Tus Sau: John Stephens
Hnub Kev Tsim: 2 Lub Ib Hli Ntuj 2021
Hloov Hnub: 14 Lub Kaum Ib Hli Ntuj 2024
Anonim
GLEEVEC (IMATINIB) MOA
Daim Duab: GLEEVEC (IMATINIB) MOA

Zoo Siab

Gleevec yog dab tsi?

Gleevec yog ib hom tshuaj muaj npe rau tshuaj. Nws tau siv los kho qee hom mob qog ntshav ntshav hauv tus neeg laus thiab menyuam yaus. Gleevec kuj tseem siv los kho hom mob qog nqaij hlav thiab ib hom qog nqaij hlav cancer.

Gleevec muaj cov tshuaj imatinib mesylate, uas belongs rau ib chav kawm ntawm cov tshuaj hu ua tyrosine kinase inhibitors.

Gleevec los ua ib ntsiav tshuaj uas koj noj ntawm qhov ncauj. Koj noj cov tshuaj ib zaug lossis ob zaug ib hnub, nyob ntawm seb ntau npaum li cas uas koj tus kws kho mob tau sau.

Nws ua li cas

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo Gleevec los kho qee yam mob qog nqaij hlav ntshav, suav nrog:

  • Philadelphia chromosome-zoo (Ph +) mob myeloid leukemia (CML) rau cov neeg laus thiab menyuam yaus
  • Ph + mob lymphocytic mob ntshav dawb (TXHUA) uas rov mob plab * * rau cov neeg laus
  • nyuam qhuav muaj mob Ph + TAG rau hauv cov menyuam yaus
  • myelodysplastic / myeloproliferative kab mob (mob pob txha mob pob txha) hauv cov neeg laus uas muaj platelet los ntawm kev loj hlob tau txais (PDGFR) kev faib cov noob
  • hypereosinophilic syndrome lossis mob hlwb eosinophilic mob nqaij hlav ntev rau cov neeg laus
  • txhoj puab heev mastocytosis rau cov laus tsis muaj D816v c-pob hloov khoom

* Mob kheesxaws rov qab tau rov qab los tom qab kho dua, uas yog qhov txo qis qog nqaij hlav thiab mob tshwm sim. Refractory cancer tsis tau teb rau kev kho mob cancer yav dhau los.


Gleevec tseem pom zoo los kho:

  • ib hom mob cancer ntawm daim tawv nqaij hu ua dermatofibrosarcoma protuberans (DFSP) hauv cov neeg laus
  • ib hom mob cancer plab hnyuv hu ua Kit-positive gastrointestinal stromal hlav (GIST) rau cov neeg laus

Txog cov ntsiab lus, saib cov ntu rau “Gleevec rau CML” thiab “Lwm Yam Siv rau Gleevec.”

Gleevec siv tau

Gleevec tau pom tias muaj txiaj ntsig zoo hauv kev kho ntau yam mob qog ntshav ntshav.

Hauv ib qhov kev tshawb fawb soj ntsuam, cov neeg laus uas tau kuaj pom tias CML tshiab nyob rau theem ntev coj Gleevec tau xya xyoo. Hauv cov pab pawg no, 96.6% ntawm cov tib neeg tau teb tiav rau cov tshuaj. Qhov no txhais tau hais tias tsis muaj cov kab mob cancer nyob hauv lawv cov ntshav, thiab lawv tsis muaj tsos mob tshwm rau tus kabmob.

Cov lus teb tiav yog ib txoj hauv kev los piav qhia txog qib ua tiav. Hauv pawg neeg cov neeg uas tau txais kev kho mob raws li cov kws kho mob, 56.6% tau teb tiav.

Gleevec kuj tau pom tias muaj txiaj ntsig zoo hauv kev kho mob txoj hnyuv qog nqaij hlav (GIST) hauv kev tshawb fawb soj ntsuam. Qhov feem pua ​​ntawm cov muaj sia nyob tau txog plaub xyoos. Qhov no txhais tau hais tias ib nrab ntawm cov neeg hauv txoj kev tshawb no tau nyob txog plaub xyoos tom qab lawv pib noj Gleevec. Cov neeg uas coj Gleevec tom qab kev phais mob tau nyob hauv kwv yees li tsib xyoos tom qab pib siv tshuaj yeeb.


Txhawm rau kawm paub Gleevec muaj txiaj ntsig zoo npaum li cas hauv kev kho lwm yam mob qog nqaij hlav, saib tshooj "Lwm Siv rau Gleevec".

Gleevec generic

Gleevec yog muaj raws li cov tshuaj muaj npe kev lag luam thiab cov tshuaj sau rau cov qauv.

Gleevec muaj cov tshuaj txuam ua yeeb yaj kiab imatinib mesylate.

Gleevec phiv

Gleevec tuaj yeem ua rau mob hnyav lossis mob loj. Cov npe hauv qab no muaj qee qhov tseem ceeb phiv uas yuav tshwm sim thaum noj Gleevec. Cov npe no tsis suav txhua yam tshwm sim.

Yog xav paub cov ntaub ntawv ntau ntxiv txog qhov tshwm sim zoo tuaj ntawm Gleevec, tham nrog koj tus kws kho mob lossis kws muag tshuaj. Lawv tuaj yeem muab cov lus qhia rau koj txog kev yuav ua li cas nrog cov kev mob tshwm sim uas tuaj yeem thab.

Ntau cov kev mob tshwm sim

Cov kev mob tshwm sim heev dua ntawm Gleevec tuaj yeem suav nrog:

  • zawv plab
  • mob plab
  • qaug zog (tsis muaj lub zog)
  • edema (o, tshwm sim ntawm koj ob txhais ceg, pob taws, lossis ko taw thiab ib ncig ntawm koj lub qhov muag)
  • mob leeg los yog mob
  • xeev siab
  • ntuav
  • ua pob

Ntau cov kev mob tshwm sim no yuav ploj mus li ob peb hnub lossis ob peb lub lis piam. Yog tias lawv mob hnyav dua lossis tsis ploj mus, nrog koj tus kws kho mob lossis kws muag tshuaj tham.


Cov kev mob tshwm sim hnyav heev

Cov kev mob tshwm sim hnyav los ntawm Gleevec tsis tshua muaj tshwm sim, tab sis lawv kuj tuaj yeem tshwm sim. Hu rau koj tus kws kho mob tam sim ntawd yog tias koj muaj kev phiv loj heev. Hu 911 yog koj tus mob hnov ​​lub neej tsis zoo lossis yog koj xav tias koj muaj mob xwm txheej kub ntxhov ceev.

Cov kev mob tshwm sim hnyav heev thiab lawv cov tsos mob tuaj yeem suav nrog cov hauv qab no:

  • Kuaj ntshav heev (dej ntau dhau los yog dej) hauv thiab ib ncig koj lub plawv, lub ntsws (pleural effusion), thiab plab (ascites). Cov tsos mob tuaj yeem suav nrog:
    • npaj txhij txog, yuag hnyav dua
    • mob hauv siab
    • txog siav
    • teeb meem noj pa tob tob
    • teeb meem ua pa thaum koj pw
    • hnoos qhuav
    • o hauv plab
  • Ntshav tsis txaus, nrog rau kev ua haujlwm ntshav (ntshav qes qes), neutropenia (cov qe ntshav dawb), thiab thrombocytopenia (ntshav qes ntshav tsawg). Cov tsos mob tuaj yeem suav nrog:
    • qaug zog (tsis muaj lub zog)
    • lub plawv dhia ceev ceev
    • txog siav
    • nquag muaj tus kab mob
    • kev kub taub hau
    • doog ntshav yooj yim
    • cov pos hniav los ntshav
    • cov ntshav nyob rau hauv cov zis lossis cov quav
  • Txheeb lub plawv tsis ua hauj lwm thiab lwm cov teeb meem plawv, xws li lub plawv tawg. Cov tsos mob tuaj yeem suav nrog:
    • nce mus tsis tau txog qhov hnyav lawm
    • edema (o ntawm koj txhais taw, pob taws, thiab ceg)
    • lub plawv dhia tsis zoo lossis lub plawv khiav ceev (lub plawv dhia nrawm dhau, qeeb dhau, lossis lub cev)
    • mob hauv siab
    • txog siav
  • Lub siab ua haujlwm lossis nplooj siab tsis ua haujlwm. Cov tsos mob tuaj yeem suav nrog:
    • xeev siab
    • zawv plab
    • tsis qab los noj mov
    • khaus tawv
    • Qhov muag daj (xim daj ntawm koj cov tawv nqaij thiab ntsiab muag ntawm koj lub qhov muag)
    • edema (o ntawm koj ob ceg, pob taws, thiab ko taw)
    • ascites (kua buildup hauv koj lub plab)
    • nquag doog ntshav
    • nquag los ntshav
  • Mob leeg ntshav hnyav (los ntshav uas tsis nres), feem ntau nyob hauv koj cov hnyuv. Cov tsos mob tuaj yeem suav nrog:
    • cov ntshav nyob hauv cov quav
    • dub lossis tarry quav
    • qaug zog (tsis muaj lub zog)
    • hnoos tau ntshav
    • hnoos tau dub sludge
    • xeev siab
    • mob plab zom mov
  • Mob lub plab muaj teeb meem, suav nrog perforations (kua muag) hauv koj lub plab lossis plab hnyuv. Cov tsos mob tuaj yeem suav nrog:
    • xeev siab
    • ntuav
    • mob hnyav hauv koj lub plab
    • ua npaws
    • txog siav
    • lub plawv dhia ceev
  • Cov teeb meem tawv nqaij hnyav heev. Cov tsos mob tuaj yeem suav nrog:
    • erythema multiforme (ua rau thaj liab liab lossis ua hlwv, feem ntau nyob rau ib qho ntawm koj txhais taw lossis xib teg ntawm koj txhais tes)
    • Stevens-Johnson syndrome (kub taub hau; qhov ncauj tawm ntawm koj lub qhov ncauj, caj pas, qhov muag, caj ces, lossis lub cev tag nrho)
    • ua npaws
    • mob ib ce
  • Hypothyroidism (cov qog ntshav qis tsawg tsawg) hauv cov neeg uas tau tshem tawm cov thyroid thiab tau noj cov tshuaj thyroid hloov. Cov tsos mob tuaj yeem suav nrog:
    • qaug zog (tsis muaj lub zog)
    • cem quav
    • kev nyuaj siab
    • hnov txias
    • daim tawv nqaij qhuav
    • hnyav
    • teeb meem nco
  • Kev loj hlob qeeb hauv cov menyuam yaus. Cov tsos mob tuaj yeem suav nrog:
    • tsis tuaj yeem loj hlob ntawm tus nqi qub
    • me dua lwm cov me nyuam lawv hnub nyoog
  • Mob qog nqaij hlav hauv hlwb (thaum cov qog ntshav hlav tawm cov tshuaj tsis zoo rau hauv koj cov ntshav). Cov tsos mob tuaj yeem suav nrog:
    • qaug zog (tsis muaj lub zog)
    • xeev siab
    • ntuav
    • zawv plab
    • mob leeg
    • atherosclerosis plawv txawv txav (lub plawv dhia nrawm dhau, qeeb dhau, los yog lus)
    • qaug dab peg
  • Raum puas. Cov tsos mob tuaj yeem suav nrog:
    • tso zis tsawg dua li ib txwm
    • edema (o ntawm koj ob ceg, pob taws, thiab ko taw)
    • qaug zog (tsis muaj lub zog)
    • xeev siab
    • tsis meej pem
    • ntshav siab
  • Phiv uas tuaj yeem ua rau tsheb sib tsoo. Cov tsos mob tuaj yeem suav nrog:
    • kiv taub hau
    • kev tsaug zog tsaug zog
    • qhov muag plooj

Sab sij huam cov ntsiab lus

Tej zaum koj yuav xav paub ntau npaum li cas tej kev mob tshwm sim nrog cov tshuaj no, lossis seb puas muaj qee yam kev mob tshwm sim los cuam tshuam rau nws.Nov yog qee qhov kev qhia ntawm ob peb ntawm kev phiv cov tshuaj no tuaj yeem ua lossis tsis ua.

