E nā poʻe maʻi kanesa o ka māmā, he mea pono anei ka hoʻāʻo ʻana iā MRD?

ʻO ka MRD (Minimal Residual Disease), a i ʻole Minimal Residual Disease, he helu liʻiliʻi o nā hunaola kanesa (nā hunaola kanesa i pane ʻole a kūʻē paha i ka lāʻau) e noho ana i loko o ke kino ma hope o ka mālama ʻana i ka maʻi kanesa.
Hiki ke hoʻohana ʻia ʻo MRD ma ke ʻano he biomarker, me kahi hopena maikaʻi e hōʻike ana e hiki ke ʻike ʻia nā ʻeha i koe ma hope o ka mālama ʻana i ka maʻi kanesa (loaʻa nā hunaola kanesa, a hiki i nā hunaola kanesa i koe ke lilo i mea hana a hoʻomaka e hoʻonui ma hope o ka mālama ʻana i ka maʻi kanesa, e alakaʻi ana i ka hoʻi hou ʻana o ka maʻi), ʻoiai ʻo ka hopena maikaʻi ʻole e hōʻike ana ʻaʻole i ʻike ʻia nā ʻeha i koe ma hope o ka mālama ʻana i ka maʻi kanesa (ʻaʻohe hunaola kanesa i loaʻa);
Ua ʻike maopopo ʻia he kuleana koʻikoʻi ko ka hoʻāʻo ʻana o MRD i ka ʻike ʻana i nā poʻe maʻi kanesa māmā ʻaʻole liʻiliʻi (NSCLC) i ke kahua mua me ka pilikia nui o ka hoʻi hou ʻana a me ke alakaʻi ʻana i ka lāʻau adjuvant ma hope o ke ʻoki kino radical.
Nā hiʻohiʻona e hiki ai ke hoʻopili ʻia ʻo MRD:

No ka maʻi kanesa māmā hiki ke hana ʻia i ka wā mua

1. Ma hope o ka ʻoki ʻana i nā maʻi maʻi ʻaʻai māmā ʻaʻole liʻiliʻi ke kino i ka wā mua, hōʻike ka maikaʻi o ka MRD i kahi pilikia nui o ka hoʻi hou ʻana a koi ʻia ka mālama pono ʻana. Paipai ʻia ka nānā ʻana iā MRD i kēlā me kēia 3-6 mahina;
2. Manaʻo ʻia e hana i nā hoʻokolohua lapaʻau perioperative o ka maʻi ʻaʻai māmā liʻiliʻi ʻole e hana ʻia ma muli o MRD, a hāʻawi i nā koho lapaʻau pololei perioperative e like me ka hiki;
3. Paipai ʻia e ʻimi i ke kuleana o MRD i nā ʻano maʻi ʻelua, ka gene driver maikaʻi a me ka gene driver maikaʻi ʻole, ma ke ʻano kaʻawale.

No ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi o ka lolo holomua kūloko

1. Manaʻo ʻia ka hoʻāʻo ʻana o MRD no nā poʻe maʻi i ke kala piha ʻana ma hope o ka chemoradiotherapy radical no ka maʻi ʻaʻai māmā liʻiliʻi ʻole i holomua ma kahi kūloko, hiki ke kōkua i ka hoʻoholo ʻana i ka prognosis a me ka hoʻokumu ʻana i nā hoʻolālā lapaʻau hou aʻe;
2. Manaʻo ʻia nā hoʻokolohua lapaʻau o ka hoʻōla hoʻopaʻa ʻana ma muli o MRD ma hope o ka chemoradiotherapy e hāʻawi i nā koho hoʻōla hoʻopaʻa pololei e like me ka hiki.
No ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi
1. ʻAʻohe o nā haʻawina pili e pili ana i ka MRD i ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi;
2. Manaʻo ʻia e ʻike ʻia ka MRD i nā poʻe maʻi i ke kala piha ʻana ma hope o ka lāʻau lapaʻau systemic no ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi, hiki ke kōkua i ka hoʻoholo ʻana i ka prognosis a hoʻokumu i nā hoʻolālā therapeutic hou aʻe;
3. Manaʻo ʻia e hana i nā noiʻi e pili ana i nā hoʻolālā lapaʻau e pili ana i ka MRD i nā poʻe maʻi i ke kala piha ʻana e hoʻolōʻihi i ka lōʻihi o ke kala piha ʻana i ka hiki i hiki i nā poʻe maʻi ke hoʻonui i kā lākou mau pono.

Hiki ke ʻike ʻia ma muli o ka nele o nā haʻawina pili i ka ʻike ʻana o MRD i ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi kiʻekiʻe, ʻaʻole i hōʻike maopopo ʻia ka hoʻohana ʻana o ka ʻike ʻana o MRD i ka mālama ʻana i nā maʻi maʻi ʻaʻai māmā ʻaʻole liʻiliʻi kiʻekiʻe.
I nā makahiki i hala iho nei, ua hoʻololi ka holomua i ka immunotherapy a me ka immunotherapy i ka nānā ʻana i ka mālama ʻana no nā maʻi me ka NSCLC kiʻekiʻe.
Hōʻike nā hōʻike e kū mai ana e loaʻa ana i kekahi mau maʻi ke ola lōʻihi a manaʻo ʻia e hoʻokō i ke kala piha ʻana ma o ke kiʻi ʻana. No laila, ma lalo o ke kumumanaʻo ua ʻike mālie kekahi mau hui o nā maʻi me ka NSCLC holomua i ka pahuhopu o ke ola lōʻihi, ua lilo ka nānā ʻana i ka hoʻi hou ʻana o ka maʻi i mea pilikia nui i ka lāʻau lapaʻau, a inā paha hiki i ka hoʻāʻo ʻana o MRD ke pāʻani i kahi kuleana koʻikoʻi i loko o ia mea, pono e noiʻi ʻia i nā hoʻokolohua lapaʻau hou aʻe.