Ibyerekeye-kanseri / kuvura / ivuriro-ibigeragezo / indwara / extragonadal-germ-selile-ibibyimba / kuvura
Kuvura Igeragezwa rya Clinical ya Extragonadal Germ Tumor
Igeragezwa rya Clinical ni ubushakashatsi bwubushakashatsi burimo abantu. Igeragezwa rya clinique kururu rutonde ni kuvura mikorobe idasanzwe. Ibigeragezo byose kurutonde bishyigikiwe na NCI.
Amakuru yibanze ya NCI kubyerekeye ibizamini byamavuriro asobanura ubwoko nicyiciro cyibigeragezo nuburyo bikorwa. Igeragezwa rya Clinical rireba uburyo bushya bwo kwirinda, gutahura, cyangwa kuvura indwara. Urashobora gushaka gutekereza kubijyanye no kwitabira ikizamini cyamavuriro. Vugana na muganga wawe kugirango agufashe guhitamo niba umwe akubereye.
Ikigeragezo 1-7 cya 7
Igenzura rifatika, Bleomycine, Carboplatine, Etoposide, cyangwa Cisplatine mu kuvura abarwayi b’abana n’abakuze bafite ibibyimba byo mu Budage
Iki cyiciro cya III cyigeragezo cyiga uburyo kugenzura neza, bleomycine, karboplatine, etoposide, cyangwa cisplatine bikora mukuvura abarwayi babana nabakuze bafite ibibyimba bya selile. Igenzura rifatika rishobora gufasha abaganga gukurikirana ingingo zifite ibibyimba biterwa na mikorobe nkeya nyuma yo kuvaho. Ibiyobyabwenge bikoreshwa muri chimiotherapie, nka bleomycine, karboplatine, etoposide, na cisplatine, bikora muburyo butandukanye bwo guhagarika imikurire ya selile yibibyimba, haba mukwica selile, kubabuza gutandukana, cyangwa kubabuza gukwirakwira.
Aho uherereye: ahantu 435
Byihuta cyangwa bisanzwe BEP Chimoterapi mu kuvura abarwayi bafite ibibyimba bito cyangwa bidakabije-Ibyago byo mu ngirabuzimafatizo yo mu Budage
Iki cyiciro cya gatatu cyateganijwe cyiga uburyo gahunda yihuse ya sulfate ya bleomycine sulfate, etoposide fosifate, na cisplatine (BEP) ya chimiotherapie ikora ugereranije na gahunda isanzwe ya chimiotherapie ya BEP mukuvura abarwayi bafite ibibyimba biterwa na mikorobe byanduye bikabije bikwirakwira mubindi ahantu mu mubiri (metastatike). Ibiyobyabwenge bikoreshwa muri chimiotherapie, nka sulfate ya bleomycine, fosifate ya etoposide, na cisplatine, bikora muburyo butandukanye bwo guhagarika imikurire ya selile yibibyimba, haba mukwica selile, kubabuza gutandukana, cyangwa kubabuza gukwirakwira. Gutanga chimiotherapie ya BEP kuri gahunda yihuse, cyangwa "yihuse" irashobora gukora neza hamwe ningaruka nkeya mukuvura abarwayi bafite ibibyimba byo hagati ya mikorobe mito cyangwa ibyago bike ugereranije na gahunda isanzwe.
Aho uherereye: 126
Imiti isanzwe-Igizwe na Chimiotherapie cyangwa Imiti myinshi ikomatanya Chimiotherapie hamwe noguhindura ingirangingo mu kuvura abarwayi bafite ibibyimba byo mu Budage byongeye cyangwa byangiritse.
Igeragezwa ryicyiciro cya III ryiga uburyo bwiza bwo kuvura imiti ya chimiotherapie ikora neza ugereranije na chimiotherapie ikabije hamwe noguhindura ingirabuzimafatizo mu kuvura abarwayi bafite ibibyimba bya mikorobe byagarutse nyuma yigihe cyiterambere cyangwa ntibitabe kwivuza. Ibiyobyabwenge bikoreshwa muri chimiotherapie, nka paclitaxel, ifosfamide, cisplatine, karboplatine, na etoposide, bikora muburyo butandukanye bwo guhagarika imikurire ya selile yibibyimba, haba mukwica selile, kubabuza gutandukana, cyangwa kubabuza gukwirakwira. Gutanga chimiotherapie mbere yo guterwa ingirangingo fatizo ihagarika imikurire ya selile ya kanseri ibabuza kubacamo ibice cyangwa kubica. Gutanga ibintu bikangura ubukoroni, nka filgrastim cyangwa pegfilgrastim, hamwe nibiyobyabwenge bya chimiotherapie, ifasha ingirabuzimafatizo kuva mumagufa yerekeza mumaraso kugirango zishobore gukusanywa no kubikwa. Chimiotherapie noneho itangwa kugirango itegure igufwa ryamagufa yo guterwa ingirangingo. Ingirabuzimafatizo noneho zisubizwa umurwayi kugirango zisimbuze selile zikora amaraso zangijwe na chimiotherapie. Kugeza ubu ntiharamenyekana niba imiti myinshi ya chimiotherapie hamwe no guhinduranya ingirangingo ngengabuzima ikora neza kuruta imiti ivura imiti isanzwe mu kuvura abarwayi bafite ibibyimba biterwa na mikorobe.