Kev fab tshuaj tiv thaiv

Ib yam li nrog rau cov tshuaj feem ntau, qee tus neeg tuaj yeem muaj kev fab tshuaj tom qab siv Gleevec. Cov tsos mob ntawm kev txhaum fab hnyav tuaj yeem suav nrog:

  • daim tawv nqaij ua pob
  • khaus
  • tso tawm (sov thiab liab nyob hauv koj cov tawv nqaij)

Ib qho kev txhaum fab hnyav dua yog muaj tsawg tab sis ua tau. Cov tsos mob ntawm kev txhaum fab hnyav tuaj yeem suav nrog:

  • Mob hlwb (o rau hauv koj daim tawv nqaij, feem ntau hauv koj daim tawv muag, daim di ncauj, tes, lossis ko taw)
  • o ntawm koj tus nplaig, qhov ncauj, lossis caj pas
  • teeb meem ua pa

Hu rau koj tus kws kho mob tam sim ntawd yog tias koj muaj qhov tsis haum tshuaj Gleevec. Hu 911 yog koj tus mob hnov ​​lub neej tsis zoo lossis yog koj xav tias koj muaj mob xwm txheej kub ntxhov ceev.

Ntev phiv

Qee qhov kev mob tshwm sim pom hauv kev tshawb fawb soj ntsuam tuaj yeem tshwm sim nrog kev siv Gleevec ntev mus ntev. Cov no suav nrog cov teeb meem plawv, xws li tsis ua lub plawv tawg thiab lub plawv tawg.

Hauv qhov kev tshawb fawb soj ntsuam, ntau dua 500 tus neeg uas coj Gleevec rau kev mob qog nqaij hlav myeloid (CML) tau taug kev mus txog 11 xyoos. Cov neeg hauv txoj kev tshawb fawb mus sij hawm ntev no muaj ntau cov kev mob tshwm sim tib yam uas tau qhia hauv kev tshawb nrhiav luv luv. Txawm li cas los xij, cov kev mob tshwm sim zoo li no zoo zuj zus mus.

Cov kev mob tshwm sim hnyav pom nrog kev siv mus sij hawm ntev nrog:

  • cov ntshav muaj ntshav tsis txaus (cov qe ntshav liab tsawg, qe ntshav dawb, lossis qe ntshav) muaj 6 leeg
  • teeb meem mob plawv, suav nrog congestive plawv nres, hauv xya tus neeg
  • rau tus neeg mob qog mob cancer tshiab, suav nrog ntau yam mob myeloma hauv ib tus neeg thiab mob hnyuv loj hauv lwm tus neeg

Cov kev mob tshwm sim yog feem ntau tshwm sim thaum thawj xyoo ntawm kev kho mob nrog Gleevec. Tab sis ntev dua uas cov neeg siv Gleevec, tsawg dua lawv tau muaj ntau cov kev mob tshwm sim no. Piv txwv li, hauv thawj xyoo ntawm kev tshawb fawb, peb tus neeg muaj mob ntshav tsis txaus, tab sis tom qab xyoo thib tsib, tsuas muaj ib tus neeg.

Hauv kev tshawb nrhiav tsib lub xyoos ntawm cov neeg uas muaj mob plab hnyuv loj (GIST), 16% ntawm cov tib neeg tsis noj Gleevec vim muaj kev phiv. Cov kev mob tshwm sim tau zoo ib yam li cov lus piav hauv CML txoj kev tshawb fawb saum toj no. Plaub caug feem pua ​​ntawm cov neeg hauv txoj kev tshawb no tau sau ntawv noj tshuaj tsawg dua kom txo lawv cov kev phiv.

Yog tias koj muaj kev txhawj xeeb txog qhov yuav muaj kev phom sij ntev mus ntev los ntawm Gleevec, tham nrog koj tus kws kho mob. Lawv tuaj yeem tawm tswv yim txoj hauv kev los txo koj cov phom sij rau qee cov kev mob tshwm sim.

Qhov muag cuam tshuam txog tshuaj tiv thaiv

Hauv kev tshawb fawb soj ntsuam Gleevec, qee tus neeg muaj cov kev mob tshwm sim rau qhov muag xws li qhov o thiab qhov muag plooj.

Tawv qhov muag thiab o ncig lub qhov muag yog qee cov kev mob tshwm sim ntau dua. Txog li 74.2% ntawm cov neeg siv Gleevec muaj mob txha caj qaum (o rau thaj chaw ntawm qhov muag).

Yog tias koj muaj qhov tshwm sim no, koj tus kws kho mob tuaj yeem sau tshuaj diuretic (feem ntau hu ua ntsiav tshuaj dej). Diuretics pab koj lub cev tso dej ntxiv thiab ntsev thaum koj tso zis. Qhov no eases kua buildup. Koj tus kws kho mob kuj tseem tuaj yeem txo koj qhov koob tshuaj Gleevec, yog tias xav tau.

Tsis tas li ntawd, kev tshawb fawb soj ntsuam tau tshaj tawm txog li 11,1% ntawm cov neeg uas tau noj Gleevec muaj qhov muag plooj. Yog tias koj pom kev plooj plooj, tsis txhob tsav tsheb lossis siv cov tshuab hnyav. Thiab nco ntsoov qhia koj tus kws kho mob tias koj tsis tuaj yeem pom meej.

Lwm qhov tsis tshua pom tshwm sim qhov muag nrog:

  • qhov muag qhuav
  • kua muag daj
  • qhov muag voos
  • conjunctivitis (feem ntau hu ua qhov muag liab)
  • tawg ntshav hlab ntsha hauv qhov muag
  • o rau lub retina (txheej ntawm cov nqaij hauv qab koj lub qhov muag)

Yog tias koj tab tom noj Gleevec thiab muaj cov kev mob tshwm sim rau lub qhov muag, tham nrog koj tus kws kho mob. Lawv tuaj yeem tawm tswv yim txoj hauv kev los txo koj cov tsos mob.

Cov plaub hau poob lawm

Plaub hau poob (alopecia) yog qhov tshwm sim tsis zoo ntawm kev noj Gleevec.

Ib txoj kev tshawb nrhiav tau sim seb Gleevec ua haujlwm li cas rau cov neeg uas muaj Philadelphia chromosome-zoo (Ph +) mob myeloid leukemia (CML). Xya feem pua ​​ntawm cov neeg no tau poob plaub hau tom qab lawv siv cov tshuaj.

Hauv lwm txoj kev tshawb nrhiav, tib neeg coj Gleevec los kho kev mob plab hnyuv nqaij hlav (GIST). Ntawm 11.9% thiab 14.8% ntawm cov neeg no tau muaj plaub hau hle. Qhov kev mob tshwm sim no tau pom ntau dua nyob hauv cov neeg uas tau txhaj tshuaj ntau dua ntawm Gleevec.

Cov plaub hau poob vim kev kho mob cancer feem ntau yog ib ntus. Yog tias koj muaj kev txhawj xeeb txog qhov tshwm sim no, tham nrog koj tus kws kho mob. Lawv tuaj yeem qhia cov lus qhia los pab koj txo cov plaub hau thaum kho koj cov plaub hau.

Cov pob khaus thiab lwm yam tshwm sim ntawm daim tawv nqaij

Gleevec tuaj yeem ua rau mob hnyav thiab hnyav dua rau koj cov tawv nqaij.

Ntau hom kev xav ntawm daim tawv nqaij

Cov pob xoo thiab lwm yam tawv nqaij sawv cev tshwm sim tsawg dua hauv cov neeg uas coj Gleevec.

Hauv kev tshawb fawb soj ntsuam, tib neeg tau coj Gleevec los kho Ph + mob ntsws myeloid tawv nqaij (CML). Txog li 40.1% ntawm cov neeg no tau tawm pob lossis lwm cov tawv nqaij tom qab siv tshuaj.

Hauv lwm qhov kev tshawb fawb soj ntsuam, tib neeg coj Gleevec rau mob plab hnyuv qog nqaij hlav (GIST). Tom qab noj cov tshuaj no, nce txog 49.8% ntawm cov neeg no tau ua pob lossis lwm yam tawv nqaij dhau los. Cov no suav nrog:

  • tev ntawm daim tawv nqaij
  • daim tawv nqaij qhuav
  • tawv nqaij ua kom tawv nqaij (tawv muag daj rau daim tawv)
  • mob ntawm cov hauv paus plaub hau (hnab hauv qab koj daim tawv uas tuav cov hauv paus ntawm koj cov plaub hau)
  • erythema (liab ntawm daim tawv nqaij)
  • purpura (ntshav xim tawv nqaij ntawm cov tawv nqaij)

Cov kev mob tshwm sim no tshwm sim heev dua rau cov neeg uas tau txhaj tshuaj ntau dua ntawm Gleevec.

Yog tias koj txhawj xeeb txog pob khaus lossis lwm yam tawv nqaij me vim tias Gleevec, nrog koj tus kws kho mob tham. Lawv yuav tawm tswv yim txoj hauv kev los pab txo cov tsos mob kom yooj yim.

Cov tawv nqaij mob hnyav

Hauv cov kev tshawb fawb soj ntsuam, kev tsis haum cov tawv nqaij hnyav muaj tsawg heev hauv cov neeg uas coj Gleevec. Txog li 1% ntawm cov neeg uas siv cov tshuaj no muaj kev tsis haum ntawm daim tawv nqaij. Piv txwv ntawm cov tawv nqaij cuam tshuam nrog tshuaj muaj xws li:

  • Stevens-Johnson syndrome (kub taub hau; qhov ncauj tawm ntawm koj lub qhov ncauj, caj pas, qhov muag, caj ces, lossis lub cev tag nrho)
  • exfoliative dermatitis (tawv nqaij pleev rau ntau qhov chaw ntawm koj lub cev)
  • hlwv ua pob (pob me me thiab ua pob)

Cov pob xoo thiab sawv hlwv yuav ua rau mob heev. Thiab yog tias lawv tsis kho, lawv tuaj yeem cuab cov kab mob thiab ua rau kis mob loj. Yog li yog tias koj tab tom noj Gleevec thiab tawm pob xoo lossis ua hlwv nrog ua npaws lossis koj tsis xis nyob, qhia koj tus kws kho mob tam sim ntawd. Kuj tseem hais txog lwm yam kev cuam tshuam ntawm daim tawv nqaij uas koj muaj.

Phiv los cuam tshuam tsav

Hauv kev tshawb fawb soj ntsuam, qee cov neeg siv Gleevec muaj cov kev mob tshwm sim uas yuav cuam tshuam lawv lub peev xwm tsav tsheb. Cov no suav nrog:

  • kiv tob hau: nce txog 19.4% neeg
  • qhov muag plooj: hauv 11,1% tib neeg
  • kev nkees: hauv 74.9% neeg

Cov kev mob tshwm sim no yuav cuam tshuam koj lub peev xwm tsav los yog siv tshuab hnyav. Muaj cov ntaub ntawv tshaj tawm txog kev muaj tsheb sib tsoo los ntawm cov neeg uas tau coj Gleevec. Yog li koj yuav tsum siv kev ceev faj thaum tsav tsheb los yog siv tshuab thaum siv Gleevec.

Kev kho mob qeeb qeeb (tsis muaj kev cuam tshuam)

Kev kho mob qeeb qeeb tsis tau qhia tawm hauv kev tshawb fawb soj ntsuam Gleevec.

Qee hom kev kho mob cancer, xws li hluav taws xob thiab tshuaj kho mob, tej zaum yuav ua rau koj lub cev tsis muaj zog. Qhov no tuaj yeem ua rau cov qhov txhab zoo sai.

Yog tias koj txhawj xeeb txog kev kho cov qhov txhab kom qeeb, nug koj tus kws kho mob seb koj puas muaj kev pheej hmoo siab rau cov teebmeem no raws li koj tus mob.

Mob siab mob cancer (tej zaum yuav tsis muaj sab tshwm sim)

Daim siab mob cancer tsis qhia txog kev phiv los ntawm kev tshawb fawb soj ntsuam Gleevec. Txawm li cas los xij, kev mob siab rau lub siab tau tshwm sim nyob rau hauv ob qho tib si luv-thiab ntev siv Gleevec. Qee qhov xwm txheej ua rau lub siab puas ua rau lub siab ua haujlwm thiab lub siab hloov.

Feem ntau mob siab yog pom thaum cov kws kho mob saib xyuas cov enzymes (tshwj xeeb cov protein) uas ua hauv lub siab. Enzyme qib uas siab dua li ib txwm tuaj yeem ua lub cim ntawm daim siab puas.

