zotupa za thymic ndi zotupa zamagulu apakati, komanso ma sarcomas, melanomas, zotupa zama cell, kapena epithelial malignancies metastatic to mapapu, pleura kapena mediastinum opanda umboni wa matenda (NED) kapena matenda ochepa otsalira (MRD) kutsatira mankhwala amitundu yambiri adzakhala Katemera wa H1299 cell lysates ndi Iscomatrix adjuvant. Katemera adzapatsidwa kapena wopanda metronomic oral cyclophosphamide (50 mg PO BID x 7d q 14d), ndi celecoxib (400 mg PO BID). Mayankho a Serologic ku ma CTA angapo ophatikizanso komanso mayankho a immunologic ku chotupa cha autologous kapena ma epicetic modified autologous EBVtransformed lymphocyte adzayesedwa isanathe komanso itatha nthawi ya katemera wa miyezi isanu ndi umodzi. Zolinga Zapamwamba: 1. Kuyesa kuchuluka kwa mayankho a immunologic ku ma CTA mwa odwala omwe ali ndi thoracic malignancies kutsatira katemera wa katemera wa H1299 cell lysate / Iscomatrix (TM) okha poyerekeza ndi odwala omwe ali ndi zotupa za thoracic zotsatila katemera wa H1299 cell lysate / Iscomatrix katemera kuphatikiza ndi metronomic cyclophosphamide ndi celecoxibib . Zolinga Zachiwiri: 1. Kuwona ngati mankhwala am'thupi a cyclophosphamide ndi celecoxib mankhwala amachepetsa kuchuluka ndi kuchuluka kwa ma cell olamulira a T ndikuchepetsa zochitika zamaselowa mwa odwala omwe ali ndi zilonda zamtundu wa thoracic ali pachiwopsezo chobwereranso. 2. Kuyesa ngati katemera wa H1299 cell lysate / Iscomatrix (TM) amathandizira kuyankha kwa immunologic ku chotupa cha autologous kapena ma lymphocyte osinthidwa a EBV osinthidwa (B cell). Kuvomerezeka: - Odwala omwe ali ndi khansa yaying'ono kapena khansa yaying'ono yam'mapapo (SCLC; NSCLC), khansa ya esophageal (EsC), malignant pleural mesothelioma (MPM), zotupa zamatenda a thymic kapena mediastinal, sarcomas, kapena melanomas, sarcomas, kapena ma epithelial malignancies metastatic to mapapu, pleura kapena mediastinum omwe alibe umboni wazachipatala wa matenda opatsirana (NED), kapena matenda ochepa otsalira (MRD) osafikirika mosavuta ndi biopsy yosasokoneza kapena resection / radiation kutsatira mankhwala omwe adakwaniritsidwa m'masabata 26 apitawa . - Odwala ayenera kukhala azaka 18 kapena kupitilira apo omwe ali ndi mawonekedwe a ECOG a 0 2. - Odwala ayenera kukhala ndi fupa lokwanira, impso, chiwindi, mapapo ndi ntchito yamtima. - Odwala sangakhale kuti ali ndi mankhwala amthupi mwawo nthawi iliyonse katemera amene amayamba. Kupanga: - Pambuyo pochira opaleshoni, chemotherapy, kapena chemo / XRT, odwala omwe ali ndi NED kapena MRD adzalandira katemera kudzera pa jakisoni wa IM ndi ma lysates a H1299 cell ndi Iscomatrix (TM) othandizira mwezi uliwonse kwa miyezi 6. - Katemera adzagwiritsidwa ntchito popanda kapena metronomic oral cyclophosphamide ndi celecoxib. - Zoyambitsa zodetsa komanso kuyankha kwa immunologic kuchipatala zitha kulembedwa. Pre and post vaccinology serologic and cell mediated mayankho pagulu lofananira la ma antigen a CT komanso ma cell a chotupa a autologous (ngati alipo) ndi ma lymphocyte osinthidwa a EBV adzayesedwa kale komanso pambuyo pa katemera. - Manambala / kuchuluka ndi magwiridwe antchito amtundu wa T m'magazi azida azayesedwa kale, nthawi, komanso katemera. - Odwala amatsatiridwa kuchipatala ndikuwunikira mpaka momwe matenda amabwerera.

Kumalo: National Institutes of Health Clinical Center, Bethesda, Maryland