{"id":30254,"date":"2023-05-03T18:15:23","date_gmt":"2023-05-03T11:15:23","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30254"},"modified":"2023-05-03T18:15:23","modified_gmt":"2023-05-03T11:15:23","slug":"ung-dung-moi-cua-mosunetuzumab-trong-dieu-tri-u-lympho-nang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/ung-dung-moi-cua-mosunetuzumab-trong-dieu-tri-u-lympho-nang\/","title":{"rendered":"\u1ee8ng d\u1ee5ng m\u1edbi c\u1ee7a Mosunetuzumab trong \u0111i\u1ec1u tr\u1ecb u lympho nang"},"content":{"rendered":"

U lympho nang l\u00e0 m\u1ed9t lo\u1ea1i ung th\u01b0 h\u1ec7 th\u1ed1ng lympho, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, Mosunetuzumab \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho nang v\u1edbi nh\u1eefng k\u1ebft qu\u1ea3 kh\u1ea3 quan<\/strong><\/p>\n

1.Gi\u1edbi thi\u1ec7u v\u1ec1 U Lympho Nang\u00a0<\/strong><\/h2>\n

1.1 \u0110\u1ecbnh ngh\u0129a v\u00e0 d\u1ecbch t\u1ec5<\/span><\/h3>\n

U lympho nang<\/a> l\u00e0 m\u1ed9t lo\u1ea1i u lympho kh\u00f4ng Hodgkin li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng c\u1ee7a t\u1ebf b\u00e0o lympho B (t\u1ebf b\u00e0o B). T\u1ebf b\u00e0o lympho v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n t\u1ebf b\u00e0o b\u1ea5t th\u01b0\u1eddng c\u00f3 th\u1ec3 di chuy\u1ec3n kh\u1eafp c\u01a1 th\u1ec3 v\u00e0 h\u00ecnh th\u00e0nh kh\u1ed1i u, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ung th\u01b0 h\u1ea1ch, trong c\u00e1c h\u1ea1ch b\u1ea1ch huy\u1ebft, l\u00e1 l\u00e1ch, t\u1ee7y x\u01b0\u01a1ng, m\u00e1u ho\u1eb7c c\u00e1c c\u01a1 quan kh\u00e1c. Kho\u1ea3ng 20% \u200b\u200bb\u1ec7nh nh\u00e2n ung th\u01b0 h\u1ea1ch d\u1ea1ng nang ti\u1ebfn tri\u1ec3n b\u1ec7nh trong v\u00f2ng 2 n\u0103m \u0111\u1ea7u h\u00f3a tr\u1ecb, v\u1edbi t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t sau 5 n\u0103m l\u00e0 50%. U lympho nang \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c c\u00e1 nh\u00e2n thu\u1ed9c m\u1ecdi ch\u1ee7ng t\u1ed9c v\u00e0 v\u00f9ng \u0111\u1ecba l\u00fd. Trong \u0111\u00f3, ung th\u01b0 h\u1ea1ch nang chi\u1ebfm kho\u1ea3ng 35% NHL \u1edf Hoa K\u1ef3, v\u1edbi t\u1ef7 l\u1ec7 m\u1eafc \u01b0\u1edbc t\u00ednh l\u00e0 3,18 tr\u01b0\u1eddng h\u1ee3p tr\u00ean 100.000 c\u00e1 nh\u00e2n. T\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh \u1edf ng\u01b0\u1eddi Da tr\u1eafng cao h\u01a1n g\u1ea5p \u0111\u00f4i so v\u1edbi ng\u01b0\u1eddi Da \u0111en v\u00e0 nh\u00f3m ng\u01b0\u1eddi ch\u00e2u \u00c1.\u00a0<\/span><\/p>\n

