章鱼彩票app-「肺癌攻略连载专栏」Part5.5 靶向医治admin 2019-10-29 共144人围观 ，发现0个评论
Targeted therapy is a class of drugs. It works by stopping key molecules that help cancer cells grow. It is less likely to harm normal cells than chemotherapy. Targeted therapies for lung cancer are listed in Guide 6.
These treatments are briefly described next. Some side effects are listed. Ask your treatment team for a full list of common and rare side effects. In Part 7,information on who should receive these drugs is provided. Targeted therapy is often given when certain mutations are present.
Cell growth is started by growth signals. EGFR is one of the surface receptors in lung cancer cells that can trigger growth signals. Some people with lung cancer have gene mutations that cause EGFR to be overactive. With overactive EGFRs, new cancer cells form quickly. There are five medicines used to stop EGFRs from triggering growth signals. See Figure 17.
埃罗替尼与表皮成长因子受体的一部分衔接，这部分是细胞内的一个组成部分。EGFR的这一部分是酪氨酸激酶。它是磷酸盐的一个对接地，由于它从一个分子移动到另一个分子。埃罗替尼阻断磷酸盐，阻挠 EGFR完结它们的作业。因而，成长信号不是由EGFR 触发的。
Erlotinib attaches to a part of EGFR that is within cells. This part of EGFR is a tyrosine kinase. It is a docking site for phosphate as it is moved from one molecule to another. Erlotinib blocks phosphate and stops EGFRs from completing their job. Thus, growth signals aren’t triggered by EGFRs.
Erlotinib is made as a pill. It should be taken on an empty stomach. The dose given differs among people. Your doctor will decide the dose you need.
Common side effects of erlotinib are rash; diarrhea; not feeling hungry; weakness; trouble breathing; and cough. You may have severe eye, skin, lung, kidney, or liver problems, but these are rare. Other rare events include tears in your gut and bleeding. Don’t take erlotinib if you are pregnant, trying to get pregnant, or breastfeeding.
Gefitinib is the same type of drug as erlotinib. Gefitinib is made as a pill. It can be taken with or without food. It is usually taken once a day.
The most common side effects of gefitinib are ski reactions and diarrhea. Serious side effects include a tear in your gut and eye problems.
Very rarely, severe lung and liver problems occur. Don’t take gefitinib if pregnant, trying to get pregnant, or breastfeeding.
Afatinib is the same type of drug as erlotinib. However, it also stops another surface receptor called HER2. Unlike erlotinib and gefitinib, afatinib doesn’t detach from EGFR and HER2. Its effect on cells doesn’t stop.
Afatinib is made as a pill. It should be taken on an empty stomach. The dose given differs among people. Your doctor will decide the dose you need.
Common side effects of afatinib include diarrhea, nausea, vomiting, skin rash or dryness, acne, nail infection, mouth sores, itching, and not feeling hungry. Diarrhea and skin problems may be severe. Likewise, you may also have lung, liver, heart, and eye problems. Don’t take afatinib if you are pregnant, trying to get pregnant, or breastfeeding.
Osimertinib is the same type of drug as erlotinib. It is made as a pill.It can be taken with or without food. The dose given differs among people.Your doctor will decide the dose you need.
The most common side effects of osimertinib are tiredness, diarrhea, skin rash, dry skin, and nail changes. Nail changes include redness, swelling, pain, and nails breaking and detaching from the finge. Osimertinib may also cause severe eye, lung, or heart problems, but these problems are rare. Osimertinib may harm your baby if you’re pregnant or breastfeeding.
Cetuximab attaches to the ends of EGFRs that are outside of the cell. Thus, molecules (ligands) are blocked from attaching to and turning on EGFRs.
No growth signals are started. Cetuximab also attracts immune cells that help to kill the cancer cells.
Cetuximab with afatinib may be received if the cancer worsens while taking another EGFR-targeted therapy. It is given by infusion. It is usually received once a week or every other week. It may take 2 hours to receive the first dose. Later doses will take only 1 hour.
Common side effects of cetuximab are skin problems. These problems include acne-like rash, dry skin, eye inflammation, and skin infections. Other common side effects are diarrhea and loss of appetite. Blood magnesium levels may drop. Rare but serious side effects include a severe reaction to the infusion and lung damage. Cetuximab may harm your baby if you’re pregnant or breastfeeding.
ALK is a surface receptor that can trigger growth signals in lung cancer cells. In lung cancers with an ALK rearrangement, ALK is overactive. With overactive ALK, new cancer cells form quickly. There are four medicines used to stop ALK from triggering growth signals.