Qee cov tsos mob ntawm lub cev ntawm daim siab ua rau muaj xws li:

  • xeev siab
  • zawv plab
  • tsis qab los noj mov
  • khaus tawv
  • Qhov muag daj (cov xim daj ntawm koj cov tawv nqaij thiab lub ntsej muag dawb)
  • edema (o ntawm koj ob ceg, pob taws, thiab ko taw)
  • ascites (kua buildup hauv koj lub plab)
  • nquag doog ntshav
  • nquag los ntshav

Thaum cov kev tshawb fawb soj ntsuam, nce txog 5% ntawm cov neeg muaj tus mob myeloid leukemia (CML) muaj mob siab rau daim siab ua rau cov ntshav siab thaum lub caij Gleevec. Mus txog 6.8% ntawm cov tib neeg muaj mob qog ua qog pob qog (GIST) muaj cov nplooj siab enzyme siab heev thaum kho. Thiab li 0.1% ntawm cov neeg uas tau noj Gleevec muaj mob rau daim siab.

Thaum koj noj Gleevec, koj tus kws kho mob yuav soj ntsuam seb koj lub siab ua haujlwm li cas. Yog tias koj muaj cov cim qhia ntawm daim siab ua lub siab thaum noj Gleevec, koj tus kws kho mob yuav txo koj cov koob tshuaj. Qhov no yuav tiv thaiv kev puas tsuaj uas tuaj yeem ua rau lub siab ua tsis tau.

Sab kev tshwm sim rau cov menyuam yaus

Cov menyuam yaus hauv cov kev tshawb fawb soj ntsuam uas coj Gleevec muaj kev phiv uas zoo sib xws rau cov neeg laus. Tab sis cov kws tshawb nrhiav pom cov kev txwv no:

  • tsawg dua cov menyuam yaus tau mob leeg lossis pob txha li cov neeg laus muaj
  • edema (o ntawm ob txhais ceg, pob taws, ko taw, thiab ib puag ncig qhov muag) tsis tau hais qhia rau cov menyuam yaus

Feem ntau cov kev phiv hais qhia rau cov menyuam yaus yog xeev ntuav thiab ntuav. Feem ntau cov kev mob tshwm sim loj tshaj plaws yog cov ntshav dawb thiab qe ntshav tsawg.

Yog tias koj tus menyuam muaj cov kev mob tshwm sim no, nrog koj tus menyuam tus kws kho mob tham txog cov hau kev los tswj lawv.

Gleevec rau CML

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo Gleevec rau qee tus neeg nrog Philadelphia chromosome-positive (Ph +) mob myeloid leukemia (CML). Lub Philadelphia chromosome yog chromosome tus naj npawb 22 nrog rau muaj qhov tsis zoo. Cov neeg muaj Ph + CML muaj qhov hloov pauv tshwj xeeb hauv lawv cov DNA uas ua rau cov ntshav qog ntshav ntau dhau heev lawm.

CML tau muab faib ua peb ntu:

  • Mob theem. Nov yog thawj theem ntawm CML Feem ntau cov neeg tau kuaj pom tus mob CML thaum lub sij hawm mob nyhav. Cov tsos mob feem ntau yog mob me ntsis, yog tias muaj txhua yam.
  • Qib nrawm. Hauv qib ob, tus naj npawb ntawm cov qog nqaij hlav cancer hauv koj cov ntshav nce ntxiv. Tej zaum koj yuav muaj tsos mob ntau, xws li ua npaws thiab poob cev.
  • Moj tej tawg theem. Hauv theem no ntau tshaj plaws, cov qog nqaij hlav cancer hauv koj cov ntshav tau kis mus rau lwm yam kabmob thiab cov nqaij mos. Koj cov tsos mob tej zaum yuav mob hnyav dua.

Gleevec raug pom zoo los kho tus mob tshiab Ph + CML hauv ntu ua ntu zus mob rau cov neeg ntawm txhua lub hnub nyoog.

Nws kuj tseem pom zoo los kho Ph + CML nyob rau ntu mob ntev, nrawm, lossis moj tej tawg rau cov neeg uas tsis tau txais kev kho zoo nrog kev kho mob interferon-alpha. Tshuaj Interferon-alpha yog ib hom tshuaj uas tau siv ntau dua yav tas los kho CML. Nws tau hloov los ntawm cov tshuaj xws li Gleevec uas tau pom tias yuav pab tau zoo dua.

Txij nkawm

Hauv kev tshawb nrhiav xya xyoo, kev muaj sia nyob rau cov neeg laus uas tau siv Gleevec rau Ph-CML tshiab yog 86.4%. Qhov no txhais tau hais tias 86,4% ntawm cov neeg laus tau muaj sia nyob rau xya xyoo tom qab lawv pib noj Gleevec. Qhov no tau piv rau 83.3% ntawm cov tib neeg uas tau txais cov tshuaj lom neeg lub cev.

Hauv kev soj ntsuam kawm, cov neeg uas yav dhau los sim tshuaj interferon-alpha rau CML coj Gleevec. Qee tus neeg no tau teb tiav Gleevec kev kho mob. Qhov no txhais tau hais tias tsis muaj cov kab mob cancer nyob hauv lawv cov ntshav, thiab lawv tsis muaj tsos mob tshwm rau tus kabmob. Nov yog pes tsawg tus neeg nrog CML tau teb tiav los noj Gleevec:

  • 95% ntawm cov neeg nyob rau theem ua ntu zus
  • 38% ntawm cov neeg nyob rau theem nrawm
  • 7% ntawm cov neeg nyob rau theem kev daws teeb meem

Cov kev tshawb fawb soj ntsuam tseem suav cov menyuam yaus uas muaj Ph + CML hauv ntu ua ntu zus. Hauv pawg uas coj Gleevec, 78% ntawm cov menyuam yaus tau teb tiav rau cov tshuaj.

Lwm yam siv rau Gleevec

Ntxiv rau cov mob caj dab ntev (saib saum toj no), Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo Gleevec kho lwm yam mob.

Gleevec rau cov mob ua qog ua ntshav dawb (TXHUA)

Gleevec yog FDA pom zoo kho:

  • Philadelphia chromosome-positive (Ph +) mob lymphocytic mob ntshav dawb (TXHUA) uas rov mob plab
  • Cov Tshuaj Ntsuam Tshiab Ph + TXHUA tus menyuam yaus thaum siv tshuaj khomob

* Mob kheesxaws rov qab tau rov qab los tom qab kho dua, uas yog qhov txo qis qog nqaij hlav thiab mob tshwm sim. Refractory cancer tsis tau teb rau kev kho mob cancer yav dhau los.

Hauv qhov kev tshawb fawb soj ntsuam, 19% ntawm cov neeg laus uas muaj mob rov qab los lossis refractory TXHUA tus neeg uas coj Gleevec tau muaj lus teb tag nrho hauv lawv cov ntshav los kho. Qhov no txhais tau tias lawv tsis muaj mob dabtsi txog mob qog nqaij hlav.

Ib qho kev tshawb fawb soj ntsuam kuj tau saib cov menyuam yaus nrog TXHUA tus uas tau Gleevec thiab tau siv tshuaj khomob. Rau 70% ntawm cov menyuam, lawv cov kabmob cancer tsis mob ntxiv txog plaub xyoos.

Gleevec rau lwm hom mob qog ntshav ntshav

Gleevec yog FDA pom zoo kho lwm hom mob qog ntshav ntshav, suav nrog:

  • Cov mob Myelodysplastic / myeloproliferative (mob pob txha pob txha) rau cov neeg laus uas muaj platelet los ntawm qhov kev loj hlob tau txais (PDGFR) kev hloov kho tshiab. Hauv kev tshawb fawb soj ntsuam me me, 45% ntawm cov neeg kho nrog Gleevec muaj cov lus teb tiav hauv lawv cov ntshav los kho. Qhov no txhais tau tias tsis pom muaj cov kab mob cancer nyob hauv lawv cov ntshav, thiab lawv tsis muaj tsos mob tshwm rau tus kabmob.
  • Hypereosinophilic syndrome thiab / lossis mob ntsws eosinophilic mob ntshav dawb rau cov neeg laus, suav nrog cov neeg mob FIP1L1-PDGFRα fusion kinase. Hauv cov kev tshawb fawb soj ntsuam me me, 100% ntawm cov neeg muaj PDGFR kev hloov pauv uas tau coj Gleevec muaj cov lus teb tiav hauv lawv cov ntshav los kho. Ntawm 21% thiab 58% ntawm cov tib neeg tsis muaj kev hloov dua siab tshiab ntawm cov noob los yog nrog kev tsis paub txog kev hloov pauv uas tau coj Gleevec muaj cov lus teb tiav hauv lawv cov ntshav.
  • Kev txhoj puab heev mastocytosis rau cov laus tsis muaj D816v c-pob hloov khoom. Hauv kev soj ntsuam me me, 100% ntawm cov tib neeg uas muaj FIP1L1-PDGFRα fusion kinase hloov uas tau kho nrog Gleevec muaj cov lus teb tiav los kho.

Gleevec rau cov tawv nqaij ua nqaij hlav

Gleevec yog FDA pom zoo kom kho cov kab mob dermatofibrosarcoma protuberans, uas tsis tshua muaj mob qog nqaij daim tawv, muaj rau cov laus. Nws pom zoo rau cov neeg uas muaj mob qog noj ntshav:

  • tsis tuaj yeem ua haujlwm ntawm
  • tau rov qab los tom qab kho tas
  • yog metastatic (tau kis mus rau lwm qhov ntawm lub cev)

Coob tus neeg tau raug kho nrog Gleevec rau tus mob no hauv kev tshawb fawb soj ntsuam. Ntawm cov neeg uas coj Gleevec, 39% muaj teb txhij rau kev kho. Qhov no txhais tau tias daim tawv nqaij txiav (tshem thiab sim ib qho me me ntawm daim tawv nqaij) tsis muaj cov cim qhia tias muaj mob qog nqaij hlav.

Gleevec rau mob cancer plab hnyuv tws

Gleevec yog FDA pom zoo kho kho pob khoom muaj txoj hnyuv plab hnyuv loj (GIST) hauv cov neeg laus uas tsis tuaj yeem ua haujlwm lossis muaj metastatic (tau kis mus rau lwm qhov ntawm lub cev). Gleevec tseem pom zoo kom kho GIST rau cov neeg laus uas tau raug phais los tshem tawm cov qog. Daim qauv kev kho mob no (siv tshuaj tiv thaiv) siv los tiv thaiv tus kabmob qog kom rov qab los tom qab kev phais.

Hauv cov kev tshawb fawb soj ntsuam, cov neeg uas muaj GIST uas tsis tuaj yeem raug phais tau siv 400 lossis 800 mg ntawm Gleevec. Lawv dim tau plaub xyoos.

Lwm tus neeg nrog GIST puas tau raug phais. Ntawm 14 thiab 70 hnub tom qab, lawv pib noj Gleevec hauv txoj kev kawm. Lawv tau li ntawm 60% qis dua kev pheej hmoo ntawm kev tuag los yog muaj mob qog rov qab lub sijhawm 12 lub hlis. Qhov no piv rau cov neeg uas tau noj cov placebo (kho mob uas tsis muaj tshuaj lom).

Cov ntawv siv tsis ua haujlwm rau Gleevec

Ntxiv nrog rau kev siv teev saum toj no, Gleevec tej zaum yuav siv tawm cov ntawv lo rau lwm qhov kev siv. Daim ntawv tshuaj uas tsis yog daim ntawv lo yog thaum tshuaj uas tau kev pom zoo rau ib qho kev siv raug tshuaj rau ib qho txawv uas tsis tau tso cai.

Gleevec yuav siv cov ntawv qhia rau lwm cov qog nqaij hlav, nrog rau:

  • prostate cancer, raws li kev tshawb fawb 2015
  • melanoma, raws li National Comprehensive Cancer Network cov lus qhia kho
  • ntshav qab zib hom 1, raws li kev kuaj mob xyoo 2018

Txawm li cas los xij, tsis muaj kev tshawb nrhiav ntau npaum li cas Gleevec ua haujlwm rau tib neeg nrog cov mob no. Tseem muaj cov kev tshawb fawb ntxiv los txiav txim siab seb Gleevec pab kho txhua yam mob.