\"U
U lympho nang<\/figcaption><\/figure>\n

U lympho nang kh\u00f4ng Hodgkin kh\u00f4ng gi\u1ed1ng v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh ung th\u01b0 v\u00ec kh\u00f4ng di truy\u1ec1n trong gia \u0111\u00ecnh. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, b\u1ee9c x\u1ea1 ho\u1eb7c h\u00f3a ch\u1ea5t g\u00e2y ung th\u01b0, ho\u1eb7c m\u1ed9t s\u1ed1 b\u1ec7nh nhi\u1ec5m tr\u00f9ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n. C\u00e1c y\u1ebfu t\u1ed1 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh u lympho nang, bao g\u1ed3m \u0111ang b\u1ecb nhi\u1ec5m HIV, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, b\u1ec7nh Lupus ho\u1eb7c b\u1ec7nh Celiac.<\/span><\/p>\n

1.2 Tri\u1ec7u ch\u1ee9ng v\u00e0 bi\u1ebfn ch\u1ee9ng\u00a0<\/span><\/h3>\n

\u0110\u00f4i khi kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh ung th\u01b0 h\u1ea1ch nang. Nh\u01b0ng n\u1ebfu c\u00f3 tri\u1ec7u ch\u1ee9ng bao g\u1ed3m: s\u01b0ng h\u1ea1ch kh\u00f4ng \u0111au \u1edf c\u1ed5, b\u1eb9n, d\u1ea1 d\u00e0y, n\u00e1ch, h\u1ee5t h\u01a1i, m\u1ec7t m\u1ecfi, \u0111\u1ed5 m\u1ed3 h\u00f4i v\u00e0o ban \u0111\u00eam, gi\u1ea3m c\u00e2n.<\/span><\/p>\n

U lympho d\u1ea1ng nang c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ee7y x\u01b0\u01a1ng v\u00e0 l\u00e1 l\u00e1ch khi\u1ebfn l\u00e1 l\u00e1ch to b\u1ea5t th\u01b0\u1eddng. Khi u lympho d\u1ea1ng nang \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c l\u00e1 l\u00e1ch, d\u1eabn \u0111\u1ebfn l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng c\u00e1c lo\u1ea1i t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u, b\u1ea1ch c\u1ea7u v\u00e0 ti\u1ec3u c\u1ea7u.\u00a0<\/span><\/p>\n

2.T\u1ed5ng quan v\u1ec1 thu\u1ed1c Mosunetuzumab<\/strong><\/h2>\n

Cu\u1ed1i n\u0103m 2022, FDA \u0111\u00e3 ph\u00ea duy\u1ec7t Mosunetuzumab-axgb (Lunsumio) \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n tr\u01b0\u1edfng th\u00e0nh b\u1ecb ung th\u01b0 h\u1ea1ch d\u1ea1ng nang t\u00e1i ph\u00e1t ho\u1eb7c kh\u00e1ng tr\u1ecb sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng \u00edt nh\u1ea5t 2 d\u00f2ng li\u1ec7u ph\u00e1p to\u00e0n th\u00e2n tr\u01b0\u1edbc \u0111\u00f3. M\u1eb7c d\u00f9 th\u1eed nghi\u1ec7m giai \u0111o\u1ea1n 3 v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c ho\u00e0n th\u00e0nh, nh\u01b0ng th\u1eed nghi\u1ec7m GO29781 giai \u0111o\u1ea1n 2 \u0111\u00e3 ch\u1ee9ng minh hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c. Mosunetuzumab-axgb hi\u1ec7n l\u00e0 lo\u1ea1i thu\u1ed1c \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho nang l\u00e0 d\u1ea1ng ung th\u01b0 h\u1ea1ch kh\u00f4ng Hodgkin ph\u00e1t tri\u1ec3n ch\u1eadm ph\u1ed5 bi\u1ebfn.Trong nghi\u00ean c\u1ee9u GO29781 giai \u0111o\u1ea1n 2, nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb u lympho nang n\u1eb7ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc bao g\u1ed3m c\u1ea3 nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 ti\u1ebfn tri\u1ec3n b\u1ec7nh cao ho\u1eb7c b\u1ec7nh kh\u00f3 \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c li\u1ec7u ph\u00e1p tr\u01b0\u1edbc \u0111\u00f3. K\u1ebft qu\u1ea3 cho th\u1ea5y t\u1ef7 l\u1ec7 \u0111\u00e1p \u1ee9ng kh\u00e1ch quan l\u00e0 80% \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c Mosunetuzumab-axgb. H\u01a1n n\u1eefa, th\u1eddi gian \u0111\u00e1p \u1ee9ng trung b\u00ecnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c l\u00e0 g\u1ea7n 2 n\u0103m v\u1edbi t\u1ec9 l\u1ec7 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u1edf 60% b\u1ec7nh nh\u00e2n\u00a0<\/span><\/p>\n

