Vuto la phala la Lapatinib


I.Lapatinib ufa Anthu oyambirira:

Name: Lapatinib ufa
CAS: 231277-92-2
Makhalidwe a Maselo: C29H26ClFN4O4S
Kulemera kwa maselo: 581.05
Melt Point: 136-140 ° C
Kusungirako nyengo: Firiji
mtundu; Yoyera kapena kuchotsa nyemba yakuyera ya Crystalline


1.Tykerbpowder zofunika makhalidwe.

dzina Tykerb
Cas 231277-92-2
Molecular Formula C29H26CIFN4O4S
Kulemera kwa maselo 581.05
mtundu Yoyera kapena kuchotsa nyemba yakuyera ya Crystalline
Dzina lina lapatini


2.Chiani Tykerb?

Mayina amalonda a Tykerb ndi Tyverb ndi mankhwala okhudzana ndi khansa ya m'mawere ndi zina zotupa. Ndi awiri a tyrosine kinase inhibitor omwe amasokoneza njira ya HER2 / neu ndi epidermal kukula factor receptor (EGFR) njira. Amagwiritsidwa ntchito pothandizana pamodzi kwa khansa ya m'mawere ya HER2. Amagwiritsidwa ntchito pochiza odwala ali ndi kansa yapakhungu kapena yamatenda omwe amatulutsa overexpress HER2 (ErbB2) .Mnjira yambiri ya US inakakamiza Tyker ndipo makamaka Europe ndi Russia yotchedwa Tyverb.In January 2010, Tykerb analandira mwamsanga kulandira chithandizo cha amayi a postmenopausal omwe ali ndi kansa ya kansa ya m'mawere Lapatinib imalepheretsa mauthenga a receptor ndi kumangiriza kuthumba la ATP ya EGFR / HER2 protein kinase domain, kuteteza phosphorylation ndi kutsegula chizindikiro, Tykerb (lapatinib) ndi mankhwala a khansa omwe amagwiritsidwa ntchito pamodzi ndi mankhwala ena omwe amatchedwa capecitabine (Xeloda) kuti adziwe mtundu wina wa khansa yapakati ya m'mawere yomwe yafalikira kumbali zina za thupi, ndipo nthawi zambiri amaperekedwa pambuyo pa mankhwala ena a khansa popanda kuyesedwa bwino.


3.Kodi ili bwanji Tykerbntchito?

Chithandizo cha khansa cha m'mawere chimayika makamaka kupha mwapang'onopang'ono maselo chifukwa chimodzi mwa ziwalo za khansa ya m'mawere ndi chakuti amagawana mofulumira.Achidule cha mankhwalawa ndikulongosola zochitika zina za khansa ya m'mawere maselo.Alipo mitundu yosiyanasiyana ya mankhwala ochiritsidwa, omwe amatchulidwa muzigawo zitatu. Zina zothandizira zamankhwala zimaganizira zofunikira za mkati komanso ntchito ya khansa ya m'mawere. Njira zochiritsirazo zimagwiritsa ntchito mamolekyu ang'onoang'ono omwe angalowe mu selo ndi kusokoneza ntchito ya maselo, kuwapangitsa kufa. Pali mitundu yambiri ya mankhwala opatsirana omwe amayang'ana mkati mwa maselo. Zina zogwiritsidwa ntchito ndi zothandizira zakulandila zomwe zili kunja kwa selo. Mankhwala omwe amalimbana ndi mapiritsi amadziwikanso amadzimadzi a monoclonal. Antiangiogenesis inhibitors amayang'ana mitsempha ya magazi yomwe imapereka mpweya ku maselo, ndipo pamapeto pake imachititsa maselo kukhala ndi njala.Pertuzumab ndi antioclonal antibody yomwe imayang'ana pamwamba pa maselo a epidermal growth factor receptor 2 protein (HER2) pa selo ya khansa, yotsutsana ndi HER2 yomwe imayambitsa khansa ya m'mawere ya m'mawere. Pertuzumab imamangirira kumalo ena a mapuloteni a HER2 kusiyana ndi trastuzumab kuti pamene pertuzumab ili pamodzi ndi trastuzumab, kutsekedwa kwathunthu kwa HER2 kuonekera kumachitika mkati mwa khungu la khansa ya bere ya HER2, HER2 receptors amagwiritsa ntchito mapuloteni, otchedwa kinases, kuti ayambitse selo likukula ndikugawa molakwika. Kinase amayang'anira kuchuluka kwa mphamvu ya maselo kuti ikule ndikuchuluka. Maselo a khansa ya m'mawere omwe amachititsa kuti HER2 ikhale ndi zochita zambiri, kotero maselo a khansa amakula kwambiri, mofulumira kwambiri.Tykerb imagwira ntchito polepheretsa maukwati a HER2 mkati mwa selo, kuchepetsa kuchuluka kwa maselo a khansa ya m'mawere akuyenera kukula ndi kuchulukitsa . Mwa kuchepetsa kuchuluka kwa mphamvu, Tykerb ikhoza kuchepetsa kapena kuletsa kukula kwa khansa ya m'mawere.


