{"id":12150,"date":"2018-10-02T07:25:42","date_gmt":"2018-10-02T00:25:42","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/cuoc-chien-ung-thu-la-cuoc-chien-voi-chinh-minh\/"},"modified":"2018-10-02T07:25:42","modified_gmt":"2018-10-02T00:25:42","slug":"cuoc-chien-ung-thu-la-cuoc-chien-voi-chinh-minh","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/cuoc-chien-ung-thu-la-cuoc-chien-voi-chinh-minh\/","title":{"rendered":"Cu\u1ed9c chi\u1ebfn ung th\u01b0 l\u00e0 cu\u1ed9c chi\u1ebfn v\u1edbi ch\u00ednh m\u00ecnh"},"content":{"rendered":"

G\u00f3c nh\u00ecn<\/h2>\n

(Vi\u1ebft t\u1eb7ng c\u00e1c b\u1ec7nh nh\u00e2n \u0111ang ch\u1ed1ng ch\u1ecdi v\u1edbi c\u0103n b\u1ec7nh ung th\u01b0, nh\u00e2n ng\u00e0y GS. Honjo Tasuku, \u0110\u1ea1i h\u1ecdc Kyoto nh\u1eadn gi\u1ea3i Nobel Y h\u1ecdc v\u00e0 Sinh l\u00fd h\u1ecdc 2018 v\u1ec1 nh\u1eefng ph\u00e1t hi\u1ec7n li\u00ean quan t\u1edbi \u0111i\u1ec1u tr\u1ecb mi\u1ec5n d\u1ecbch).<\/p>\n

Ung th\u01b0 l\u00e0 m\u1ed9t d\u1ea1ng \u201ctham nh\u0169ng\u201d x\u1ea3y ra trong c\u01a1 th\u1ec3 con ng\u01b0\u1eddi<\/strong>, v\u1ed1n l\u00e0 t\u1eadp h\u1ee3p c\u1ee7a h\u00e0ng t\u1ec9 t\u1ebf b\u00e0o nh\u1ecf li ti v\u1edbi c\u00f4ng vi\u1ec7c, ch\u1ee9c n\u0103ng kh\u00e1c nhau. Trong c\u0103n b\u1ec7nh n\u00e0y, nh\u1eefng t\u1ebf b\u00e0o ung th\u01b0, gi\u1ed1ng nh\u01b0 nh\u1eefng \u201cc\u00e1n b\u1ed9 bi\u1ebfn ch\u1ea5t\u201d<\/strong> t\u0103ng sinh kh\u00f4ng ki\u1ec3m so\u00e1t; t\u1ea1o th\u00e0nh nh\u1eefng kh\u1ed1i u b\u1ec1 th\u1ebf chi\u1ebfm h\u1ebft \u0111\u1ea5t s\u1ed1ng v\u00e0 ch\u1ea5t dinh d\u01b0\u1ee1ng c\u1ee7a t\u1ebf b\u00e0o th\u01b0\u1eddng. C\u01a1 th\u1ec3 suy y\u1ebfu ki\u1ec7t qu\u1ec7 v\u00ec t\u1ebf b\u00e0o \u201cth\u01b0\u1eddng d\u00e2n\u201d ch\u1eb3ng c\u00f2n g\u00ec m\u00e0 s\u1ed1ng ti\u1ebfp.<\/p>\n

Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p ti\u00eau di\u1ec7t kh\u1ed1i u nh\u01b0 x\u1ea1 tr\u1ecb, h\u00f3a tr\u1ecb kinh \u0111i\u1ec3n tr\u01b0\u1edbc gi\u1edd \u0111a s\u1ed1 d\u1ef1a tr\u00ean nguy\u00ean t\u1eafc t\u1ea5n c\u00f4ng v\u00e0o c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n sinh tr\u01b0\u1edfng, sinh s\u1ea3n c\u1ee7a t\u1ebf b\u00e0o v\u1edbi hi v\u1ecdng l\u00e0 t\u1ebf b\u00e0o t\u0103ng sinh c\u00e0ng nhanh c\u00e0ng d\u1ec5 b\u1ecb ti\u00eau di\u1ec7t. Nh\u01b0 trong h\u00f3a tr\u1ecb, nguy\u00ean l\u00fd n\u00e0y l\u00e0 c\u01a1 s\u1edf c\u1ee7a vi\u1ec7c truy\u1ec1n thu\u1ed1c g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o m\u1ed9t \u0111\u1ee3t v\u00e0i ng\u00e0y v\u00e0 ngh\u1ec9 2-3 tu\u1ea7n r\u1ed3i truy\u1ec1n thu\u1ed1c ti\u1ebfp. T\u1ebf b\u00e0o \u201c\u0103n tham ch\u1ebft tr\u01b0\u1edbc, \u0103n \u00edt ch\u1ebft sau\u201d,<\/strong> v\u00e0 c\u01a1 th\u1ec3 s\u1ebd h\u1ed3i ph\u1ee5c trong 2-3 tu\u1ea7n \u0111\u00f3 \u0111\u1ec3 chu\u1ea9n b\u1ecb tr\u1eadn \u0111\u00e1nh k\u1ebf ti\u1ebfp. Sau v\u00e0i \u0111\u1ee3t \u201cnh\u1ea1y thu\u1ed1c\u201d nh\u01b0 v\u1eady kh\u1ed1i u s\u1ebd teo nh\u1ecf \u0111i v\u00e0 b\u1ec7nh \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t.<\/p>\n

L\u00fd thuy\u1ebft l\u00e0 v\u1eady nh\u01b0ng th\u1eadt ra c\u00f3 nhi\u1ec1u lo\u1ea1i ung th\u01b0 kh\u00e1c nhau v\u00e0 \u0111\u1ed9 nh\u1ea1y v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c c\u0169ng kh\u00e1c nhau. C\u00f3 nhi\u1ec1u lo\u1ea1i ung th\u01b0 r\u1ea5t nh\u1ea1y v\u1edbi h\u00f3a tr\u1ecb nh\u01b0 Lymphoma, Germinoma,\u2026 nh\u01b0ng c\u0169ng c\u00f3 nh\u1eefng lo\u1ea1i k\u00e9m nh\u1ea1y h\u01a1n; khi \u0111\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u01b0\u1ee3c cao b\u1eb1ng.<\/p>\n

C\u1ed1t l\u00f5i c\u1ee7a v\u1ea5n \u0111\u1ec1 v\u1eabn n\u1eb1m \u1edf ch\u1ed7 r\u1ea5t kh\u00f3 ph\u00e2n bi\u1ec7t t\u1ebf b\u00e0o ung th\u01b0 v\u1edbi t\u1ebf b\u00e0o th\u01b0\u1eddng<\/strong>, c\u0169ng nh\u01b0 chuy\u1ec7n c\u00e1c c\u00e1n b\u1ed9 tham nh\u0169ng \u0111\u1ec1u t\u1eeb th\u01b0\u1eddng d\u00e2n m\u00e0 ra, tho\u1ea1t nh\u00ecn m\u1eb7t ai c\u0169ng na n\u00e1 nhau. C\u00f9ng v\u1edbi ti\u1ebfn b\u1ed9 khoa h\u1ecdc ng\u01b0\u1eddi ta \u0111\u00e3 ph\u00e1t hi\u1ec7n th\u00eam nhi\u1ec1u \u0111\u1eb7c t\u00ednh kh\u00e1c bi\u1ec7t c\u1ee7a kh\u1ed1i u \u0111\u1ec3 nh\u1eafm \u0111\u00edch t\u1ea5n c\u00f4ng chu\u1ea9n x\u00e1c h\u01a1n, \u00edt \u1ea3nh h\u01b0\u1edfng t\u1edbi t\u1ebf b\u00e0o th\u01b0\u1eddng h\u01a1n. Gi\u1ed1ng nh\u01b0 \u00f4ng n\u00e0o nhi\u1ec1u ru\u1ed9ng \u0111\u1ea5t, \u0111i xe x\u1ecbn v\u1edbi phong c\u00e1ch c\u1eeda quy\u1ec1n s\u1ebd b\u1ecb \u0111\u01b0a v\u00e0o t\u1ea7m ng\u1eafm \u0111\u1ec3 lo\u1ea1i b\u1ecf h\u1eefu hi\u1ec7u h\u01a1n l\u00e0 b\u1ecf bom gi\u1ebft nh\u1ea7m.<\/p>\n