\"Mosunetuzumab
Mosunetuzumab (Lunusumio)<\/figcaption><\/figure>\n

2.1 Nh\u00f3m d\u01b0\u1ee3c l\u00fd v\u00e0 ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng\u00a0<\/span><\/h3>\n

Mosunetuzumab l\u00e0 m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u k\u00e9p ch\u1ed1ng CD20\/CD3 v\u00e0 d\u01b0\u1edbi d\u1ea1ng \u0111\u01a1n tr\u1ecb li\u1ec7u \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n tr\u01b0\u1edfng th\u00e0nh m\u1eafc u lympho nang t\u00e1i ph\u00e1t ho\u1eb7c kh\u00f3 \u0111i\u1ec1u tr\u1ecb \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u00edt nh\u1ea5t hai li\u1ec7u ph\u00e1p to\u00e0n th\u00e2n tr\u01b0\u1edbc \u0111\u00f3.<\/span><\/p>\n

2.2 C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng\u00a0<\/span><\/h3>\n

Mosunetuzumab l\u00e0 m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u k\u00e9p kh\u00e1ng CD20\/CD3, c\u1ee5 th\u1ec3 thu\u1ed1c c\u00f3 th\u1ec3 nh\u1eadn bi\u1ebft v\u00e0 li\u00ean k\u1ebft CD20 tr\u00ean t\u1ebf b\u00e0o B ung th\u01b0 v\u00e0 CD3 tr\u00ean t\u1ebf b\u00e0o T theo t\u1ec9 l\u1ec7 1:1. Mosunetuzumab k\u00edch ho\u1ea1t c\u00e1c t\u1ebf b\u00e0o T b\u1eb1ng c\u00e1ch th\u00fac \u0111\u1ea9y s\u1ef1 h\u00ecnh th\u00e0nh kh\u1edbp th\u1ea7n kinh mi\u1ec5n d\u1ecbch gi\u1eefa t\u1ebf b\u00e0o B v\u00e0 t\u1ebf b\u00e0o T g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o. H\u01a1n n\u1eefa, vi\u1ec7c k\u00edch ho\u1ea1t c\u00e1c t\u1ebf b\u00e0o T d\u1eabn \u0111\u1ebfn vi\u1ec7c gi\u1ea3i ph\u00f3ng tr\u1ef1c ti\u1ebfp Perforin v\u00e0 Granzyme th\u00f4ng qua kh\u1edbp th\u1ea7n kinh mi\u1ec5n d\u1ecbch, t\u1eeb \u0111\u00f3 g\u00e2y ra s\u1ef1 ly gi\u1ea3i t\u1ebf b\u00e0o B v\u00e0 g\u00e2y ch\u1ebft t\u1ebf b\u00e0o.<\/span><\/p>\n

2.3 D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/span><\/h3>\n

H\u1ea5p thu: Trong kho\u1ea3ng li\u1ec1u s\u1eed d\u1ee5ng 0,05 \u2013 60mg, Mosunetuzumab h\u1ea5p thu theo t\u1ec9 l\u1ec7 thu\u1eadn v\u1edbi li\u1ec1u. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 h\u1ea1ch kh\u00f4ng Hodgkin t\u1ebf b\u00e0o B t\u00e1i ph\u00e1t ho\u1eb7c kh\u00e1ng tr\u1ecb \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Mosunetuzumab, n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft thanh \u0111\u1ea1t \u0111\u1ebfn C max v\u00e0o cu\u1ed1i qu\u00e1 tr\u00ecnh truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0 gi\u1ea3m. Mosunetuzumab c\u00f3 sinh kh\u1ea3 d\u1ee5ng g\u1ea7n 100% khi ti\u00eam t\u0129nh m\u1ea1ch\u00a0<\/span><\/p>\n