Gleevec rau menyuam yaus

Gleevec yog FDA pom zoo ua kev kho mob rau menyuam yaus nrog rau cov xwm txheej hauv qab no:

  • nyuam qhuav raug mob tshiab Philadelphia-zoo (Ph +) mob myeloid leukemia (CML) hauv cov theem mob (thawj theem ntawm tus mob)
  • nyuam qhuav raug mob Ph + mob mob lymphocytic leukemia (TXHUA) thaum siv nrog kev siv tshuaj

Gleevec raug pom zoo rau siv rau cov menyuam yaus txhua lub hnub nyoog. Txawm li cas los xij, tsis tau muaj kev tshawb fawb txog kev saib xyuas Gleevec kom nyab xeeb lossis zoo npaum li cas rau cov menyuam yaus hnub nyoog qis dua 1 xyoos.

Gleevec nqi

Raws li nrog txhua yam tshuaj, tus nqi ntawm Gleevec tuaj yeem sib txawv.

Tus nqi tiag uas koj yuav them yog nyob ntawm koj cov nyiaj pov hwm thiab lub tsev muag tshuaj uas koj siv.

Kev pab nyiaj thiab kev tuav pov hwm

Yog tias koj xav tau kev txhawb nqa nyiaj txiag los them rau Gleevec, lossis yog koj xav tau kev pab kom nkag siab txog koj cov nyiaj tuav pov hwm, muaj kev pab cuam.

Novartis Pharmaceutical Corporation, cov chaw tsim khoom ntawm Gleevec, muaj ib qho kev pab hu ua Novartis Oncology Kev Them Nyiaj Raug Universal. Yog xav paub cov ntaub ntawv ntau ntxiv thiab txhawm rau nrhiav yog tias koj tsim nyog rau kev txhawb nqa, hu 877-577-7756 lossis mus saib lub vev xaib website.

Gleevec tsuas tshuaj

Cov Gleevec ntau npaum koj tus kws kho mob sau yuav yog nyob ntawm ntau yam. Cov no suav nrog:

  • hom thiab mob hnyav uas koj tau siv Gleevec los kho
  • muaj hnub nyoog
  • phaus (rau menyuam yaus)
  • muaj cov noob hloov
  • lwm yam mob uas koj yuav muaj
  • lwm yam tshuaj uas koj tuaj yeem noj
  • phiv los sis koj yuav muaj

Cov koob tshuaj koj yuav tau txais nyob ntawm koj mob qog noj ntshav. Rau qee cov qog nqaij hlav, koj tus kws kho mob yuav pib koj rau qhov noj tsawg kawg. Tom qab ntawd lawv yuav tau kho nws lub sijhawm kom ncav cuag qhov muab tshuaj uas haum rau koj.

Cov ntaub ntawv hauv qab no piav qhia ntau npaum li cas cov tshuaj uas feem ntau siv los yog ua kom siv. Txawm li cas los xij, nco ntsoov siv qhov ntau npaum koj tus kws kho mob sau rau koj. Koj tus kws kho mob yuav txiav txim siab muab qhov zoo tshaj plaws kom haum koj cov kev xav tau.

Cov ntaub ntawv tshuaj thiab qhov ua tau zoo

Gleevec los ua ib ntsiav tshuaj uas koj noj ntawm qhov ncauj (koj nqos nws). Nws muaj nyob hauv 100-mg ntsiav tshuaj thiab 400-mg ntsiav tshuaj.

Cov 100-mg thiab 400-mg ntsiav tshuaj tuaj rau hauv lub raj mis. Cov ntsiav tshuaj 400-mg tseem tuaj yeem ua cov hlwv qhwv uas nyuaj rau cov menyuam yaus qhib.

Gleevec tsuas tshuaj pes

Cov koob tshuaj nram no yog pib siv tshuaj rau txhua yam mob:

  • cov neeg laus nrog Philadelphia-positive (Ph +) mob myeloid leukemia (CML) hauv kev ua ntu zus (thawj theem ntawm tus mob): 400 mg / hnub
  • cov neeg laus uas muaj Ph + CML nyob rau qib nrawm lossis tawg kev phom sij (qib ob thiab qib peb yuav kis tus kab mob): 600 mg / hnub
  • cov neeg muaj mob Ph + mob lymphocytic rau cov leeg ntshav (TXHUA): 600 mg / hnub
  • cov laus nrog tus mob myelodysplastic / myeloproliferative: 400 mg / hnub
  • cov neeg laus uas muaj mastocytosis nruj: 100 mg lossis 400 mg / hnub
  • cov laus uas muaj cov tsos mob ua hypereosinophilic thiab / lossis mob ntsws mob eosinophilic zoo: 100 mg / hnub lossis 400 mg / hnub
  • cov neeg laus nrog dermatofibrosarcoma protuberans: 800 mg / hnub
  • cov laus uas mob plab zom mov (GIST): 400 mg / hnub

Koj tus kws kho mob yuav sau ntawv muab lwm qhov sib txawv rau koj. Lawv yuav txiav txim seb koj lub cev teb rau qhov tshuaj zoo npaum li cas, koj cov kev mob tshwm sim txaus ntshai npaum li cas, thiab lwm yam. Yog tias koj muaj lus nug txog kev siv tshuaj Gleevec rau koj, tham nrog koj tus kws kho mob.

Kev noj tshuaj rau cov me nyuam

Cov koob tshuaj rau cov menyuam yaus yog cov hauv qab no:

  • cov menyuam yaus uas muaj Ph + CML hauv ntu mob ntev (thawj theem ntawm tus mob): 340 mg / m2 / hnub
  • cov menyuam nrog Ph + TAG NRHO: 340 mg / m2 / hnub kom raug coj nrog tshuaj kho mob

Koj tus menyuam tus kws khomob yuav muab cov tshuaj rau koj tus menyuam qhov siab thiab qhov hnyav. (Yog li 340 mg / m2 txhais tau tias 340 mg rau ib square meter ntawm lub cev qhov chaw saum npoo.) Piv txwv, yog koj tus menyuam siab 4 feet thiab hnyav 49 lbs., Lawv lub cev thaj tsam yog li 0.87 m2. Yog li cov tshuaj rau Ph + CML yuav yog 300 mg.

Yog tias kuv plam koob tshuaj?

Yog tias koj tsis nco qab koob Gleevec, noj ib qho sai li koj nco tau. Yog tias nws yuav luag txog sijhawm rau koj li tshuaj ntxiv, tos thiab noj tshuaj ntxiv raws li tau teem tseg. Tsis txhob noj ob lub tshuaj ua kom lub koob tshuaj ploj. Qhov no tuaj yeem txhawb koj kev phom sij loj heev.

Kuv puas yuav tau siv cov tshuaj no ntev?

Gleevec yog txhais tau tias siv los ua kev kho mob ntev. Yog tias koj thiab koj tus kws kho mob txiav txim siab tias Gleevec muaj kev nyab xeeb thiab zoo rau koj, koj yuav tau siv sijhawm ntev.

Xaiv rau Gleevec

Muaj lwm yam tshuaj uas tuaj yeem kho koj tus mob. Qee tus kuj yuav zoo dua rau koj dua li lwm tus. Yog tias koj xav paub txog lwm txoj kev xaiv rau Gleevec, tham nrog koj tus kws kho mob kom paub ntxiv txog lwm cov tshuaj uas yuav ua haujlwm zoo rau koj.

Nco tseg: Qee cov tshuaj teev rau ntawm no tau siv daim ntawv lo npe coj los kho cov mob no.

Xaiv rau CML

Piv txwv ntawm lwm cov tshuaj uas tuaj yeem siv los kho Philadelphia-zoo (Ph +) mob myeloid leukemia (CML) yog:

  • dasatinib (Sprycel)
  • nilotinib (Tasigna)
  • bosutinib (Bosulif)
  • ponatinib (Iclusig)
  • omacetaxine (Synribo)
  • daunorubicin (Cerubidine)
  • cytarabine
  • tshuaj interferon-alpha (Intron A)

Xaiv rau GIST

Piv txwv ntawm lwm yam tshuaj uas tuaj yeem siv coj los kho tus mob plab hnyuv loj (GIST) yog:

  • sunitinib (Sutent)
  • regorafenib (Stivarga)
  • sorafenib (Nexavar)
  • nilotinib (Tasigna)
  • dasatinib (Sprycel)
  • pazopanib (Votrient)

Lwm txoj kev xaiv rau lwm yam mob Gleevec tuaj yeem kho kho mob los kuj tseem muaj. Tham nrog koj tus kws kho mob txog cov tshuaj twg tuaj yeem siv rau koj tus mob.

Gleevec vs. Tasigna

Tej zaum koj yuav xav paub Gleevec piv rau lwm cov tshuaj uas tau sau tseg rau kev siv zoo sib xws. Ntawm no peb saib yuav ua li cas Gleevec thiab Tasigna zoo ib yam thiab txawv.

Kev Siv

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo ob leeg Gleevec thiab Tasigna los kho qee yam mob qog ntshav ntshav.

Ob qho tshuaj no tau pom zoo los kho FDA kom kho tau tus mob tshiab Philadelphia-positive (Ph +) mob myeloid leukemia (CML) hauv cov muaj mob mus ntev rau cov laus thiab cov menyuam yaus.

Mob ntshav qab zib myeloid (CML) tau muab faib ua peb ntu:

  • Mob theem. Nov yog thawj theem ntawm CML Feem ntau cov neeg tau kuaj pom tus mob CML thaum lub sij hawm mob nyhav. Cov tsos mob feem ntau yog mob me ntsis, yog tias muaj txhua yam.
  • Qib nrawm. Hauv qib ob, tus naj npawb ntawm cov qog nqaij hlav cancer hauv koj cov ntshav nce ntxiv. Tej zaum koj yuav muaj tsos mob ntau, xws li ua npaws thiab poob cev.
  • Moj tej tawg theem. Hauv theem no ntau tshaj plaws, cov qog nqaij hlav cancer hauv koj cov ntshav tau kis mus rau lwm yam kabmob thiab cov nqaij mos. Koj cov tsos mob tej zaum yuav mob hnyav dua.

Gleevec raug pom zoo los kho Philadelphia-positive (Ph +) CML rau cov neeg laus uas muaj kev kho mob ntev, nrawm nrawm, lossis pob tawg ntsoog yog tias cuam tshuam nrog kev kho alpha tsis tau ua haujlwm.

Tshuaj Interferon-alpha yog ib hom tshuaj uas feem ntau siv los kho CML yav dhau los. Nws yog tib neeg tsim tshuaj uas ua zoo li qee yam tshuaj tiv thaiv kab mob tiv thaiv thiab tiv thaiv kev loj hlob ntawm cov qog nqaij hlav cancer.

Tasigna tau txais kev pom zoo los kho Ph + CML hauv ntu mob ntev lossis nrawm hauv cov neeg laus yog tias lwm txoj kev kho tsis tau ua haujlwm, suav nrog kev kho nrog Gleevec. Tasigna tsis tau pom zoo rau theem kev muaj tshuaj lom neeg tawg.

Tasigna kuj tau txais kev pom zoo los kho Ph + CML rau cov menyuam yaus hnub nyoog 1 xyoos thiab laus dua yog tias lwm txoj kev khomob tsis ua haujlwm. Gleevec raug pom zoo kom kho kho Ph + CML tshiab hauv cov menyuam yaus.

Gleevec tseem pom zoo kom kho lwm hom qog nqaij hlav thiab. Saib hauv seem "Lwm Siv rau Gleevec" kom paub ntau ntxiv.

Cov ntaub ntawv tshuaj thiab kev tswj hwm

Gleevec muaj cov tshuaj imatinib. Tasigna muaj cov tshuaj nilotinib.

Gleevec los ua ib ntsiav tshuaj. Tasigna los ua ib lub tshuaj ntsiav. Ob qhov tshuaj no yog noj ntawm qhov ncauj.

Gleevec noj ib zaug lossis ob zaug ib hnub, nyob ntawm koj cov koob tshuaj. Tasigna noj ob zaug ib hnub.

Gleevec los ua 100-mg thiab 400-mg ntsiav tshuaj. Tasigna ua li 50-mg, 150-mg, thiab 200-mg tsiav tshuaj.

Phiv thiab txaus ntshai

Gleevec thiab Tasigna muaj cov tshuaj zoo sib xws. Yog li, ob hom tshuaj ua rau muaj kev phiv zoo heev. Hauv qab no yog cov piv txwv ntawm cov kev mob tshwm sim no.

