{"id":24087,"date":"2022-01-12T19:56:37","date_gmt":"2022-01-12T16:56:37","guid":{"rendered":"https:\/\/zdmaa.com\/precision-medicine-is-redefining-what-makes-a-cancer-rare\/"},"modified":"2022-01-13T00:23:32","modified_gmt":"2022-01-12T21:23:32","slug":"precision-medicine-is-redefining-what-makes-a-cancer-rare","status":"publish","type":"post","link":"https:\/\/zdmaa.com\/tr\/precision-medicine-is-redefining-what-makes-a-cancer-rare\/","title":{"rendered":"Hassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor"},"content":{"rendered":"

Hassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor<\/span><\/span><\/span><\/span><\/p>\n

\n

Kansere sahip olmak yeterince zordur, ancak nadir g\u00f6r\u00fclen kanser te\u015fhisine genellikle ek zorluklar e\u015flik eder. <\/span>Nadir g\u00f6r\u00fclen bir\u00e7ok kanserin tan\u0131mlanmas\u0131 zordur, bu da gecikmi\u015f bir tan\u0131ya veya tan\u0131 kayb\u0131na neden olabilir. <\/span>Bu hastal\u0131klar\u0131 tedavi etme konusunda deneyimli doktorlar bulmak da zordur ve genellikle onlar hakk\u0131nda \u00e7ok az bilgi mevcuttur. <\/span>Tan\u0131m gere\u011fi \u00e7ok daha az hastay\u0131 etkiledi\u011finden, nispeten az say\u0131da klinik \u00e7al\u0131\u015fma, nadir g\u00f6r\u00fclen kanserler i\u00e7in yeni tedaviler geli\u015ftirmek i\u00e7in zaman ve kaynak harcar, bu da genellikle onlar\u0131 tedavi etmek i\u00e7in daha az se\u00e7ene\u011fin mevcut oldu\u011fu anlam\u0131na gelir.<\/span><\/span><\/p>\n

Ancak giderek artan say\u0131da vakada, hassas t\u0131p \u00e7a\u011f\u0131, nadir ve yayg\u0131n kanserler hakk\u0131ndaki alg\u0131lar\u0131 de\u011fi\u015ftirdi. <\/span>Ara\u015ft\u0131rmalar, uzun s\u00fcredir yayg\u0131n oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen baz\u0131 kanserlerin, ayn\u0131 k\u00f6keni payla\u015fan bir grup nadir alt tip oldu\u011funu g\u00f6stermi\u015ftir. <\/span>\u0130mm\u00fcnoterapideki ilerlemeler, bir zamanlar tedavisi zor olan baz\u0131 nadir kanser t\u00fcrleri i\u00e7in yeni tedavilere de yol a\u00e7m\u0131\u015ft\u0131r. <\/span>Geli\u015fmi\u015f genomik testler, baz\u0131 nadir kanserlerde, hastal\u0131\u011f\u0131n daha yayg\u0131n formlar\u0131 i\u00e7in \u00f6nceden geli\u015ftirilmi\u015f ila\u00e7larla tedavi edilebilen molek\u00fcler \u00f6zellikleri ortaya \u00e7\u0131kard\u0131. <\/span>T\u0131p ve Bilim Departman\u0131 Ba\u015fkan\u0131 Murray Markman, “Nadir kanserlerin tan\u0131m\u0131 , <\/span>genetik testlerin rol\u00fc ve farkl\u0131 alt tiplerin tedavinin sonu\u00e7lar\u0131n\u0131 etkileyen klinik olarak yararl\u0131 bilgiler sa\u011flad\u0131\u011f\u0131na dair kan\u0131tlar nedeniyle zaman i\u00e7inde de\u011fi\u015fti” diyor. Amerikan Kanser tedavi merkezleri <\/span><\/span>\u00ae<\/span><\/span><\/sup> (CTCA).<\/span><\/span><\/p>\n

Kanser hakk\u0131nda nadir ger\u00e7ekler<\/span><\/span><\/h2>\n
    \n
  • Nadir kanserler, yeti\u015fkinlerde t\u00fcm kanser te\u015fhislerinin yakla\u015f\u0131k y\u00fczde 20’sini olu\u015fturur.<\/span><\/span><\/li>\n
  • Avrupa’da, nadir kanser, y\u0131lda 100.000 ki\u015fi ba\u015f\u0131na 6 veya daha az vakan\u0131n te\u015fhis edildi\u011fi bir durum olarak tan\u0131mlanmaktad\u0131r; bu, Amerika Birle\u015fik Devletleri’nde kullan\u0131lan say\u0131n\u0131n (15) yar\u0131s\u0131ndan daha azd\u0131r.<\/span><\/span><\/li>\n
  • Nadir g\u00f6r\u00fclen kanserlerin \u00e7o\u011fu \u00e7ocuklarda, gen\u00e7lerde ve gen\u00e7 eri\u015fkinlerde te\u015fhis edilir. <\/span>Nadir kanserler, 20 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck hastalarda tan\u0131lar\u0131n y\u00fczde 71’ini ve 20 ila 39 ya\u015f aras\u0131ndaki hastalarda y\u00fczde 39’unu olu\u015fturmaktad\u0131r.<\/span><\/span><\/li>\n<\/ul>\n