Ph\u00e2n b\u1ed1: Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 (Vd) d\u00f9ng qua \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch l\u00e0 5,49L<\/span><\/p>\n

Chuy\u1ec3n h\u00f3a: Mosunetuzumab l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1eb1ng protein, b\u1ecb ph\u00e2n h\u1ee7y th\u00e0nh c\u00e1c peptide nh\u1ecf v\u00e0 acid amin th\u00f4ng qua con \u0111\u01b0\u1eddng d\u1ecb h\u00f3a<\/span><\/p>\n

Th\u1ea3i tr\u1eeb: V\u00ec Mosunetuzumab l\u00e0 m\u1ed9t kh\u00e1ng th\u1ec3 immunoglobulin G (IgG) n\u00ean \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf ch\u1ee7 y\u1ebfu th\u00f4ng qua qu\u00e1 tr\u00ecnh d\u1ecb h\u00f3a n\u1ed9i b\u00e0o. Suy gan ho\u1eb7c suy th\u1eadn kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i thu\u1ed1c. Mosunetuzumab c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y (T1\/2) l\u00e0 16,1 ng\u00e0y v\u00e0 \u0111\u1ed9 thanh th\u1ea3i (Cl) l\u00e0 1,08L\/ng\u00e0y\u00a0<\/span><\/p>\n

2.4 T\u00e1c d\u1ee5ng ph\u1ee5\u00a0<\/span><\/h3>\n

C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a Mosunetuzumab bao g\u1ed3m: s\u1ed1t, \u1edbn l\u1ea1nh, m\u1ec7t m\u1ecfi, bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, ti\u00eau ch\u1ea3y, nh\u1ee9c \u0111\u1ea7u, ho, h\u1ea1 huy\u1ebft \u00e1p, ph\u00e1t ban, gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u, t\u0103ng glucose v\u00e0 acid uric. M\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean, nh\u1ecbp tim nhanh, th\u1edf nhanh ho\u1eb7c th\u1edf n\u00f4ng, s\u1ed1t cao, m\u1ea5t \u00fd th\u1ee9c, tr\u00ed nh\u1edb k\u00e9m<\/span><\/p>\n

3.K\u1ebft lu\u1eadn\u00a0<\/strong><\/h2>\n

T\u00f3m l\u1ea1i, Mosunetuzumab l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ti\u00ean ti\u1ebfn v\u00e0 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb u lympho nang. V\u1edbi c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng \u0111\u1eb7c bi\u1ec7t, Mosunetuzumab c\u00f3 th\u1ec3 gi\u00fap ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0 m\u1ed9t c\u00e1ch nhanh ch\u00f3ng v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n so v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb truy\u1ec1n th\u1ed1ng kh\u00e1c. Nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111\u00e3 cho th\u1ea5y Mosunetuzumab c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c t\u00e1c \u0111\u1ed9ng ph\u1ee5.<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

U lympho nang l\u00e0 m\u1ed9t lo\u1ea1i ung th\u01b0 h\u1ec7 th\u1ed1ng lympho, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, Mosunetuzumab \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho nang v\u1edbi nh\u1eefng k\u1ebft qu\u1ea3 kh\u1ea3 quan 1.Gi\u1edbi thi\u1ec7u v\u1ec1 U Lympho Nang\u00a0 1.1 \u0110\u1ecbnh ngh\u0129a v\u00e0 d\u1ecbch t\u1ec5 […]<\/p>\n","protected":false},"author":54,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12],"tags":[],"yoast_head":"\n\u1ee8ng d\u1ee5ng m\u1edbi c\u1ee7a Mosunetuzumab trong \u0111i\u1ec1u tr\u1ecb u lympho nang<\/title>\n<meta name=\"description\" content=\"Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, Mosunetuzumab \u0111\u00e3 ch\u1ea5p thu\u1eadn \u0111\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho nang v\u1edbi nh\u1eefng k\u1ebft qu\u1ea3 kh\u1ea3 quan\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, 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