Crizotinib attaches to a part of ALK that is within cells. This part of ALK is a tyrosine kinase. It is a docking site for phosphate as it is moved from one molecule to another. Crizotinib blocks the phosphate and stops ALK signaling.
Crizotinib is made as a pill. It is taken twice a day. It can be taken with or without food.
Common side effects of crizotinib include vision problems; stomach problems (nausea, vomiting, diarrhea, constipation); not feeling hungry; fluid buildup; and feeling tired despite sleep. It can cause dizziness, lung infections, and nerve damage. Severe problems may include lung, liver, and heart problems. Crizotinib may harm your baby if you’re pregnant or breastfeeding.
Ceritinib is the same type of drug as crizotinib. However, the structure of ceritinib differs from crizotinib. Thus, it is able to block phosphate when crizotinib can’t.
Ceritinib is made as a pill. It should be taken on an empty stomach. However, your doctor may suggest a different dose with food. It is taken once a da .
Common side effects of ceritinib are diarrhea, nausea, vomiting, abdominal pain, tiredness, not feeling hungry, and weight loss. It rarely causes severe lung, heart, and liver problems. Ceritinib may harm your baby if you’re pregnant or breastfeeding.
Alectinib is the same type of drug as crizotinib and ceritinib. However, its structure differs.Thus, it is able to block phosphate when other medicines do not.
Alectinib is made as a pill. It is taken twice a day with food. Common side effects of alectinib are tiredness, constipation, swelling, and muscle pain. It rarely causes severe lung, heart, kidney, and liver problems. Alectinib may harm your baby if you’re pregnant or breastfeeding.
Brigatinib works much like the other medicines but its structure differs.Thus, it is able to block phosphate when other medicines do not.Brigatinib is made as a pill. It can be taken with or without food. It is taken once a day. It is given at half dose for the first week of treatment Common side effects include nausea, diarrhea, headache, cough, and tiredness. It may cause severe lung, heart, vision, and muscle problems. Brigatinib may harm your baby if you’re pregnant or breastfeeding.
ROS1 is surface receptor that can trigger growth signals in lung cancer cells. In lung cancers with a ROS1 rearrangement, ROS1 is overactive. With overactive ROS1, new cancer cells form quickly. There are two medicines used to stop ROS1 from triggering growth signals.
Besides ALK, ceritinib also stops growth signals from ROS1. It works by blocking the transfer of phosphate by the tyrosine kinase. Read the section, ALK rearrangement, to learn more about ceritinib.
Besides ALK, crizotinib also stops growth signals from ROS1. It works by blocking the transfer of phosphate by the tyrosine kinase. Read the section, ALK rearrangement, to learn more about crizotinib.
BRAF是细胞内的激酶。它将磷酸盐从一个分子搬运到另一个分子。磷酸盐能激起下一个增加的信号通路。在有BRAF V600E骤变的肺癌中，BRAF过度活泼。跟章鱼彩票app-「肺癌攻略连载专栏」Part5.5 靶向医治着过度活泼的BRAF，新的癌细胞敏捷构成。有三种药物能够医治过度活泼的BRAF信号。参见图18所示。
BRAF is a kinase inside of cells. It transfers phosphates from one molecule to another. The phosphate “turns on” the next growth signal in the pathway. In lung cancers with a BRAF V600E mutation, BRAF is overactive. With overactive BRAF, new cancer cells form quickly. There are three medicines to treat overactive BRAF signals. See Figure 18.
Dabrafenib and trametinib are most often used together for treatment. Dabrafenib attaches to BRAF and blocks the transfer of phosphate. Trametinib blocks the transfer of phosphate by another kinase called MEK. BRAF and MEK are within the same growth signal pathway. MEK is further down in the pathway.
Dabrafenib and trametinib are made as pills. Both should be taken on an empty stomach. Dabrafenib is taken twice a day. Trametinib is taken once a day at the same time each day.
Common side effects of dabrafenib with trametinib include fever, chills, and fatigue. You may feel nauseated, vomit, have diarrhea, or not feel hungry. Your skin may become dry or get a rash. You face, arms, or legs may swell. Bleeding, cough, and shortness of breath are also common.
There are rare but serious side effects.These include tears in your gut, blood clots, and heart, eye, or lung problems. Fever, rash, or bleeding may be severe. Blood sugar may become very high. Other types of cancer may develop.
If you want to have a baby, tell your doctor. Sperm counts can drop in men. Women may have trouble getting pregnant. Don’t use dabrafenib and trametinib if you’re pregnant or breastfeeding. These medicines may harm your baby.