Tuy nhi\u00ean, c\u00f3 m\u1ed9t hi\u1ec7n t\u01b0\u1ee3ng qu\u00e1i l\u1ea1 kh\u00f4ng c\u00f3 l\u1eddi gi\u1ea3i su\u1ed1t v\u00e0i ch\u1ee5c n\u0103m qua l\u00e0 trong kh\u1ed1i u c\u00f3 kh\u00e1 nhi\u1ec1u t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch x\u00e2m nh\u1eadp v\u00e0o nh\u01b0ng l\u1ea1i \u1edf tr\u1ea1ng th\u00e1i b\u1ea5t ho\u1ea1t.<\/strong> N\u00f3 \u0111\u01b0\u1ee3c v\u00ed nh\u01b0 c\u1ea3 nh\u00f3m c\u1ea3nh s\u00e1t chuy\u00ean d\u1eb9p lo\u1ea1n nh\u01b0ng khi v\u00e0o \u0111\u1ebfn s\u00e0o huy\u1ec7t l\u1ea1i \u0111\u1eafp ch\u0103n n\u1eb1m ng\u1ee7! Gi\u00e1o s\u01b0 James P Allison (M\u1ef9) v\u00e0 Tasuku Honjo (Nh\u1eadt) l\u00e0 2 ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean t\u00ecm ra nguy\u00ean nh\u00e2n t\u1ea1i sao nh\u01b0 v\u1eady. H\u00f3a ra, c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 s\u1eed d\u1ee5ng m\u1ed9t nh\u00f3m t\u00edn hi\u1ec7u \u0111\u1ec3 \u201c\u0111i \u0111\u00eam\u201d v\u00e0 ru ng\u1ee7 b\u1ecdn c\u1ea3nh s\u00e1t mi\u1ec5n d\u1ecbch. C\u1ee5 th\u1ec3 h\u01a1n, \u0111\u00f3 l\u00e0 c\u00e1c t\u01b0\u01a1ng t\u00e1c t\u1ebf b\u00e0o li\u00ean quan t\u1edbi c\u00e1c ph\u00e2n t\u1eed c\u00f3 t\u00ean CTLA-4 v\u00e0 PD-1 l\u00e0m t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch xem kh\u1ed1i u nh\u01b0 l\u00e0 \u201cng\u01b0\u1eddi nh\u00e0\u201d v\u00e0 kh\u00f4ng t\u1ea5n c\u00f4ng lo\u1ea1i tr\u1eeb n\u1eefa. Trong l\u00e2m s\u00e0ng, c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf \u201cgiao ti\u1ebfp ng\u1ea7m\u201d n\u00f3i tr\u00ean nh\u01b0 nivolumab, pembrolizumab (kh\u00e1ng PD-1), hay ipilimumab (kh\u00e1ng CTLA-4)\u2026\u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u ph\u00e1t tri\u1ec3n d\u01b0\u1edbi t\u00ean g\u1ecdi chung l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch (immune checkpoint inhibitor, ICI), gi\u00fap c\u00e1c ch\u00fa c\u1ea3nh s\u00e1t b\u1ecf \u0111\u01b0\u1ee3c nh\u1eefng b\u00f9a m\u00ea \u0111\u1ec3 ti\u1ebfp t\u1ee5c c\u00f4ng vi\u1ec7c thay tr\u1eddi h\u00e0nh \u0111\u1ea1o.\"Cu\u1ed9c<\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0H\u00ecnh \u1ea3nh minh h\u1ecda.<\/p>\n