Ntau cov kev mob tshwm sim

Cov npe no muaj cov piv txwv ntawm cov kev mob tshwm sim ntau dua uas tuaj yeem tshwm sim nrog Gleevec, nrog Tasigna, lossis nrog ob qho tshuaj (thaum noj ib leeg).

  • Yuav tshwm sim nrog Gleevec:
    • edema (o ntawm koj ob txhais ceg, pob taws, thiab ko taw, thiab ib ncig ntawm koj lub qhov muag)
    • mob leeg
    • mob leeg
    • mob pob txha
    • mob plab
  • Yuav tshwm sim nrog Tasigna:
    • mob taub hau
    • khaus tawv
    • hnoos
    • cem quav
    • mob tej pob txha
    • nasopharyngitis (khaub thuas nquag)
    • ua npaws
    • tsaus ntuj tawm hws
  • Yuav tshwm sim nrog ob Gleevec thiab Tasigna:
    • xeev siab
    • ntuav
    • zawv plab
    • ua pob
    • qaug zog (tsis muaj lub zog)

Cov kev mob tshwm sim hnyav heev

Cov npe no muaj cov piv txwv ntawm cov kev mob tshwm sim loj heev uas tuaj yeem tshwm sim nrog Gleevec, nrog Tasigna, lossis nrog ob qho tshuaj (thaum noj ib leeg).

  • Yuav tshwm sim nrog Gleevec:
    • congestive plawv tsis ua hauj lwm los sis teeb meem plawv xws li lub plawv tawg
    • lub plab zom mov perforations (qhov nyob hauv koj lub plab lossis hnyuv)
    • cov tawv nqaij sawv cev hnyav, suav nrog Stevens-Johnson syndrome (kub taub hau; qhov ncauj tawm ntawm koj lub qhov ncauj, caj pas, qhov muag, caj ces, lossis lub cev tag nrho)
    • raum puas tsuaj
    • hypothyroidism (muaj cov thyroid tsawg) hauv cov neeg uas tau tshem tawm cov thyroid tawm
  • Yuav tshwm sim nrog Tasigna:
    • ntev QT luv (cov hluav taws xob tsis zoo hauv koj lub siab), uas yog tsawg tsawg tab sis tuaj yeem ua rau tuag sai
    • thaiv cov hlab ntsha hauv lub plawv
    • pancreatitis
    • electrolyte tsis txaus (theem siab lossis qis ntawm qee yam minerals)
  • Yuav tshwm sim nrog ob Gleevec thiab Tasigna:
    • cov ntshav tsis haum, suav nrog kev ua haujlwm ntshav (ntshav qes qes), neutropenia (cov qe ntshav dawb), thiab thrombocytopenia (ntshav qes ntshav tsawg)
    • mob siab puas tsuaj
    • Mob ntsws lysis syndrome (cov qog nqaij hlav cancer tso cov tshuaj tsis zoo rau hauv koj cov ntshav)
    • hemorrhage (los ntshav uas tsis nres)
    • Kev ceev cov dej loj (ntau dhau ntawm cov dej lossis dej)
    • kev loj hlob qeeb hauv cov menyuam yaus

Txij nkawm

Gleevec thiab Tasigna muaj cov khoom siv pom zoo los ntawm FDA. Tab sis lawv ob leeg kho Ph + CML nyob rau theem ntev thiab nrawm yog tias muaj lwm yam kev kho mob tsis ua haujlwm. CML muaj peb ntu: mob ntev (theem 1), nrawm (theem 2), thiab qhov tawg ntsoog (theem 3).

Kev siv Gleevec thiab Tasigna hauv kev kho tus mob tshiab khos Ph + CML rau cov neeg laus tau muab piv rau hauv kev soj ntsuam tshawb fawb. Cov kws tshawb nrhiav tau muab piv rau cov neeg uas tau Gleevec 400 mg ib hnub ib zaug lossis 300 mg ntawm Tasigna ib hnub ob zaug.

Tom qab 12 lub hlis ntawm kev kho mob, 65% ntawm cov neeg uas tau siv Gleevec tsis muaj Ph + cov hlwb hauv lawv cov pob txha pob txha (qhov uas cov keeb hlav mob hlwb loj hlob CML). Ntawm cov tib neeg uas siv Tasigna, 80% muaj tsis muaj Ph + cov hlwb hauv lawv cov pob txha caj qaum.

Tom qab tsib xyoos ntawm kev kho mob, 60% ntawm cov neeg uas tau noj Gleevec muaj ntau cov qog nqaij hlav cancer ntshav hauv lawv cov ntshav qis. Qhov no tau piv rau 77% ntawm cov neeg uas tau noj Tasigna.

Tsis tas li ntawd tom qab tsib xyoos ntawm kev kho mob, 91.7% ntawm cov neeg uas coj Gleevec tseem muaj sia nyob. Qhov ntawd yog piv rau 93.7% ntawm cov neeg uas tau noj Tasigna.

Cov txiaj ntsig ntawm txoj kev kawm no qhia tias Tasigna tej zaum yuav ua hauj lwm zoo dua li Gleevec ntawm kev kho tus mob tshiab Ph + CML hauv ntu mob ntev.

Cov nqi

Gleevec thiab Tasigna yog ob hom tshuaj muaj npe. Tasigna tsis muaj daim foos ntau, tab sis Gleevec muaj ib daim qauv tsis tseem ceeb hu ua imatinib. Cov tshuaj muaj npe lag luam feem ntau raug nqi ntau dua li cov generics.

Raws li kev kwv yees nyob rau GoodRx.com, cov npe lag luam Gleevec tej zaum yuav raug nqi tsawg dua li Tasigna. Daim qauv ntawm Gleevec (imatinib) kuj tseem raug nqi tsawg dua li Tasigna. Tus nqi tiag uas koj yuav them rau cov tshuaj nyob ntawm koj cov koob tshuaj, kev npaj tuav pov hwm, koj qhov chaw nyob, thiab lub tsev muag tshuaj uas koj siv.

Gleevec thiab Sprycel

Tej zaum koj yuav xav paub Gleevec piv rau lwm cov tshuaj uas tau sau tseg rau kev siv zoo sib xws. Ntawm no peb saib seb Gleevec thiab Sprycel zoo ib yam thiab txawv.

Kev Siv

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo ob leeg Gleevec thiab Sprycel los kho qee yam mob qog ntshav ntshav.

Ob qho tshuaj puav leej yog FDA ob leeg tau pom zoo kho cov mob tshiab Philadelphia-positive (Ph +) mob myeloid leukemia (CML) hauv cov muaj mob mus ntev rau cov laus thiab cov menyuam yaus.

CML tau muab faib ua peb ntu:

  • Mob theem. Nov yog thawj theem ntawm CML Feem ntau cov neeg tau kuaj pom tus mob CML thaum lub sij hawm mob nyhav. Cov tsos mob feem ntau yog mob me ntsis, yog tias muaj txhua yam.
  • Qib nrawm. Hauv qib ob, tus naj npawb ntawm cov qog nqaij hlav cancer hauv koj cov ntshav nce ntxiv. Tej zaum koj yuav muaj tsos mob ntau, xws li ua npaws thiab poob cev.
  • Moj tej tawg theem. Hauv theem no ntau tshaj plaws, cov qog nqaij hlav cancer hauv koj cov ntshav tau kis mus rau lwm yam kabmob thiab cov nqaij mos. Koj cov tsos mob tej zaum yuav mob hnyav dua.

Gleevec thiab Sprycel tau siv los kho Ph + CML rau cov neeg laus hauv ntu mob ntev.

Gleevec kuj tseem siv los kho Ph + CML rau cov neeg laus hauv ntu mob ntev, nrawm nrawm, los sis tawg-tawg yog tias cuam tshuam nrog cov tshuaj kho alpha tsis ua haujlwm. Tshuaj Interferon-alpha yog ib hom tshuaj uas feem ntau siv los kho CML yav dhau los. Nws yog tib neeg tsim tshuaj uas ua zoo li qee yam tshuaj tiv thaiv kab mob tiv thaiv thiab tiv thaiv kev loj hlob ntawm cov qog nqaij hlav cancer.

Sprycel tseem tseem siv los kho Ph + CML rau cov laus hauv cov mob ntev, nrawm nrawm, lossis pob tawg-ntsoog yog tias Gleevec tsis ua haujlwm.

Ob Gleevec thiab Sprycel raug pom zoo kom kho Ph + CML hauv ntu mob mus ntev hauv cov menyuam yaus. Lawv kuj tau pom zoo rau kev kho Ph + mob mob lymphocytic rau cov ntshav (TXHUA) hauv menyuam yaus nrog kev siv tshuaj kho mob.

Gleevec tseem pom zoo kom kho lwm hom qog nqaij hlav thiab. Saib hauv seem "Lwm Siv rau Gleevec" kom paub ntau ntxiv.

Cov ntaub ntawv tshuaj thiab kev tswj hwm

Gleevec muaj cov tshuaj imatinib. Sprycel muaj cov tshuaj dasatinib.

Gleevec thiab Sprycel ob leeg los ua ntsiav tshuaj uas koj noj ntawm qhov ncauj (koj nqos lawv).

Gleevec ntsiav tshuaj tuaj hauv ob lub zog: 100 mg thiab 400 mg. Nws tau noj ib zaug lossis ob zaug ib hnub, nyob ntawm koj cov koob tshuaj.

Sprycel ntsiav tshuaj tuaj rau hauv qab no muaj zog: 20 mg, 50 mg, 70 mg, 80 mg, 100 mg, thiab 140 mg. Sprycel tau noj ib hnub ib zaug.

Phiv thiab txaus ntshai

Gleevec thiab Sprycel zoo sib xws tab sis muaj cov tshuaj sib txawv. Yog li, ob hom tshuaj ua rau muaj kev phiv zoo heev. Hauv qab no yog cov piv txwv ntawm cov kev mob tshwm sim no.

Ntau cov kev mob tshwm sim

Cov npe no muaj cov piv txwv ntawm cov kev mob tshwm sim ntau dua uas tuaj yeem tshwm sim nrog Gleevec, nrog Sprycel, lossis nrog ob qho tshuaj (thaum noj ib leeg).

  • Yuav tshwm sim nrog Gleevec:
    • ntuav
    • mob leeg
    • mob plab
    • qhov muag ntawm thaj chaw o (o ncig thaj qhov muag)
  • Yuav tshwm sim nrog Sprycel:
    • teeb meem ua pa
    • mob taub hau
    • los ntshav
    • Lub cev tsis muaj zog tiv thaiv kab mob (koj lub cev tiv thaiv tsis tau cov kab mob ib yam nkaus)
  • Yuav tshwm sim nrog ob Gleevec thiab Sprycel:
    • edema (o ntawm koj ob ceg, pob taws, thiab ko taw)
    • xeev siab
    • mob leeg
    • mob pob txha
    • zawv plab
    • ua pob
    • qaug zog (tsis muaj lub zog)

Cov kev mob tshwm sim hnyav heev

Cov npe no muaj cov piv txwv ntawm cov kev mob tshwm sim loj uas tuaj yeem tshwm sim nrog Gleevec, nrog Sprycel, lossis nrog ob qho tshuaj (thaum noj ib leeg).

  • Yuav tshwm sim nrog Gleevec:
    • teeb meem mob plawv, xws li congestive plawv nres
    • mob siab puas tsuaj
    • lub plab ua paug (qhov nyob hauv koj lub plab lossis hnyuv)
    • raum puas tsuaj
    • hypothyroidism (muaj cov thyroid tsawg) hauv cov neeg uas tau tshem tawm cov thyroid tawm
  • Yuav tshwm sim nrog Sprycel:
    • pulmonary arterial hypertension (ntshav siab hauv cov hlab ntshav hauv koj lub ntsws)
    • ntev QT luv (ib hom kev txawv txav hluav taws xob hauv koj lub siab)
    • ischemic lub plawv nres (tsis muaj oxygen rau cov leeg ntshav)
  • Yuav tshwm sim nrog ob Gleevec thiab Sprycel:
    • kev tso dej kom ntau (ntau dhau ntawm cov dej lossis dej) nyob ib ncig ntawm koj lub ntsws, lub plawv, thiab lub plab
    • cov ntshav qog ntshav ntau heev (cov qe ntshav liab qis, qe ntshav dawb, lossis qe ntshav dawb)
    • mob ntshav khov (los ntshav uas tsis nres)
    • cov tawv nqaij sawv cev hnyav, suav nrog Stevens-Johnson syndrome (kub taub hau; qhov ncauj tawm ntawm koj lub qhov ncauj, caj pas, qhov muag, caj ces, lossis lub cev tag nrho)
    • Mob ntsws lysis syndrome (cov qog nqaij hlav cancer tso cov tshuaj tsis zoo rau hauv koj cov ntshav)
    • lub plawv dhia tsis zoo lossis lub plawv khiav ceev (lub plawv dhia nrawm dhau, qeeb dhau, lossis lub cev)
    • stunted kev loj hlob ntawm cov menyuam yaus

Txij nkawm

Gleevec thiab Sprycel muaj cov khoom siv pom zoo los ntawm FDA. Tab sis lawv ob qho tib si kho tus mob Ph + CML tshiab hauv cov theem ntev (thawj theem ntawm CML) rau cov laus thiab menyuam yaus. Gleevec thiab Sprycel kuj ob leeg kho Ph + TXHUA tus me nyuam thaum siv nrog kev siv tshuaj lom neeg.

