Ku saabsan-kansarka / daaweynta / tijaabooyinka-kiliinikada / cudurka / extragonadal-jeermiska-unugyada / burooyinka / daaweynta

Daaweynta Tijaabooyinka Kiliinikada Daaweynta ee 'Extragonadal Germ Cell Tumor'

Tijaabooyinka caafimaad waa daraasado cilmi baaris ah oo dadka ku lug leh. Tijaabooyinka caafimaad ee liiskan waxaa loogu talagalay daaweynta burooyinka unugyada jeermiska dheeriga ah. Dhammaan tijaabooyinka ku jira liiska waxaa taageera NCI.

Macluumaadka aasaasiga ah ee NCI ee ku saabsan tijaabooyinka bukaan socodka wuxuu sharxayaa noocyada iyo wejiyada tijaabooyinka iyo sida loo fuliyo. Tijaabooyinka caafimaad waxay eegaan habab cusub oo looga hortago, lagu ogaado, ama lagu daweeyo cudur. Waxaa laga yaabaa inaad rabto inaad ka fikirto kaqeybqaadashada tijaabada caafimaadka. La hadal dhakhtarkaaga si uu kaaga caawiyo go aansashada haddii mid kugu habboon yahay.

Tijaabooyinka 1-7 ee 7

Kormeerka Firfircoon, Bleomycin, Carboplatin, Etoposide, ama Cisplatin ee Daaweynta Bukaanka Carruurta iyo Dadka Waaweyn ee leh Burooyinka Jeermiska Jeermiska

Tijaabadan wejiga III waxay tijaabineysaa sida ugu wanaagsan ee kormeerka firfircoon, bleomycin, karboplatin, etoposide, ama cisplatin ay uga shaqeeyaan daaweynta bukaanka carruurta iyo dadka waaweyn ee qaba burooyinka unugyada jeermiska. Lasocodka firfircoon wuxuu ka caawin karaa dhakhaatiirta inay la socdaan maadooyinka leh burooyinka unugyada jeermiska ee halista yar ka dib marka laga saaro burooyinka. Daawooyinka loo isticmaalo kiimoteraabiga, sida bleomycin, karboplatin, etoposide, iyo cisplatin, waxay u shaqeeyaan siyaabo kala duwan si ay u joojiyaan koritaanka unugyada burooyinka, iyagoo dilaya unugyada, iyaga oo ka joojinaya inay kala baxaan, ama ka joojiyaan faafitaanka.

Goobta: 435 goobood

Dardargelinta ama Heerka Daaweynta Daaweynta Daaweynta Daaweynta Daaweynta Daaweynta Daaweynta Bukaanka ee Bukaannada Dhexe ama Khatarta Khatarta ah

Wejigan tijaabada ah ee la kala soocay III ayaa daraasad ku sameeya sida wanaagsan ee jadwalka loo dardar geliyey ee loo yaqaan 'bleomycin sulfate, etoposide phosphate, iyo cisplatin (BEP) chemotherapy ayaa u shaqeeya marka la barbar dhigo jadwalka caadiga ah ee daaweynta' BEP chemotherapy 'ee lagu daaweynayo bukaannada qaba burooyinka unugyada jeermiska dhexe ama kuwa halista ah ee ku faafay kuwa kale meelaha jirka (metastatic). Daawooyinka loo isticmaalo kiimoteraabiga, sida bleomycin sulfate, etoposide phosphate, iyo cisplatin, waxay u shaqeeyaan siyaabo kala duwan si loo joojiyo koritaanka unugyada burooyinka, iyadoo la dilayo unugyada, iyadoo laga joojinayo inay kala baxaan, ama laga joojiyo faafitaanka. Bixinta daaweynta kemotherabi ee BEP si dhakhso leh, ama "xawaareyn" ah ayaa laga yaabaa inay sifiican ula shaqeyso waxyeelo yar oo ka timaadda daaweynta bukaanka qaba burooyinka unugyada unugyada jeermiska dhexe ama kuwa saboolka ah ee saboolka marka la barbar dhigo jadwalka caadiga ah.