4.Kodi Tykerb Ikugwirani Ntchito?

Mayesero anayi angagwiritsidwe ntchito kuti aone ngati kansa ndi HER2-positive ndipo ngati idzayankha Tykerb:

  • IHC (ImmunoHistoChemistry)

IHC ndiyeso yogwiritsidwa ntchito kwambiri kuti tiwone ngati chotupa chili ndi mapuloteni ambiri a HER2 pamwamba pa maselo a khansa. Kuyeza kwa IHC kumapereka mphambu ya 0 kwa 3 + yomwe imasonyeza kuchuluka kwa mapuloteni a HER2 mumatumbo. Ngati 0 imapangitsa kuti 1 + iwonongeke, imatchedwa "HER2." Ngati imatulutsa 2 + kapena 3 +, imatchedwa "HER2 zabwino." Azimayi omwe ali ndi HC zabwino amakonda kuwayankha bwino Tykerb. Mankhwalawa sagwiritsidwa ntchito moyenera pa zotupa ndi IHC zilembo za 0 kapena 1 +.

  • Nsomba (Fluorescence In Situation Hybridization)

Mayeso a FISH amafufuzira mtundu wa HER2 wosalongosoka. Mayesowa ndi olondola kwambiri, koma osachepera, omwe angapeze ngati chotupa cha m'mawere chikhoza kuyankha kwa Tykerb ..

Ndi mayeso a FISH, mumapeza mpata wa "zabwino" kapena "zoipa" (zipatala zina zimayesa mayeso oipa "zero"). Ngati khansara ndi NTHAWI zabwino, zikhoza kukhala za Tykerb.

Kuyeza kwa HER2 Kishi ya SpoT kuyang'ana ma gene HER2 mu chitsanzo cha khansa ya m'mawere. Mayeso a SpoT-Light amagwiritsa ntchito banga limene limapangitsa mtundu wa HER2 / neu kusintha mtundu.Pamayeso a SPoT-Light, mumapeza mpata wa "zabwino" kapena "zosayenera." Ngati khansara ndi SPoT-Light, Yankhani bwino Tykerb.

  • Lembani HER2 Dual ISH (In Situation Hybridization)

Mauthenga a HER2 Dual ISH amagwiritsira ntchito banga lapadera lomwe limapangitsa kuti HER2 mapuloteni asinthe mtundu. Tsamba limagwiritsidwa ntchito ku zitsanzo za khansa ya m'mawere ndi kuyang'ana pansi pa microscope. Chiyesochi chimapereka zotsatira zenizeni kuposa HC HER HER.Tsiku lodziwitsa mayeso a HER2 Dual ISH, mumapeza mpikisano wa "HER2 zabwino" kapena "HER2".


5.Kodi kugwiritsidwa ntchito kwa mankhwala a Tykerb ndi kotani?

Tykerb imakonzedwa ndi michere ya chiwindi CYP3A4. Mankhwala omwe amaletsa kapena kukopa CYP3A4 angakhudze anthu ambiri a Tykerb mu thupi. Zizindikiro zimayambitsa magazi a Tykerb ndi inducers amachepetsa m'magazi ake. Kusintha kwazitsulo kwa Tykerb kuyenera kuganiziridwa kwa odwala omwe alandira amphamvu CYP3A4 inhibitors kapena inducers. Zotsatirazi siziri mndandandanda wa ziwalo zowonongeka ndi ma inducers.Inhibitors: ketoconazole, clarithromycin, atazanavir, nefazodone, nelfinavir (Viracept), telithromycin, ndi voriconazole.Inducers: dexamethasone, phenytoin, carbamazepine, rifampin, phenobarbital, ndi St John's wort.