Ib qho ntxiv, ob Gleevec thiab Sprycel kho Ph + CML rau hauv cov tshaj tawm thiab tawg ntu hauv cov neeg laus, lossis Ph + TXHUA, yog tias lwm yam tshuaj tsis ua haujlwm rau lawv.

Kev siv Gleevec thiab Sprycel hauv kev kho tus kab mob Ph + CML tshiab hauv cov neeg laus tau muab piv rau hauv kev soj ntsuam tshawb fawb. Cov kws tshawb nrhiav tau sib piv cov neeg uas siv Gleevec ib hnub twg 400 mg lossis 100 mg ntawm Sprycel ib hnub.

Hauv 12 lub hlis, 66.2% ntawm cov tib neeg uas tau Gleevec tsis muaj Ph + cov hlwb hauv lawv cov pob txha pob txha (qhov uas cov hlav hlwb CML muaj mob loj). Hauv pawg uas coj Sprycel, 76.8% ntawm cov neeg tsis muaj Ph + hlwb hauv lawv cov pob txha caj qaum.

Tom qab tsib xyoos ntawm kev kho mob, kwv yees li 89.6% ntawm cov neeg uas tau noj Gleevec tseem muaj sia nyob. Qhov ntawd yog piv rau kwv yees 90.9% ntawm cov neeg uas coj Sprycel.

Cov txiaj ntsig ntawm txoj kev kawm no qhia tias Sprycel yuav ua haujlwm zoo dua li Gleevec ntawm kev kho tus mob nyuam qhuav muaj Ph + CML nyob rau theem ntev.

Cov nqi

Gleevec thiab Sprycel yog ob hom tshuaj muaj npe. Sprycel tsis muaj daim ntawv uas tsis muaj qauv, tab sis Gleevec muaj daim foos hu ua imatinib. Cov tshuaj muaj npe lag luam feem ntau raug nqi ntau dua li cov generics.

Raws li kev kwv yees ntawm GoodRx.com, cov npe lag luam Gleevec tej zaum yuav raug nqi tsawg dua Sprycel. Daim qauv ntawm Gleevec (imatinib) kuj tseem yuav raug nqi tsawg dua Sprycel. Tus nqi tiag uas koj yuav them rau cov tshuaj nyob ntawm koj cov koob tshuaj, koj txoj kev npaj fajseeb khomob, koj qhov chaw nyob, thiab lub tsev muag tshuaj uas koj siv.

Gleevec thiab cawv

Nws tsis paub meej tias Gleevec thiab haus dej cawv sib txuam nrog txhua lwm yam.

Txawm li cas los xij, koj lub siab ua rau lub cev sib zom (rhuav tshem) ob qho Gleevec thiab cawv. Yog li haus cawv ntau heev thaum koj noj Gleevec tuaj yeem tiv thaiv koj lub siab kom tsis txhob quav yeeb tshuaj. Qhov no tuaj yeem nce qib Gleevec hauv koj lub cev thiab ua rau koj muaj kev phom sij txaus ntshai, nrog rau daim siab puas.

Ob Gleevec thiab cawv yuav ua rau muaj kev phiv xws li:

  • xeev siab
  • zawv plab
  • mob taub hau
  • qaug zog (tsis muaj lub zog)

Haus cawv thaum koj mus kho Gleevec tuaj yeem ua kom koj muaj feem yuav muaj tej kev mob tshwm sim no.

Yog tias koj haus dej cawv, tham nrog koj tus kws kho mob txog kev nyab xeeb rau koj npaum li cas thaum kho Gleevec.

Kev sib tshuam Gleevec

Gleevec tuaj yeem cuam tshuam nrog ntau lwm yam tshuaj. Nws tuaj yeem cuam tshuam nrog qee yam tshuaj ntxiv nrog rau qee yam zaub mov.

Kev sib cuam tshuam sib txawv tuaj yeem ua rau txawv txav. Piv txwv li, qee tus tuaj yeem cuam tshuam nrog cov tshuaj ua haujlwm zoo li cas, thaum lwm tus tuaj yeem ua rau muaj kev mob tshwm sim ntxiv.

Gleevec thiab lwm yam tshuaj noj

Hauv qab no yog cov npe tshuaj uas tuaj yeem cuam tshuam nrog Gleevec. Daim ntawv no tsis muaj tag nrho cov tshuaj uas yuav cuam tshuam nrog Gleevec.

Ua ntej noj Gleevec, tham nrog koj tus kws kho mob thiab kws muag tshuaj. Qhia rau lawv txog txhua yam tshuaj noj, tsis-kiab khw, thiab lwm yam tshuaj koj noj. Kuj tseem qhia rau lawv txog cov vitamins, tshuaj ntsuab, thiab tshuaj siv uas koj siv. Sib qhia cov ntaub ntawv no tuaj yeem pab koj kom tsis txhob muaj kev cuam tshuam.

Yog tias koj muaj lus nug txog kev sib txuam nrog tshuaj uas yuav cuam tshuam koj, nug koj tus kws kho mob lossis kws muag tshuaj.

Gleevec thiab Tylenol

Noj Gleevec nrog Tylenol (Acetaminophen) tuaj yeem ua rau koj muaj kev phom sij txaus ntshai, xws li daim siab puas.

Enzymes (protein tshwj xeeb) hauv koj lub siab zom ob qho Gleevec thiab Tylenol. Ua ke, ob lub tshuaj tuaj yeem ua rau loj dhau ntawm cov enzymes thiab ua rau cov hlwb puas hauv koj lub siab.

Nug koj tus kws kho mob seb nws puas zoo rau koj noj Tylenol thaum lub sijhawm kho Gleevec.

Gleevec thiab qee cov tshuaj chua leeg

Siv Gleevec nrog qee cov tshuaj qaug dab peg yuav txo qis Gleevec ntau hauv koj lub cev. Qhov no tuaj yeem ua rau Gleevec siv tsis tau zoo (ua haujlwm tsis tshua zoo).

Piv txwv ntawm cov tshuaj chua leeg uas tuaj yeem txo qis qib Gleevec suav nrog:

  • phenytoin (Dilantin, Phenytek)
  • carbamazepine (Carbatrol, Tegretol)
  • phenobarbital

Yog tias koj tau noj Gleevec thiab qee cov tshuaj qaug dab peg, koj tus kws kho mob tuaj yeem sau tshuaj sib txawv lossis kho qhov ntau npaum li cas ntawm Gleevec.

Gleevec thiab qee yam tshuaj tua kab mob

Noj Gleevec nrog qee yam tshuaj tua kab mob (cov tshuaj uas kho cov kab mob) tuaj yeem nce Gleevec ntau ntau hauv koj lub cev. Tshuaj tua kab mob tiv thaiv Gleevec los ntawm kev rhuav tshem hauv koj lub cev. Qhov no nce koj qhov kev pheej hmoo rau phiv loj heev.

Ib qho piv txwv ntawm cov tshuaj tua kab mob uas tuaj yeem nce Gleevec qib yog clarithromycin (Biaxin XL).

Yog tias koj tab tom noj Gleevec thiab xav tau tshuaj tua kab mob, koj tus kws kho mob yuav soj ntsuam koj kom muaj kev phiv. Lawv kuj tseem yuav txo koj qhov Gleevec ntau ntau zaug.

Gleevec thiab qee yam antifungals

Noj Gleevec nrog qee yam tshuaj tua kab mob (tshuaj uas kho cov kab mob fungal) tuaj yeem tiv thaiv kev puas tsuaj ntawm Gleevec hauv koj lub cev. Qhov no tuaj yeem nce qib Gleevec hauv koj cov ntshav thiab ua rau koj muaj kev phom sij txaus ntshai.

Piv txwv ntawm antifungals uas tuaj yeem nce Gleevec qib yog:

  • itraconazole (Onmel, Sporanox, Tolsura)
  • ketoconazole (Extina, Ketozole, Xolegel)
  • voriconazole (Vfend)

Yog tias koj tab tom noj Gleevec thiab xav tau tshuaj tua kab mob, koj tus kws kho mob yuav soj ntsuam koj txog kev phiv. Lawv kuj tseem yuav txo koj qhov Gleevec ntau ntau zaug.

Gleevec thiab opioids

Siv Gleevec nrog qee cov tshuaj kom txo qhov mob tuaj yeem nce ntau ntawm cov mob kom txo tus mob hauv koj lub cev. Qhov no tuaj yeem ua rau koj muaj kev phiv tshuaj ntau dua xws li ua kom tsaug zog (hnov tsaug zog thiab tsis paub meej) thiab ua pa nyuaj siab (ua pa qeeb).

Piv txwv ntawm cov tshuaj opioid mob uas tuaj yeem nce qib Gleevec muaj xws li:

  • cov tshuaj oxygencodone (Oxycontin, Roxicodone, Xtampza ER)
  • tramadol (ConZip, Ultram)
  • Tshuaj txiav yeeb (Dolophine, Methadose)

Tham nrog koj tus kws kho mob txog seb nws puas muaj kev nyab xeeb rau kev noj tshuaj thaum mob Gleevec. Lawv yuav muab lwm txoj hauv kev los txo koj qhov mob.

Gleevec thiab qee cov tshuaj tiv thaiv HIV

Noj Gleevec nrog qee cov tshuaj HIV tuaj yeem ua rau koj muaj feem phom sij phiv. Qee cov tshuaj HIV tuaj yeem tiv thaiv Gleevec los ntawm kev rhuav tshem, uas ua rau Gleevec ntau ntau hauv koj lub cev.

Piv txwv ntawm cov tshuaj tua kab mob HIV uas tuaj yeem nce qib Gleevec suav nrog:

  • atazanavir (Reyataz)
  • nevirapine (Viramune)
  • saquinavir (Invirase)

Lwm txoj kev siv tshuaj HIV, efavirenz (Sustiva), tuaj yeem txo Gleevec ntau ntau hauv koj lub cev. Qhov no tuaj yeem ua rau Gleevec tsis muaj txiaj ntsig.

Ntau cov tshuaj HIV los ua ke ua ke, uas txhais tau tias lawv suav nrog ntau dua ib hom tshuaj. Yog li nco ntsoov sib tham nrog koj tus kws kho mob txog txhua hom tshuaj HIV koj noj.

Yog tias koj xav siv Gleevec nrog qee cov tshuaj HIV, koj tus kws kho mob yuav hloov koj Gleevec ntau npaum.

Gleevec thiab qee cov tshuaj ntshav siab

Noj Gleevec nrog qee cov tshuaj ntshav siab tuaj yeem ua rau nce siab lossis txo qis ntawm cov tshuaj hauv koj lub cev. Qhov no tuaj yeem ua rau koj muaj kev phiv tshuaj ntau dua lossis txo qhov tshuaj ua haujlwm tau zoo.

Cov piv txwv ntawm cov tshuaj no suav nrog verapamil (Calan, Tarka).

Yog tias koj yuav tsum tau noj Gleevec nrog ib qho ntawm cov tshuaj no, koj tus kws kho mob yuav soj ntsuam koj zoo dua rau cov kev mob tshwm sim. Lawv kuj tuaj yeem hloov kho ntau npaum li cas ntawm kev noj tshuaj lossis pom zoo rau lwm cov tshuaj sib txawv.