Goobta: 126 goobood

Isugeynta Heerka Qiyaasta Chemotherapy ama Isku-darka Qiyaasta-Chemotherapy iyo Qalitaanka Qalitaanka 'Stem Cell' ee lagu daaweynayo Bukaannada Burooyinka Unugyada Jeermiska Jecel

Wejigan la kala soocay ee tijaabada ah ayaa daraasad ku sameeya sida ugu fiican ee loo qaato qiyaasta isku-darka daaweynta kiimoteraabiga marka loo eego isugeynta sare ee isku-darka kiimoteraabiga iyo unugyada unugyada unugyada unugyada ee lagu daweeyo bukaanada qaba burooyinka unugyada jeermiska ee soo noqday ka dib muddo horumar ah ama aan ka jawaabin daaweynta. Daawooyinka loo isticmaalo kiimoteraabiga, sida paclitaxel, ifosfamide, cisplatin, karboplatin, iyo etoposide, waxay u shaqeeyaan siyaabo kala duwan si ay u joojiyaan koritaanka unugyada burooyinka, iyagoo dilaya unugyada, iyaga oo ka joojinaya inay kala baxaan, ama ka joojiyaan inay faafaan. Siinta kiimoteraabiga kahor unugga unugyada xididku waxay joojisaa koritaanka unugyada kansarka iyagoo ka joojinaya inay qaybiyaan ama dilaan. Siinta arrimo gumeysi kiciya, sida filgrastim ama pegfilgrastim, iyo dawooyinka kimikalka qaarkood, waxay ka caawisaa unugyada jirku inay ka guuraan dhuuxa lafta una wareegaan dhiigga si markaa loo ururiyo loona keydiyo. Chemotherapy ayaa markaa la siiyaa si loogu diyaariyo dhuuxa lafta xubinta unugyada asliga ah. Unugyada asliga ah ayaa dib loogu celiyaa bukaanka si loo beddelo unugyada dhiigga sameysma ee lagu baabi'iyey kiimoteraabiga. Wali lama oga in isku-darka daawada isku-darka ah ee loo yaqaan 'chemotherapy' iyo unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada jeermiska.

Goobta: 54 goobood

Durvalumab iyo Tremelimumab oo lagu daaweynayo bukaanka burooyinka Unugyada Jeermiska ee Soo Noqday

Tijaabadan wejiga II ah waxay daraasad ku samaynaysaa sida ugu wanaagsan ee durvalumab iyo tremelimumab uga shaqeeyaan daaweynta bukaanada qaba burooyinka unugyada jeermiska ee soo noqday ka dib muddo horumar ah ama aan ka jawaabin daaweynta. Immunotherapy oo leh unugyada unugyada monoclonal, sida durvalumab iyo tremelimumab, ayaa laga yaabaa inay ka caawiso habka difaaca jirka inuu weeraro kansarka, wuxuuna faragelin karaa awooda unugyada burooyinka inay koraan oo ay faafaan.

Goobta: 7 goobood

Qalliinka Unugyada Dhiigga Dhiigga Gaarka ah ee 'Autologous'

Fursadaha daaweynta ee burooyinka unugyada jeermiska soo noqnoqda ama diidmada leh (GCT) bukaanku way xadidan yihiin. Daaweynta kiimikada ee sare leh oo la socota badbaadinta unugyada asliga ah (autologous stem cell transplant), markii la siiyo si isdaba-joog ah, waxay muujisay in qayb ka mid ah bukaanada la daaweyn karo. Si kastaba ha noqotee, lama garanayo nidaamka dawaynta kiimikada ee ugu sarreeya. Tijaabadan, waxaan u adeegsan doonnaa tandem translanting translantes with non-cross resisting regimens si loogu daaweeyo bukaanada qaba GCT-yada soo noqnoqda / diidan.