Dabrafenib and trametinib may be too hard on your body. In this case, dabrafenib used alone may be an option. Common side effects include changes in your skin. Your skin may become thick or get warts. Your hands or feet may become red, swell, peel, or feel tender. Other common side effects are feve, joint aches, and hair loss.
Vemurafenib may also be an option if dabrafenib with trametinib can’t be taken. It works like dabrafenib and stops BRAF signals. It is used to treat melanoma. More research is needed on lung cancer.
Vemurafenib is made as a pill. It is taken twice a day. It can be taken with or without food.
Side effects may be alike for melanoma and lung cancer. Common side effects for melanoma treatment include joint pain, tiredness, and nausea. Your skin may get a rash or warts. You may have hair loss or easily get a sunburn. You may feel itchy. Serious side effects include allergic or skin reactions, heart problems, liver or kidney damage, and eye problems.
Cancer cells need the food and oxygen in blood to grow. Cancer cells get blood from blood vessels that have grown into the tumor. VEGF (vascular endothelial growth factor) is one of the molecules that triggers the growth of these blood vessels.
Unlike other biomarkers, VEGF is not mutated. However, it plays a role in most lung cancers. VEGF is made by cancer cells. It travels from cancer cells to endothelial cells. Endothelial cells form blood vessels.
VEGF attaches to surface receptors on the outside of endothelial cells. Attachment of VEGF to surface receptors triggers growth signals. There are two medicines used to stop the growth signals caused by VEGF.
Bevacizumab attaches to VEGF before it attaches to receptors on endothelial cells. See Figure 19. As a result, VEGF can’t attach to receptors. No growth signals caused by VEGF are started.
贝伐单抗是由输液完结的。初次医治大约需求90分钟，之后大约需求30分钟。贝伐单抗一般会与化疗一同进行，4 - 6次医治后则能够独自运用，以坚持杰出的作用。依据化疗计划的不同，每2或3周给予一次。
Bevacizumab is given by infusion. It takes about 90 minutes to get the first dose and 30 minutes for later doses. Bevacizumab is always first given with chemotherapy and after 4 to 6 treatments, may be given alone to maintain good results. It is given every 2 or 3 weeks depending on the chemotherapy.
Common side effects of bevacizumab are high blood pressure, nosebleeds, and headache. You might also have a runny nose, protein in the urine, and rectal bleeding. Rare but serious side effects include stroke, heart attack, blood clots, kidney damage, a tear in your gut, abnormal passage between body parts, and bleeding. Very rarely, brain damage occurs. Don’t take bevacizumab if you are pregnant, trying to get pregnant, or breastfeeding.
Ramucirumab attaches to VEGF receptors on the outside of endothelial cells. This blocks VEGF from attaching. No growth signals caused by VEGF are started.
Ramucirumab is given by infusion. It takes 60 minutes to receive the full dose. Ramucirumab is always given with chemotherapy. It is given every two weeks on the first day of chemotherap .
Common side effects of ramucirumab are high blood pressure and diarrhea. Serious side effects include bleeding, blood clots, tears in your gut, abnormal passage between body parts, and slow wound healing. Very rarely, brain damage occurs. Don’t take bevacizumab if pregnant, trying to get pregnant, or breastfeeding.
Although rare, there are other biomarkers of lung cancer for which there are treatments. These treatments are approved for lung or other cancers but still need more research. Such treatments include ado-trastuzumab for HER2. Cabozantinib and vandetanib target RET. In addition to targeting ALK and ROS1, crizotinib targets MET.
CAM (complementary and alternative medicine) is a group of treatments that aren’t often given by doctors. There is much interest today in CAM for cancer. Many CAMs are being studied to see if they are truly helpful.
Complementary medicines are treatments given along with usual medical treatments. While CAMs aren’t known to kill cancer cells, they may improve your comfort and wellbeing. Two examples are acupuncture for pain management and yoga for relaxation.
代替医学用来代替常见的医学医治。一些代替药物被出售用于医治，虽然它们尚未被证明在 临床试验中有用。假如有充沛的依据证明 CAMs或其他医治办法治好了癌症，他们将会被归入这本书中。
Alternative medicine is used in place of usual medicine. Some alternative medicines are sold as cures even though they haven’t been proven to work in clinical trials. If there was good proof that CAMs or other treatments cured cancer, they would be included in this book.
It is important to tell your treatment team if you are using any CAMs. They can tell you which CAMs may be helpful and which CAMs may limit how well medical treatments work.