T\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch (T cell) nh\u1eadn \u201ch\u1ed1i l\u1ed9\u201d qua c\u1eb7p t\u00edn hi\u1ec7u PD-1 v\u00e0 PD-L1, im re c\u00f4ng nh\u1eadn t\u1ebf b\u00e0o ung th\u01b0 l\u00e0 \u201cng\u01b0\u1eddi nh\u00e0\u201d. Thu\u1ed1c kh\u00e1ng PD-1 ho\u1eb7c PD-L1 l\u00e0m h\u1ec7 mi\u1ec5n d\u1ecbch nh\u1eadn ra k\u1ebb \u0111\u1ecbch v\u00e0 v\u00f9ng l\u00ean chi\u1ebfn \u0111\u1ea5u<\/em><\/strong>!<\/p>\n

\u1ede nhi\u1ec1u lo\u1ea1i b\u1ec7nh nh\u01b0 ung th\u01b0 ph\u1ed5i, melanoma, ung th\u01b0 th\u1eadn, ung th\u01b0 b\u00e0ng quang, ung th\u01b0 \u0111\u1ea7u m\u1eb7t c\u1ed5, ung th\u01b0 Hodgkin Lymphoma,\u2026ICI \u0111\u00e3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n h\u00f3a tr\u1ecb th\u00f4ng th\u01b0\u1eddng, \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o s\u1eed d\u1ee5ng v\u1edbi chi tr\u1ea3 t\u1eeb b\u1ea3o hi\u1ec3m v\u00e0 thay \u0111\u1ed5i c\u1ee5c di\u1ec7n \u0111i\u1ec1u tr\u1ecb ung th\u01b0 tr\u00ean to\u00e0n th\u1ebf gi\u1edbi ch\u1ec9 trong m\u1ed9t th\u1eddi gian ng\u1eafn. G\u1ea7n \u0111\u00e2y, ung th\u01b0 \u0111\u1ea1i tr\u00e0ng, ung th\u01b0 d\u1ea1 d\u00e0y, ung th\u01b0 t\u1eed cung\u2026c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc ph\u00f9 h\u1ee3p v\u1edbi d\u1ef1 \u0111o\u00e1n nh\u1ea1y v\u1edbi thu\u1ed1c mi\u1ec5n d\u1ecbch. Tuy nhi\u00ean, xin nh\u1ea5n m\u1ea1nh ch\u1eef n\u1ebfu\u00a0<\/strong>v\u00ec kh\u00f4ng ph\u1ea3i thu\u1ed1c mi\u1ec5n d\u1ecbch n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i ung th\u01b0, hay v\u1edbi t\u1ea5t c\u1ea3 m\u1ecdi ng\u01b0\u1eddi. L\u00e0 b\u00e1c s\u0129 c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng v\u00e0 tham gia v\u00e0i th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1edbi thu\u1ed1c \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch t\u1ea1i \u0110\u1ea1i h\u1ecdc Kyoto, m\u00ecnh th\u1ea5y v\u1eabn c\u00f2n kh\u00e1 nhi\u1ec1u b\u1ec7nh nh\u00e2n m\u00e0 h\u1ec7 mi\u1ec5n d\u1ecbch kh\u00f4ng k\u00edch ho\u1ea1t \u0111\u1ec3 \u0111\u00e1nh l\u1ea1i ung th\u01b0 khi d\u00f9ng thu\u1ed1c n\u00e0y. H\u1ec7 mi\u1ec5n d\u1ecbch \u201cb\u1ecb tr\u01a1\u201d <\/strong>ho\u1eb7c qu\u00e1 y\u1ebfu c\u00f3 th\u1ec3 do nhi\u1ec1u y\u1ebfu t\u1ed1 (v\u00ed d\u1ee5, t\u1ebf b\u00e0o ung th\u01b0 s\u1eed d\u1ee5ng h\u00e0ng t\u00e1 \u201cth\u1ebb b\u00e0i\u201d ru ng\u1ee7 t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch m\u00e0 thu\u1ed1c ch\u1ec9 x\u1eed l\u00fd \u0111\u01b0\u1ee3c v\u00e0i c\u00e1i, thu\u1ed1c c\u00f3 th\u1ec3 b\u1ecb l\u1eddn,…) v\u00e0 v\u1eabn c\u1ea7n l\u00e0m th\u00eam nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u1ec3 t\u00ecm ra nguy\u00ean nh\u00e2n. T\u1eeb \u0111\u00f3 ch\u1ecdn l\u1ecdc nh\u00f3m b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ea3 n\u0103ng h\u01b0\u1edfng l\u1ee3i nhi\u1ec1u nh\u1ea5t t\u1eeb nh\u1eefng \u0111i\u1ec1u tr\u1ecb c\u00f2n m\u1eafc ti\u1ec1n n\u00e0y.<\/p>\n