Goobta: Jaamacadda Minnesota / Xarunta Kansarka ee Masonic, Minneapolis, Minnesota

Melphalan, Carboplatin, Mannitol, iyo Sodium Thiosulfate ee lagu daaweynayo bukaanka qaba CNS Embryonal soo noqnoqda ama Horumar leh

Tijaabadan wejiga I / II waxay daraasad ku samaynaysaa dhibaatooyinka soo raaca iyo qiyaasta ugu wanaagsan ee melphalan marka la siiyo karboplatin, mannitol, iyo sodium thiosulfate, iyo in la arko sida wanaagsan ee ay ugu shaqeeyaan daaweynta bukaanada leh nidaamka soo noqnoqda ama soo noqnoqda (CNS) embriyaha ama jeermiga burooyinka unugyada. Daawooyinka loo isticmaalo kiimoteraabiga, sida melphalan iyo karboplatin, waxay u shaqeeyaan siyaabo kala duwan si ay u joojiyaan koritaanka unugyada burooyinka, iyagoo dilaya unugyada, iyaga oo ka joojinaya kala qaybinta, ama joojinta faafitaanka. Dhibaatada ka timaada maskaxda-maskaxda ee loo yaqaan 'BBBD' waxay isticmaashaa mannitol si loo furo marinnada dhiigga ee ku wareegsan maskaxda loona oggolaado walxaha dila kansarka in si toos ah loogu qaado maskaxda. Sodium thiosulfate waxay kaa caawin kartaa yareynta ama ka hortagga maqal la'aanta iyo sunta sunta ah ee bukaannada ku jira kiimoterapi ee leh karboplatin iyo BBBD.

Goobta: 2 goobood

Tallaalka Adjuvant Tumor Lysate iyo Iscomatrix oo leh ama aan lahayn Metronomic Oral Cyclophosphamide iyo Celecoxib oo ku jira Bukaannada qaba Xasaasiyadda ku lug leh Sambabka, Esophagus, Pleura, ama Mediastinum