Aho uherereye: ahantu 54
Durvalumab na Tremelimumab mu kuvura abarwayi bafite ibibyimba byo mu Budage byongeye cyangwa byangiritse
Iki cyiciro cya II cyikigereranyo cyiga uburyo durvalumab na tremelimumab bikora neza mukuvura abarwayi bafite ibibyimba bya selile bagarutse nyuma yigihe cyiterambere cyangwa ntibitabe kwivuza. Immunotherapy hamwe na antibodiyite za monoclonal, nka durvalumab na tremelimumab, irashobora gufasha sisitemu yumubiri yumubiri gutera kanseri, kandi irashobora kubangamira ubushobozi bwingirabuzimafatizo yibibyimba gukura no gukwirakwira.
Aho uherereye: ahantu 7
Autologous Peripheral Blood Stem Cell Transplant for Germ Cell Tumors
Amahitamo yo kuvura abarwayi ba mikorobe yisubiramo cyangwa yangiritse (GCT) ni make. Imiti ikabije ya chimiotherapie hamwe no gutabara ingirabuzimafatizo (autologique stem selile transplant), iyo itanzwe bikurikiranye, yerekanye ko igice cyabarwayi gishobora gukira. Uburyo bwiza bwo gukoresha imiti myinshi ya chimiotherapie, ariko, ntibizwi. Muri iki kigeragezo, tuzakoresha tandem autologique transplant hamwe na rejime zidashobora kwihanganira imiti ivura abarwayi bafite GCTs yongeye kwisubiraho.
Aho uherereye: Kaminuza ya Minnesota / Ikigo cya Kanseri ya Masonic, Minneapolis, Minnesota
Melphalan, Carboplatin, Mannitol, na Sodium Thiosulfate mu kuvura abarwayi hamwe na CNS Embryonal cyangwa Germ selile yibibyimba.
Iki cyiciro cya I / II cyiga ku ngaruka n’igipimo cyiza cya melphalan iyo gitanzwe hamwe na karboplatine, mannitol, na sodium thiosulfate, no kureba uburyo bakora neza mu kuvura abarwayi bafite sisitemu yo hagati y’imyanya myororokere (CNS) isoro cyangwa mikorobe. ibibyimba bya selile. Ibiyobyabwenge bikoreshwa muri chimiotherapie, nka melphalan na karboplatine, bikora muburyo butandukanye bwo guhagarika imikurire ya selile yibibyimba, haba mukwica selile, kubabuza gutandukana, cyangwa kubabuza gukwirakwira. Osmotic maraso-barrière barrière (BBBD) ikoresha mannitol kugirango ifungure imiyoboro yamaraso ikikije ubwonko kandi itume ibintu byica kanseri bijyanwa mubwonko. Sodium thiosulfate irashobora gufasha kugabanya cyangwa gukumira kunanirwa kwumva nuburozi kubarwayi barimo kuvura chimiotherapie hamwe na karboplatine na BBBD.