6.Tykerb Mbali Zotsatira

Common zotsatira zoyipazi wa Tykerb ndi awa:

kunyoza, kusanza, kupwetekedwa m'mimba, zilonda zam'kamwa, kuthamanga, khungu louma, ululu kapena kuphulika pamanja a manja anu kapena mapazi anu, tsitsi lanu, mavuto anu ndi zokopa zanu, ndikuphatikizira kugona. Pamene Tykerb akuperekedwa ndi Xeloda chemotherapy , mukhoza kutenga mankhwala okhudza mankhwala a chemotherapy. Makamaka, Xeloda amagwirizanitsidwa ndi matenda a ubongo, kapena kufiira ndi kumangiriza m'manja ndi mapazi. Pamene Tykerb amaperekedwa ndi Femara, inunso mukhoza kukhala ndi zotsatira za Femara. Zotsatira zoyipa za Femara ndi fupa zopepuka komanso kupweteka kwa mafupa. Tkerker sawoneka kuti amachititsa mavuto a mtima ndi mapapu okhudzana ndi Herceptin. Ngati mutenga pakati kapena kuganiza kuti mutha kutenga pakati, muuzeni dokotala wanu. Sichidziwika ngati mankhwalawa akudutsa mkaka wa m'mawere. Chifukwa cha kuyamwa kwa khanda, kuyamwa pamene mukugwiritsa ntchito mankhwalawa sikuvomerezedwa.


7.Wodi ndi machenjezo ndi zotani za Tykerb?

  • Tykerb ingakhudze momwe mtima umapopera magazi. Onetsetsani kachigawo kakang'ono kotsekedwa ka ventricular (LVEF) musanayambe Tykerb ndikupitiriza kuyang'anitsitsa pakapita mankhwala.
  • Tykerb kawirikawiri imayambitsa matenda osagwidwa ndi chiwindi. Onetsetsani chiwindi kugwira ntchito musanayambe kuchipatala komanso masabata onse a 4-6 panthawi ya mankhwala.
  • Tykerb ingachititse kutsekula m'mimba. Ngati kutsekula m'mimba kumachitika, sungani ndi anti-diarrheal mawonekedwe ndi mmalo mwa madzi.
  • Tykerb ingayambitse mavuto aakulu a m'mapapu. Kuleka Tykerb ngati zizindikiro za izi zikuchitika.
  • Tykerb ingayambitse vuto lalikulu la khungu. Zimasiya Tykerb ngati izi zikuchitika.


8.Kodi mlingo wa Tykerb ndi wotani?

  • Tykerb amaperekedwa ngati mapiritsi a 250 mg. Mapiritsi asanu amatengedwa kamodzi tsiku ndi tsiku tsiku lililonse m'mimba yopanda kanthu kwa masiku 21 m'kati mwa tsiku la 21. Musaphwanya kapena kutafuna mapiritsi. Sungani kutentha kutentha ndi kusunga chidebe mwamphamvu. T Tykerb imaperekedwa ndi Xeloda (capecitabine) 2000mg / m2 / tsiku lovomerezedwa pamlomo mu 2 mlingo wogawa, maola 12 kupatula masiku oyambirira a 14 a aliyense Zotsatira za masiku a 21. Capecitabine iyenera kutengedwa ndi chakudya kapena maminiti 30 pambuyo pa chakudya.
  • Tengani mankhwala awa monga momwe adanenera. Tsatirani malangizo anu pamakalata anu mosamala.
  • Mlingo umene dokotala wanu amalimbikitsa ukhoza kukhala wotsatira:
  • chikhalidwe chomwe chikuchitiridwa
  • matenda ena omwe muli nawo
  • mankhwala ena omwe mukuwatenga
  • momwe mumayankhira mankhwalawa
  • kulemera kwanu, kutalika kwa msinkhu wanu, msinkhu wanu, chikhalidwe chanu

Mlingo woyenera wa lapatinib wa kansa yapakhungu kapena yapamtunda ndi 1,250 mg (mapiritsi a 5) omwe amaperekedwa kamodzi tsiku ndi tsiku pa masiku 1-21. Mlingo woyenera wa lapatinib wa kansa ya mthupi ya HEM2-positive ndi 1,500 mg (Mapiritsi a 6) operekedwa pamlomo kamodzi tsiku ndi tsiku mosalekeza pamodzi ndi letrozole.