Gundhig: Sannadihii ugu dambeeyay, kansar-xiniinyaha (CT) antigens (CTA), gaar ahaan kuwa ay kuqoran yihiin hiddo-wadayaasha 'X chromosome' (hiddo-wadayaasha CT-X), ayaa u muuqday bartilmaameedyo soo jiidasho leh oo loogu talagalay ka hortagga kansarka. Halka astaamaha taariikh-darrada kaladuwan ay muujinayaan noocyo kala duwan oo CTA ah, jawaabaha difaaca ee borotiinadani waxay u muuqdaan wax aan caadi ahayn bukaannada kansarka, laga yaabee inay ugu wacan tahay heer hoose, muujinta antigen kaladuwan, iyo sidoo kale unugyada xakamaynta difaaca jirka ee unugyada jirka iyo wareega nidaamka shaqsiyaadkaas. . Si macquul ah, tallaalka bukaanjiifka kansarka leh unugyada burooyinka oo muujinaya heerar sare ee CTAs oo ay weheliso nidaamyo yareeya ama xakameynaya unugyada xakamaynta T waxay u horseedi doontaa difaac ballaaran antigens-kan. Si loo baaro arintan, bukaanada qaba kansarka sanbabada iyo hunguriga, qanjirka 'mesterheliomas', 'sarmsas thoracic', neoplasms thymic iyo burooyinka unugyada jeermiska dhexdhexaadka, iyo sidoo kale sarcomas, melanomas, burooyinka unugyada jeermiska, ama epithelial malignancies metastatic to sambabada, pleura ama mediastinum oo aan lahayn caddeyn cudur (NED) ama cudurka haraaga ugu yar (MRD) kadib daaweynta caadiga ah ee maadooyinka kala duwan. lagu tallaalay lysates unugyada unugyada H1299 ee loo yaqaan 'Iscomatrix adjuvant'. Tallaallada waxaa lagu maamuli doonaa ama aan la siin doonin cyclophosphamide-ka afka laga qaato ee metronomic (50 mg PO BID x 7d q 14d), iyo celecoxib (400 mg PO BID). Jawaabaha serologiga ee noocyada kala duwan ee CTA-yada dib-u-soo-cusbooneysiinta iyo sidoo kale jawaabaha difaaca jirka ee burooyinka autologous ama epigenetically modified autologous EBVtransformed lymphocytes ayaa la qiimeyn doonaa ka hor iyo ka dib muddada tallaalka lix bilood. Ujeeddooyinka Aasaasiga ah: 1. Si loo qiimeeyo inta jeer ee jawaabaha difaaca jirka ee CTAs ee bukaanka qaba cudurada wadnaha ka dib talaalada H1299 cell lysate / Iscomatrix (TM) oo keli ah marka la barbardhigo bukaanka qaba cudurada halista ah ee soo socda ka dib talaalada H1299 cell lysate / Iscomatrix vaccines oo lagu daray metronomic cyclophosphamide iyo celecoxibib . Ujeeddooyinka Labaad: 1. In la baaro haddii daaweynta metronomic cyclophosphamide iyo daaweynta 'selecoxib' ay hoos u dhigeyso tirada iyo boqolleyda unugyada qawaaniinta T isla markaana ay hoos u dhigeyso howlaha unugyadan bukaanada leh cudurrada halista ah ee wadnaha waxay halis ugu jiraan soo noqnoqoshada. 2. Si loo baaro haddii tallaalka unugyada H1299 lysate / Iscomatrix (TM) ay xoojiso jawaab-celinta jirka ee burooyinka autologous ama epigenetically modified autologous EBV-transformed lymphocytes (B cells). U qalmida: - Bukaannada qaba unugyo yar yar ama kansarka sanbabada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada jirka. ama cilladaha epithelial ee metastatic ee sambabada, pleura ama mediastinum kuwaas oo aan haysan caddayn caafimaad oo ku saabsan cudurka firfircoon (NED), ama cudurka hadhay ee ugu yar (MRD) oo aan si fudud loogu heli karin biopsy aan qallalan ama dib-u-soo-kabasho / shucaac ka dib daaweynta caadiga ah ee lagu dhammaystiray 26-kii toddobaad ee la soo dhaafay . - Bukaanku waa inay ahaadaan 18 sano ama ka weyn oo leh heerka waxqabadka ECOG ee 0 2. - Bukaanku waa inay lahaadaan dhuuxa lafta, kalyaha, beerka, sambabka iyo wadnaha. - Bukaanku ma qaadan karaan dawooyinka isdaba-joogga ah ee nidaamka tallaalka waqtiga ay bilaabanayaan tallaallada. Naqshad: - Ka soo kabashada qalliinka, kiimoteraabiga, ama kiimikada / XRT, bukaanka qaba NED ama MRD waxaa lagu tallaali doonaa iyada oo la adeegsanayo irbadda IM iyada oo loo qaadanayo unugyada unugyada 'H1299 cell lysates' iyo 'Iscomatrix' (TM) ee bil kasta loogu daro 6 bilood. - Tallaallada waxaa lagu maamuli doonaa ama la siin doonaa iyada oo la adeegsanayo cyclophosphamide afka laga qaato oo metronomic ah iyo celecoxib. - Sunta jir ahaaneed iyo ka jawaab celinta jirka ee daaweynta ayaa la duubi doonaa. Tallaalka kahor iyo kadib serologic iyo jawaabaha dhexdhexaadinta unugyada ee gudiga caadiga ah ee CT antigens iyo sidoo kale unugyada burooyinka autologous (haddii la heli karo) iyo EBV-loo beddelay lymphocytes ayaa la qiimeyn doonaa kahor iyo kadib tallaalka. - Tirooyinka / boqolleyda iyo shaqada unugyada xakamaynta ee T ee dhiigga durugsan ayaa la qiimeyn doonaa kahor, inta lagu jiro, iyo kadib tallaalka. - Bukaannada waxaa lagula socon doonaa rugta caafimaadka iyadoo baaritaanno joogto ah lagu sameynayo illaa cudurku ka soo laabanayo.

Goobta: Machadyada Qaranka ee Xarunta Caafimaadka, Bethesda, Maryland