Gleevec thiab warfarin

Noj Gleevec nrog warfarin (Coumadin, Jantoven) tuaj yeem ua rau koj muaj feem los ntshav ntau ntxiv. Gleevec txwv tsis pub cov tshuaj warfarin los rhuav tshem hauv koj lub cev. Qhov no nce ntxiv cov tshuaj warfarin thiab tuaj yeem ua rau ntshav los ntshav uas nyuaj rau kev tswjhwm.

Yog tias koj xav tau cov tshuaj anticoagulant (cov ntshav ua ntshav dua) thaum noj Gleevec, koj tus kws kho mob yuav xaj tshuaj ntau dua li warfarin.

Gleevec thiab St. John lub wort

Noj Gleevec nrog St. John lub wort tuaj yeem txo Gleevec ntau hauv koj lub cev. Qhov no tuaj yeem ua rau Gleevec txo qis dua (tsis ua haujlwm ib yam nkaus).

Nug koj tus kws kho mob seb St. John wort puas muaj kev nyab xeeb rau koj noj thaum koj Gleevec kho. Lawv yuav qhia lwm txoj hauv kev rau John John Wort lossis nce koj li Gleevec koob tshuaj.

Gleevec thiab txiv kab ntxwv qaub

Noj txiv kab ntxwv qaub lossis haus kua txiv kab ntxwv qaub thaum lub sijhawm kev kho Gleevec tuaj yeem ua rau koj muaj kev phom sij txog kev phiv loj heev. Txiv kab ntxwv qaub muaj tshuaj lom neeg uas tiv thaiv Gleevec hauv kev ua txhaum hauv koj lub cev. Qhov no ua rau muaj kev nce qib Gleevec, uas tuaj yeem ua rau muaj kev phiv ntau dua.

Nco ntsoov zam kom tsis txhob noj txiv kab ntxwv qaub thiab haus kua txiv txiv kab ntxwv thaum lub sijhawm kev kho Gleevec.

Yuav ua li cas Siv Gleevec

Nco ntsoov coj Gleevec raws li koj tus kws kho mob lossis tus neeg saib xyuas kev noj qab haus huv cov lus qhia.

Thaum twg mam coj

Rau Gleevec kev noj tshuaj ntawm 600 mg lossis tsawg dua, cov tshuaj yuav tsum noj ib hnub ib zaug. Koj tuaj yeem nqa nws txhua lub sijhawm.

Yog tias koj tus kws kho mob sau Gleevec 800 mg ib hnub, koj yuav tsum noj ob koob: 400 mg thaum sawv ntxov thiab 400 mg thaum yav tsaus ntuj.

Koj tus kws kho mob yuav qhia koj thaum twg koj yuav tsum noj koj lub tshuaj.

Noj Gleevec nrog zaub mov

Nqa Gleevec nrog ib pluas noj thiab ib khob dej loj. Qhov no tuaj yeem pab tiv thaiv kev mob plab.

Puas yog Gleevec tuaj yeem tsoo, sib faib, lossis zom?

Koj yuav tsum tsis txhob zuaj, sib cais, lossis zom cov ntsiav tshuaj Gleevec. Cov ntsiav tshuaj tawg thiab faib tawm tuaj yeem tsim kev puas tsuaj rau ib qho tawv nqaij lossis lwm qhov ntawm lub cev uas chwv lawv.

Yog tias koj muaj teeb meem nqos Gleevec ntsiav tshuaj, muab cov tshuaj tso rau hauv lub khob loj hauv dej lossis kua txiv. Do cov dej nrog rab diav kom pab lub ntsiav tshuaj kom yaj. Tom qab ntawd haus dej sib tov tam sim ntawd.

Gleevec ua haujlwm li cas

Gleevec muaj cov tshuaj imatinib, uas belongs rau chav kawm ntawm cov tshuaj hu ua tyrosine kinase inhibitors (TKIs). Cov tshuaj hauv TKI chav kawm tshuaj yog tsom kho. Lawv cuam tshuam cov protein ntau hauv cov keeb mob cancer.

Gleevec raug pom zoo los kho ob peb yam mob. Ntawm no peb yuav tshawb xyuas seb Gleevec ua haujlwm li cas kho ob ntawm lawv.

Rau Ph + CML

Hauv Philadelphia-positive (Ph +) mob myeloid leukemia (CML), cov keeb tsim cov qe ntshav dawb muaj qhov yuam kev hauv lawv cov caj ces pleev. Qhov kev ua yuam kev tsis ncaj ncees no tau pom nyob ntawm kab DNA DNA hu ua Philadelphia chromosome.

Lub Philadelphia chromosome muaj cov noob keeb (BCR-ABL1) uas ua rau cov qe ntshav dawb ntau dhau. Cov qe ntshav dawb no tsis loj thiab tuag zoo li lawv yuav tsum. Ntshav dawb uas hu ua "blasts" cais tawm lwm cov ntshav ntxiv uas koj cov ntshav yuav tsum ua haujlwm kom raug.

Gleevec ua haujlwm los ntawm kev txuas rau cov protein, hu ua tyrosine kinase, hauv cov hlwb ua los ntawm BCR-ABL1. Thaum Gleevec khi rau cov protein no, cov tshuaj txwv tsis pub lub cell xa cov cim qhia uas qhia lub cell loj hlob tuaj. Yog tsis muaj cov cim qhia kev loj hlob no, cov qe ntshav muaj ntshav tuag. Qhov no pab kho tus lej tawg ntawm lub hlwb mus rau tus lej noj qab haus huv dua.

Rau GIST

Gleevec kuj tseem pab kho tus mob caj dab cov leeg qog nqaij hlav (GIST). Hauv ntau lub GIST cov qog hlwb, muaj cov lej ntawm cov protein ntau dua, hu ua Cov Khoom Siv thiab platelet-derived growth factor (PDGF), dua li ntawm cov qog ua haujlwm zoo. Cov roj ntsha no pab cov qog hlwb loj hlob thiab faib.

Gleevec lub hom phiaj rau cov protein thiab tiv thaiv lawv los ntawm kev ua haujlwm. Qhov no ua rau qeeb qeeb txoj kev loj hlob mob qog noj ntshav. Nws kuj tseem ua rau cov cell mob hlwb tuag.

Yuav siv sijhawm ntev npaum li cas ua haujlwm?

Nws nyob. Lub sijhawm sijhawm ntawm thaum Gleevec pib ua haujlwm txawv rau txhua tus neeg.

Cov kev tshawb fawb soj ntsuam tau saib cov neeg CML uas coj Gleevec. Hauv ib hlis, pes tsawg ntawm cov qog nqaij hlav ntshav hauv ntshav tau txo qis li ntawm ib nrab ntawm cov neeg hauv kev puas ntsoog pob tawg (theem nyuaj ntawm CML). Hauv kev tshawb nrhiav ntawm cov neeg muaj GIST uas coj Gleevec, cov qog hlav tsis loj hlob lossis poob hauv peb lub hlis.

Koj tus kws kho mob yuav soj ntsuam koj cov ntshav tas mus seb Gleevec puas ua haujlwm rau koj.

Gleevec thiab cev xeeb tub

Koj yuav tsum zam Gleevec yog tias koj cev xeeb tub. Muaj cov ntaub ntawv hais txog kev nchuav menyuam thiab ua mob rau tus me nyuam hauv cov poj niam uas coj Gleevec thaum cev xeeb tub. Thiab hauv kev tshawb nrhiav tsiaj, cov poj niam cev xeeb tub tus poj niam uas tau muab Gleevec muaj kev pheej hmoo ntau rau kev yug los ntawm lub cev.

Yog tias koj cev xeeb tub, koj tus kws kho mob yuav qhia koj kom tos kom txog thaum tom qab koj yug los pib siv Gleevec. Lossis lawv yuav pom zoo dua lwm cov tshuaj.

Yog tias koj tab tom noj Gleevec, nws yog ib qho tseem ceeb uas yuav tsum siv kev tswj kom tsis muaj menyuam kom koj tsis txhob xeeb tub. Tom qab koj noj koj qhov kawg ntawm Gleevec, siv kev tswj kom tsis pub dhau 14 hnub.

Gleevec thiab pub niam mis

Cov kev tshawb fawb qhia tias Gleevec hla mus rau tib neeg cov kua mis. Qhov no tuaj yeem tsim kev puas tsuaj loj rau tus menyuam mos noj niam mis.

Yog tias koj pub mis niam thiab xav noj Gleevec, koj tus kws kho mob yuav qhia koj kom tsis txhob pub mis mis thaum koj pib kho.

Tom qab koj noj koj koob kawg ntawm Gleevec, tos tsawg kawg ib hlis ua ntej koj pib pub mis.

Gleevec noj overdose

Noj ntau dhau Gleevec tuaj yeem ua rau koj muaj feem phom sij txaus ntshai.

Tshuav cov tsos mob

Cov tsos mob ntawm kev noj haus ntau dhau muaj xws li:

  • xeev siab
  • ntuav
  • zawv plab
  • mob plab
  • mob pob heev
  • mob leeg pob txha (qwj)
  • mob taub hau
  • tsis qab los noj mov
  • leeg tsis muaj zog
  • qaug zog (tsis muaj lub zog)
  • o tuaj
  • cov ntshav ua haujlwm tsis zoo, xws li cov ntshav platelets, ntshav liab, lossis cov qe ntshav dawb
  • ua npaws

Dab tsi yog qhov ua txhaum cai dhau

Yog koj xav tias koj tau noj ntau dhau ntawm cov tshuaj no, hu rau koj tus kws kho mob. Koj kuj tuaj yeem hu xov tooj rau Asmeskas Lub Koom Haum Saib Xyuas Kev Lom Lom ntawm 800-222-1222 lossis siv lawv qhov online. Tab sis yog tias koj cov tsos mob hnyav, hu 911 lossis mus rau chav kho mob ze tshaj plaws tam sim ntawd.

Cov lus nug uas nquag muaj txog Gleevec

Nov yog cov lus teb rau qee cov lus nug txog Gleevec.

Puas yog Gleevec ib hom tshuaj khomob?

Gleevec tsis yog ib hom kev zaws khomob. Gleevec yog lub hom phiaj kho uas cuam tshuam cov molecules hauv qog nqaij hlav tshwj xeeb.

Los ntawm singling tawm cov kev lwg me me, cov hom phiaj kho zoo li Gleevec pab qeeb kev loj hlob thiab kis ntawm cov qog nqaij hlav cancer. Koj tus kws kho mob feem ntau yuav sau ntawv rau lub hom phiaj kho rau koj raws li hom mob cancer uas koj muaj.

Kev siv tshuaj kho cov tshuaj txawv ntawm lub hom phiaj kho. Kev siv tshuaj kho mob yuav ua rau txhua lub cev hauv lub cev uas tab tom loj hlob sai heev, tsis yog kab mob qog noj ntshav. Kev siv tshuaj kho mob feem ntau tua cov kabmob loj hlob thiab cuam tshuam rau ntau lub hlwb hauv lub cev dua li cov phiajcim kho.

Puas yog cov qauv siv dav dav ntawm Gleevec siv tau zoo li cov tshuaj uas nrov npe?

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) xav kom cov neeg tsim cov tshuaj feem ntau ua pov thawj tias lawv cov khoom muaj:

  • tib yam tshuaj sib xyaw ua ke nrog cov tshuaj uas nrov npe
  • tib lub zog thiab ntau npaum li cov tshuaj ua hom tshuaj muaj npe
  • tib txoj kev tswj hwm (koj yuav ua li cas noj tshuaj)

Cov tshuaj tsis nrov npe tseem yuav tsum tau ua haujlwm ib yam nkaus thiab tsuas yog ntxiv rau cov khoom lag luam muaj npe.

Raws li FDA, daim ntawv sau dav dav ntawm Gleevec ua tau raws li cov kev xav tau no. Qhov no txhais tau tias FDA lees tias daim foos ntau ntawm cov tshuaj muaj txiaj ntsig zoo li cov tshuaj lag luam muaj koob npe tshuaj.

Kuv puas tuaj yeem hloov kho qhov kev kho mob nrog Gleevec?

Yog lawm. Nws yog qhov ua tau rau koj tsim kom tiv taus Gleevec. Kev tawm tsam txhais tau tias cov tshuaj nres haujlwm dhau sijhawm. Nws tau xav tias qhov no tshwm sim los ntawm kev hloov pauv hauv cov caj hlav ntawm qog nqaij hlav cancer.