Aho uherereye: ahantu 2
Adjuvant Tumor Lysate Urukingo na Iscomatrix Hamwe cyangwa idafite Metronomic Oral Cyclophosphamide na Celecoxib mubarwayi bafite indwara mbi mbi yibihaha, Esophagus, Pleura, cyangwa Mediastinum
Amavu n'amavuko: Mu myaka yashize, kanseri-testis (CT) antigene (CTA), cyane cyane izashyizweho na gen kuri X chromosome X (CT-X), byagaragaye ko ari intego ishimishije yo gukingira kanseri. Mu gihe indwara mbi z’amateka atandukanye zigaragaza CTA zitandukanye, ibisubizo by’ubudahangarwa kuri izo poroteyine bigaragara ko bidasanzwe ku barwayi ba kanseri, bishoboka ko biterwa n’imvugo ya antigen yo mu rwego rwo hasi, itandukanye, ndetse n’uturemangingo T twirinda indwara T tuba mu bibyimba no kuzenguruka kuri buri muntu. . Byumvikane neza, gukingiza abarwayi ba kanseri bafite selile yibibyimba byerekana urugero rwinshi rwa CTAs hamwe nuburyo bugabanya cyangwa bubuza ingirabuzimafatizo za T bizatera ubudahangarwa bwagutse kuri izo antigene. Kugira ngo dusuzume iki kibazo, abarwayi bafite kanseri y'ibihaha y'ibanze na kanseri ya Esophageal, mesothelioma yishimye, saroma ya thoracic, thymic neoplasms hamwe na kanseri ya mikorobe ya mediastinal, hamwe na sarcomas, melanoma, ibibyimba bya selile, cyangwa epithelial malignancies metastatic to ibihaha, pleura cyangwa mediastinum nta kimenyetso cyerekana indwara (NED) cyangwa indwara nkeya zisigaye (MRD) nyuma yubuvuzi busanzwe butandukanye. Urukingo hamwe na H1299 kanseri yibibyimba lysates hamwe na Iscomatrix adjuvant. Inkingo zizatangwa hamwe na metronomic yo mu kanwa cyclophosphamide (50 mg PO BID x 7d q 14d), na celecoxib (400 mg PO BID). Ibisubizo bya serologique kuri CTAs zitandukanye hamwe nibisubizo byubudahangarwa bwibibyimba biterwa na autologique EBVtransformed lymphocytes bizasuzumwa mbere na nyuma y amezi atandatu yo gukingirwa. Intego z'ibanze: 1. Kugirango hamenyekane inshuro nyinshi ibisubizo by’ubudahangarwa kuri CTAs ku barwayi bafite indwara mbi ya thoracic nyuma yo gukingirwa na H1299 selile lysate / Iscomatrix (TM) yonyine ugereranije n’abarwayi bafite indwara ziterwa na thoracic nyuma yo gukingirwa na H1299 selile lysate / Urukingo rwa Iscomatrix hamwe na cyclophosphamide na celecoxibib. . Intego za kabiri: 1. Gusuzuma niba umunwa metronomic cyclophosphamide hamwe na celecoxib ivura bigabanya umubare nijanisha ryingirabuzimafatizo za T kandi bikagabanya ibikorwa byiyi selile kubarwayi bafite indwara mbi ya thoracic bafite ibyago byo kongera kubaho. 2. Gusuzuma niba urukingo rwa H1299 lysate / Iscomatrix (TM) rukingira ubudahangarwa bw'umubiri ku kibyimba cya autologique cyangwa cyahinduwe na autologique EBV yahinduwe na lymphocytes (B selile). Abemerewe: - Abarwayi bafite kanseri ntoya cyangwa yerekana ibimenyetso bya selile ntoya cyangwa kanseri y'ibihaha itari ntoya (SCLC; NSCLC), kanseri yo mu bwoko bwa Esophageal (EsC), mesothelioma malignant pleural mesothelioma (MPM), ibibyimba bya mikorobe ya thymic cyangwa mediastinal, thoracic sarcomas, cyangwa melanoma, sarcomas, cyangwa epithelial malignancies metastatic to ibihaha, pleura cyangwa mediastinum idafite ibimenyetso byubuvuzi byindwara zikora (NED), cyangwa indwara ntoya (MRD) idashobora kuboneka byoroshye na biopsy idatera cyangwa resection / imirasire nyuma yubuvuzi busanzwe bwarangiye mubyumweru 26 bishize. . - Abarwayi bagomba kuba bafite imyaka 18 cyangwa irenga bafite imikorere ya ECOG ya 0 2. - Abarwayi bagomba kuba bafite amagufwa ahagije, impyiko, umwijima, ibihaha numutima. - Abarwayi ntibashobora kuba kumiti ya immunosuppressive sisitemu mugihe inkingo zitangiye. Igishushanyo: - Nyuma yo gukira kubagwa, chimiotherapie, cyangwa chemo / XRT, abarwayi bafite NED cyangwa MRD bazakingirwa hakoreshejwe inshinge za IM hamwe na lysates ya H1299 na Iscomatrix (TM) buri kwezi amezi 6. - Inkingo zizakoreshwa cyangwa zidafite metronomic oral oral cyclophosphamide na celecoxib. - Uburozi bwa sisitemu hamwe nigisubizo cyikingira ryubuvuzi bizandikwa. Gukingiza mbere na nyuma yo gukingira serologique na selile byahujwe kubisubizo bisanzwe kuri antigene ya CT kimwe na selile kanseri yibibyimba (niba bihari) na lymphocytes zahinduwe na EBV bizasuzumwa mbere na nyuma yo gukingirwa. - Imibare / ijanisha n'imikorere ya selile T igenzura mumaraso ya peripheri bizasuzumwa mbere, mugihe, na nyuma yinkingo. - Abarwayi bazakurikiranwa mu ivuriro hamwe na scan ya buri gihe kugeza igihe indwara izongera.
Aho biherereye: Ikigo cyigihugu cyita ku buzima Clinical Centre, Bethesda, Maryland