9.Kodi mtengo wa Tykerb?

Avereji Zamtengo Wapatali: $ 30.10 pa 250 mg piritsi

Tsiku la 21 Supply (1 ulendo): $ 3,160.50


10.Kodi kugwiritsidwa ntchito kwa mankhwala a Tykerb ndi kotani?

Tykerb imakonzedwa ndi michere ya chiwindi CYP3A4. Mankhwala omwe amaletsa kapena kukopa CYP3A4 angakhudze anthu ambiri a Tykerb mu thupi. Zizindikiro zimayambitsa magazi a Tykerb ndi inducers amachepetsa m'magazi ake. Kusintha kwazitsulo kwa Tykerb kuyenera kuganiziridwa kwa odwala omwe amalandira mphamvu CYP3A4 inhibitors kapena inducers. Zotsatilazi sizomwe muli mndandandanda wa ziwalo zowonongeka.

Mavitamini: ketoconazole, clarithromycin, atazanavir, nefazodone, nelfinavir (Viracept), telithromycin, ndi voriconazole.

Amathandiza: dexamethasone, phenytoin, carbamazepine, rifampin, phenobarbital, ndi wonyansa wa St John.


11.Kodi ndikapitirira?

ngati inu sunganis lapatinib, funsani dokotala wanu kapena malo oletsa poizoni, kapena pitani kuchipatala chofulumira kuchipatala mwamsanga. Tengani mapiritsi a lapatinib ndi iwe ngati n'kotheka.


12.Kodi ndingapeze zambiri zambiri?

Kumbukirani, sungani mankhwalawa ndi mankhwala ena onse, musagwiritse ntchito mankhwala anu ndi ena, ndipo mugwiritseni ntchito mankhwalawa pokhapokha ngati mwalemba.
Zonse zapangidwa kuti zitsimikizire kuti zomwe zafotokozedwa ndi AASraw zakhala zatsopano, ndizokwanira, koma palibe chitsimikizo chomwe chimapangidwira. Zida zamankhwala zomwe zilipo apa zingakhale zogwirizana ndi nthawi. Mauthenga AASraw alembedwa kuti agwiritsidwe ntchito ndi ogwira ntchito zachipatala ndi ogulitsa ku United States ndipo chotero AASraw sichivomerezeka kuti ntchito kunja kwa United States ndi yoyenera, kupatula ngati atchulidwa mwachindunji. AASrawKudziwa mankhwala osokoneza bongo sikuvomereza mankhwala, kuyezetsa odwala kapena kulangiza mankhwala. Kudziwa mankhwala osokoneza bongo a AASraw ndi chinsinsi chothandizira kuthandizira odwala omwe ali ndi chithandizo pakusamalira odwala awo komanso / kapena kutumikira ogula akuwona ntchitoyi monga choonjezera, osati chilolezo, luso, luso, chidziwitso ndi chiweruzo cha ogwira ntchito zaumoyo. Kusowa chenjezo kwa mankhwala osokoneza bongo kapena mankhwala osagwiritsidwa ntchito mosayenera kulimbikitsidwa kuti ziwonetsetse kuti mankhwala osokoneza bongo kapena mankhwala ndi otetezeka, ogwira ntchito kapena oyenerera kwa odwala alionse. AASraw saganiza kuti ali ndi udindo uliwonse pa chithandizo chilichonse chachipatala chomwe chimathandizidwa ndi informationAASraw. Zomwe zili pano sizikutanthauza ntchito zonse zomwe zingagwiritsidwe ntchito, malangizo, zodzitchinjiriza, machenjezo, kugwirizanitsa mankhwala, kusokonezeka kwa mankhwala, kapena zotsatirapo zoipa. Ngati muli ndi mafunso okhudzana ndi mankhwala omwe mukuwagwiritsa ntchito, funsani dokotala wanu, namwino kapena wamasitolo.


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