Yog tias koj pib txhim kho Gleevec, koj tus kws kho mob yuav sau ntawv muab tshuaj kom siab dua. Lawv yuav pom tias cov keeb mob qog noj ntshav rov zoo dua rau cov tshuaj. Koj tus kws kho mob tseem yuav sau ntawv yuav ib cov tshuaj txawv uas koj tsis muaj tshuaj tiv thaiv.

Puas muaj kev txwv noj zaub mov uas kuv yuav tsum ua raws thaum noj Gleevec?

Tsis muaj ib qho kev txwv noj haus dab tsi uas koj yuav tsum ua raws thaum noj Gleevec. Txawm li cas los xij, koj yuav tsum tsis txhob noj cov txiv kab ntxwv qaub thiab haus cov kua txiv kab ntxwv qaub. Txiv kab ntxwv qaub muaj tshuaj uas tuaj yeem tiv thaiv koj lub cev los ntawm kev zom (rhuav tshem) Gleevec. Qhov no tuaj yeem ua rau cov tshuaj ntau dua hauv koj cov ntshav. Cov qib Gleevec uas tau siab dua li ib txwm ua rau koj muaj feem yuav muaj kev phiv loj heev.

Ib qho ntxiv, koj tus kws kho mob yuav muab tswv yim rau koj txog kev noj zaub mov kom pab txo qee yam kev mob tshwm sim. Piv txwv, Gleevec ua rau xeev siab thiab ntuav hauv ntau tus neeg. Txhawm rau tiv thaiv qhov no, koj tus kws kho mob yuav qhia koj kom tsis txhob noj zaub mov uas tuaj yeem ua rau xeev siab tsis zoo. Cov no suav nrog cov khoom noj hnyav, roj lossis lossis rog rog, thiab ntsim lossis kua zaub mov. Piv txwv li feem ntau cov kua ntses liab, zaub kib, thiab ntau yam khoom noj ceev.

Thaum kawg, yog tias koj tab tom noj Gleevec rau mob cancer plab hnyuv, xws li lub plab hnyuv qog nqaij hlav (GIST), koj tus kws kho mob yuav pom zoo kom txwv qee yam kev noj haus. Lub hom phiaj yog txhawm rau tiv thaiv teeb meem hauv koj lub plab lossis plab hnyuv. Tham nrog koj tus kws kho mob hais txog yam khoom noj twg zoo rau koj.

Kuv puas yuav muaj tsos mob thim rov qab yog tias kuv tsis siv Gleevec?

Koj yuav. Qee tus neeg muaj lub cim tshem tawm tom qab tas lawv Gleevec kho mob. Hauv ib qhov kev tshawb fawb me me, 30% ntawm cov tib neeg muaj mob nqaij pob txha los yog mob pob txha tom qab txiav Gleevec. Qhov mob ntau zaus hauv lawv lub xub pwg, lub duav, ob txhais ceg, thiab caj npab. Qhov tsos mob tshem tawm no tshwm sim li ntawm ib mus rau rau lub lim tiam ntawm kev kho mob.

Kwv yees li ib nrab ntawm cov neeg tau kho lawv qhov mob nrog rau tus neeg muab tshuaj rau qhov mob uas tsis tau hnov. Lwm qhov ib nrab xav tau tshuaj kho mob. Feem ntau ntawm cov tib neeg uas muaj cov tsos mob tshem tawm no, mob nqaij thiab pob txha mus deb li ntawm peb hlis mus rau ib xyoos lossis ntev dua.

Kuv puas yuav tsum tau siv lwm yam tshuaj nrog Gleevec rau kev kho mob?

Nws nyob ntawm seb koj qhov mob cancer yuav nce siab npaum li cas. Txog rau theem kawg ntawm mob qog nqaij hlav lossis mob qog nqaij hlav uas tau kis mus rau lub hlwb lossis tus txha nqaj qaum, koj tus kws kho mob yuav ntxiv cov tshuaj rau koj li kev kho Gleevec. Ntxiv rau, cov menyuam yaus uas muaj Philadelphia-positive (Ph +) mob lymphocytic zoo li mob ntshav (TXHUA) yuav tau txais Gleevec nrog rau kev siv tshuaj kho mob.

Rau qee yam mob qog nqaij hlav, koj tus kws kho mob kuj tseem tuaj yeem sau tshuaj steroid. Thiab koj yuav tau siv cov tshuaj los tswj cov kev mob tshwm sim, xws li cov tshuaj kom zoo rau qhov mob leeg.

Gleevec kev tas sij hawm, khaws cia thiab pov tseg

Thaum koj tau Gleevec los ntawm lub tsev muag tshuaj, tus kws muag tshuaj yuav ntxiv hnub tas sijhawm rau cov npe ntawm lub raj mis. Hnub no feem ntau ib xyoos suav txij hnub lawv xa cov tshuaj mus.

Lub hnub tas sij hawm pab lav qhov ua tau zoo ntawm cov tshuaj thaum lub sijhawm no. Txoj cai tam sim no ntawm Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) yog kom tsis txhob siv cov tshuaj uas tas sij hawm. Yog tias koj muaj cov tshuaj tsis siv uas dhau lub hnub tas sij hawm tas sijhawm, tham nrog koj tus kws muag tshuaj. Lawv tuaj yeem qhia koj seb koj puas tseem siv tau nws.

Cia

Ntev ntev npaum li cas cov tshuaj tseem tuaj yeem nyob ntawm ntau yam, nrog rau seb koj khaws cov tshuaj li cas thiab nyob qhov twg.

Muab koj cov tshuaj Gleevec nyob rau hauv chav tsev tso rau hauv lub thawv kaw ntom ntom. Nco ntsoov tiv thaiv lawv los ntawm ya raws.

Pov tseg

Yog tias koj tsis tas yuav siv Gleevec thiab noj tshuaj ntxiv, nws yog ib qho tseem ceeb uas yuav tsum muab pov tseg kom zoo.

Qhov no pab tiv thaiv lwm tus, suav nrog cov menyuam yaus thiab cov tsiaj hauv tsev, los ntawm kev noj tshuaj. Nws tseem yuav pab kom cov tshuaj ua rau muaj kev puas tsuaj ib puag ncig thiab.

FDA lub vev xaib muab ntau cov lus qhia tseem ceeb rau kev siv tshuaj pov tseg. Koj tseem tuaj yeem nug koj tus kws muag tshuaj kom paub cov ntaub ntawv pov tseg ntawm koj cov tshuaj.

Cov ntaub ntawv tshaj lij rau Gleevec

Cov ntaub ntawv hauv qab no yog muab rau cov kws kho mob thiab lwm tus kws kho mob.

Cov Khoom Qhia

Gleevec (imatinib) yog FDA pom zoo los kho cov hauv qab no:

  • cov neeg laus thiab cov menyuam yaus uas nyuam qhuav raug mob Philadelphia-zoo (Ph +) mob myeloid leukemia (CML) hauv cov theem ntev
  • cov neeg laus uas muaj Ph + CML hauv ib ntu, tom qab tsis ua raws li kev cuam tshuam los ntawm interferon-alpha txoj kev kho
  • Cov neeg laus uas rov mob lossis rov qab tso siab Ph + mob lymphocytic rau cov leeg ntshav (TXHUA)
  • cov menyuam yaus nyuam qhuav muaj mob Ph + TXHUA nrog kev siv tshuaj lom neeg
  • cov neeg laus nrog myelodysplastic / myeloproliferative muaj feem nrog platelet-derived kev loj hlob tau receptor gene rov qab
  • cov laus uas muaj qhov mastocytosis nruj zuj zus yam tsis muaj D816V c-Kit hloov pauv lossis muaj c-Kit hloov chaw tsis paub txog
  • cov laus uas muaj mob hypereosinophilic syndrome thiab / lossis mob ntsws oosinophilic zoo mob nrog FIP1L1-PDGFRα fusion kinase, tsis zoo rau FIP1L1-PDGFRα fusion kinase, lossis tsis paub qhov xwm txheej
  • cov laus uas tsis muaj kev tiv thaiv, rov qab ua dua, los yog metastatic dermatofibrosarcoma protuberans (DFSP)
  • cov laus uas tsis muaj kev tiv thaiv lossis metastatic malignant Cov Khoom Siv + lub plab zom mov qog (GIST)
  • kev pab rau cov neeg laus uas muaj Cov Khoom Siv + GIST tom qab ua tiav kev rov ua kom tas

Mechanism ntawm kev ua

Gleevec inhibits BCR-ABL tyrosine kinase, uas yog qhov txawv txav ntawm tyrosine kinase nyob hauv Ph + CML. Kev txwv tsis pub muaj BCR-ABL tyrosine kinase tiv thaiv kev tiv thaiv kab mob ntawm tes thiab ua rau muaj kabmob apoptosis hauv BCR-ABL cell kab thiab hauv cov xovtooj ntawm qe ntshav tawm. Gleevec tseem inhibits lub tyrosine kinases rau platelet-tau los ntawm kev loj hlob qhov tseem ceeb (PDGF) thiab qia cell factor (SCF) zoo li c-Kit, uas inhibits proliferation thiab induces apoptosis hauv GIST hlwb.

Pharmacokinetics thiab cov metabolism

Qhov kev txiav txim siab txog kev noj qab haus huv yog 98% raws li kev tswj hwm ntawm qhov ncauj. Kwv yees li 95% ntawm koob tshuaj yog ua txhua yam rau cov ntshav plasma (feem ntau albumin thiab α1-acid glycoprotein).

Kev tiv thaiv kab mob feem ntau tshwm sim los ntawm CYP3A4 mus rau qhov ua kom zoo metabolite, nrog cov metabolism hauv ib qho tshwm sim ntawm CYP1A2, CYP2D6, CYP2C9, thiab CYP2C19. Lub ntsiab nthuav dav rau cov khoom siv hluav taws xob nquag yog tsim los ntawm CYP3A4. Kwv yees li 68% yog tshem tawm hauv cov quav, nrog 13% tso zis. Tshem tawm ib nrab-lub neej ntawm cov tshuaj tsis hloov pauv yog 18 teev thiab tshem tawm ib nrab ntawm lub neej ntawm cov tshuaj metabolite tseem ceeb yog 40 teev.

Cov Yuav Tsum Tau Ua

Tsis muaj qhov tsis muaj tseeb contraindications rau kev siv Gleevec.

Cia thiab tuav khoom

Cov ntsiav tshuaj Gleevec yuav tsum muab cia rau hauv chav tsev qhov kub (77 ° F / 25 ° C) hauv ntim kaw ntom ntom. Tiv thaiv cov ntsiav tshuaj los ntawm ya raws.

Gleevec ntsiav tshuaj yog pom tias muaj kev phom sij, raws li Kev Nyab Xeeb Kev Ua Haujlwm thiab Kev Tswj Xyuas Kev Noj Qab Haus Huv (OSHA) cov qauv. Cov ntsiav tshuaj yuav tsum tsis txhob zuaj. Tsis txhob kov cov ntsiav tshuaj crushed. Yog tias daim tawv nqaij lossis hnoos qeev tuaj nrog qhov sib chwv ntsiav tshuaj, ntxuav thaj chaw cuam tshuam raws li OSHA qhia.

Tsis lees paub: Cov Xov Xwm Kho Mob Niaj Hnub no tau ua txhua yam kom paub tseeb tias txhua yam ntaub ntawv yog qhov tseeb, raug, thiab dhau-hnub. Txawm li cas los xij, cov kab lus no yuav tsum tsis txhob siv los hloov chaw rau qhov kev paub thiab kev paub ntawm tus neeg muaj ntawv tso cai kho mob. Koj yuav tsum tau sab laj nrog koj tus kws kho mob lossis lwm tus kws saib xyuas kev noj qab haus huv ua ntej noj tshuaj. Cov ntaub ntawv tshuaj muaj nyob ntawm no yuav raug hloov thiab tsis yog npaj rau txhua txoj kev siv, cov lus qhia, kev ceev faj, ceeb toom, kev cuam tshuam nrog tshuaj, kev fab tshuaj, lossis muaj kev cuam tshuam tsis zoo. Qhov tsis muaj lus ceeb toom lossis lwm cov ntaub ntawv rau kev muab tshuaj tsis qhia tias kev sib txuam tshuaj lossis tshuaj muaj kev nyab xeeb, siv tau, lossis tsim nyog rau txhua tus neeg mob lossis txhua qhov siv tshwj xeeb.

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