Nh\u1eadn ra nh\u1eefng k\u1ebb ph\u1ea3n th\u00f9ng trong ch\u00ednh c\u01a1 th\u1ec3 m\u00ecnh l\u00e0 \u0111i\u1ec1u kh\u00f4ng d\u1ec5. \u201c\u0110\u00e1nh chu\u1ed9t m\u00e0 kh\u00f4ng v\u1ee1 b\u00ecnh\u201d l\u00e0 m\u1ee5c ti\u00eau, \u01b0\u1edbc m\u01a1 kh\u00f4ng h\u1ec1 sai trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0, v\u00e0 c\u00e1c b\u00e1c s\u0129 v\u00e0 c\u00e1c nh\u00e0 khoa h\u1ecdc v\u1eabn \u0111ang ng\u00e0y \u0111\u00eam t\u00ecm t\u00f2i th\u00eam c\u00e1ch m\u1edbi. \u0110\u1ec3 n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb, ngo\u00e0i thu\u1ed1c men v\u00e0 chi\u1ebfn l\u01b0\u1ee3c ph\u1ed1i h\u1ee3p c\u00e1c v\u0169 kh\u00ed \u0111i\u1ec1u tr\u1ecb, b\u1ec7nh nh\u00e2n c\u1ea7n hi\u1ec3u r\u1eb1ng cu\u1ed9c chi\u1ebfn v\u1edbi ung th\u01b0 l\u00e0 cu\u1ed9c chi\u1ebfn v\u1edbi ch\u00ednh m\u00ecnh, t\u1eeb vi\u1ec7c tu\u00e2n th\u1ee7 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb, b\u1ecf thu\u1ed1c l\u00e1 r\u01b0\u1ee3u bia cho t\u1edbi ch\u0103m ch\u1ec9 t\u1eadp th\u1ec3 d\u1ee5c v\u00e0 \u0103n ng\u1ee7 \u0111i\u1ec1u \u0111\u1ed9,\u2026.T\u1ea5t c\u1ea3 nh\u1eefng vi\u1ec7c tr\u00ean \u0111\u1ec1u li\u00ean quan t\u1edbi vi\u1ec7c thay \u0111\u1ed5i ch\u00ednh m\u00ecnh; \u0111\u00f3 l\u00e0 m\u1ed9t cu\u1ed9c \u0111\u1ea5u tranh ch\u1ed1ng l\u1ea1i th\u00f3i quen hay t\u00ednh \u00ec c\u1ee7a b\u1ea3n th\u00e2n m\u00e0 t\u1ebf b\u00e0o ung th\u01b0 s\u1ee3 nh\u1ea5t l\u00e0 \u00fd ch\u00ed v\u00e0 thay \u0111\u1ed5i \u0111\u00f3!<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n

https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/immune-checkpoint-inhibitor<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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