    Ulusal Kanser Enstit\u00fcs\u00fc’ne (NCI) g\u00f6re, adenomdan (nadir bir kemik kanseri t\u00fcr\u00fc) Waldenstrom’un megaglobuline (bir t\u00fcr Hodgkin olmayan lenfoma) kadar 500’den fazla nadir kanser t\u00fcr\u00fc belgelenmi\u015ftir. <\/span>Nadir kanserler, sadece belli h\u00fccrelerde veya v\u00fccudun daha koyu b\u00f6lgelerinde bulunan, telaffuz edilemeyen kanserler de\u011fildir. <\/span>Ayr\u0131ca mide, yemek borusu, kemik, vajina, penis ve safra kesesi kanserini de i\u00e7erirler.<\/span><\/span><\/p>\n\n\n\n\n\n\n\n\n\n
    Nadir kanserleri se\u00e7in<\/span><\/span><\/th>\n\n100.000’de <\/span>yeni vaka<\/span><\/span><\/th>\n<\/tr>\n<\/thead>\n
    nefes borusu<\/span><\/span><\/td>\n
    0,2<\/span><\/span><\/center><\/td>\n<\/tr>\n
    Kabozi sarkomu<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/td>\n
    0,5<\/span><\/span><\/center><\/td>\n<\/tr>\n
    Kar\u0131n (peritoneal <\/span><\/span>
    \nve retroperitoneal)<\/span><\/span><\/td>\n
    0.7<\/span><\/span><\/center><\/td>\n<\/tr>\n
    \u00fcreter<\/span><\/span><\/td>\n
    0,8<\/span><\/span><\/center><\/td>\n<\/tr>\n
    dudak<\/span><\/span><\/td>\n
    0,8<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/center><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Bu kanserler \u00e7ok nadir oldu\u011fu i\u00e7in, onlar\u0131 nas\u0131l tan\u0131mlayaca\u011f\u0131n\u0131za, evrelendirece\u011finize veya tedavi edece\u011finize dair bilgi bulmak genellikle zordur. <\/span>Dr. Markman, “Kanser tedavisinde s\u0131n\u0131rl\u0131 deneyimin oldu\u011fu ortamlarda, nadir g\u00f6r\u00fclen kanserleri y\u00f6netmek \u00f6zel bir zorluktur” diyor. <\/span>“Bir doktor birka\u00e7 y\u0131lda bir, hatta daha az bir vakay\u0131 g\u00f6rebilir. Ve nadir g\u00f6r\u00fclen kanser t\u00fcrleri i\u00e7in klinik deneylerin olmamas\u0131 durumu daha da zorla\u015ft\u0131r\u0131yor.”<\/span><\/span><\/p>\n

    Bilim adamlar\u0131 ve onkologlar, spesifik kanser modeline ili\u015fkin anlay\u0131\u015flar\u0131n\u0131 derinle\u015ftirerek, yayg\u0131n olarak adland\u0131r\u0131lan baz\u0131 kanserlerin hi\u00e7 yayg\u0131n olmayabilece\u011fini ke\u015ffettiler. <\/span>Nadir kanserler \u00fczerine 2016 tarihli bir makalenin yazar\u0131, <\/span><\/span>Lancet Oncology’de<\/span><\/span><\/em> “genomik sonras\u0131 \u00e7a\u011fda nadir g\u00f6r\u00fclen yeni ola\u011fan durum” <\/span>diye yazd\u0131 <\/span>. <\/span>\u00d6rne\u011fin, cilt kanseri y\u0131lda 90.000’den fazla yeni vaka ile Amerika Birle\u015fik Devletleri’nde te\u015fhis edilen en yayg\u0131n be\u015finci kanserdir. <\/span>Ancak bilim adamlar\u0131, cilt kanserini, her biri DNA’lar\u0131nda benzersiz mutasyonlara sahip birden fazla alt tipe ay\u0131rd\u0131lar. <\/span>Ara\u015ft\u0131rmac\u0131lar, “Melanom, her biri tedavi i\u00e7in farkl\u0131 etkileri olan ve onkolojide giderek yayg\u0131nla\u015fan bir model olan benzersiz bir biyolojiye sahip, nadir g\u00f6r\u00fclen bir kanser grubudur” diye yazd\u0131. <\/span>Ulusal Kanser Enstit\u00fcs\u00fc y\u00f6nergelerine g\u00f6re, bu alt tiplerin her biri nadir g\u00f6r\u00fclen kanserler olarak kabul edilir.<\/span><\/span><\/p>\n\n\n\n\n\n\n\n\n\n
    En yayg\u0131n kanserler<\/span><\/span><\/th>\n\n100.000’de <\/span>yeni vaka<\/span><\/span><\/th>\n<\/tr>\n<\/thead>\n
    Kad\u0131nlarda meme kanseri<\/span><\/span><\/td>\n
    126<\/span><\/span><\/center><\/td>\n<\/tr>\n
    prostat<\/span><\/span><\/td>\n
    113<\/span><\/span><\/center><\/td>\n<\/tr>\n
    Akci\u011fer ve bron\u015flar<\/span><\/span><\/td>\n
    55<\/span><\/span><\/center><\/td>\n<\/tr>\n
    kolon ve rektum<\/span><\/span><\/td>\n
    39<\/span><\/span><\/center><\/td>\n<\/tr>\n
    Cilt kanseri<\/span><\/span><\/td>\n
    29<\/span><\/span><\/center><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Nadir kanserler i\u00e7in yap\u0131lan genetik testler, \u00e7e\u015fitli kanserlerde bulunan ve yeni tedavilere yol a\u00e7abilecek yayg\u0131n mutasyonlar\u0131 da tespit edebilir. <\/span>Dr. Markman, “Ba\u015flang\u0131\u00e7ta bir\u00e7ok yayg\u0131n kanserde veya mutasyonlar\u0131n daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fc yerlerde ger\u00e7ekle\u015ftirilen genetik analize dayal\u0131 nadir kanser tedavileri ar\u0131yor olabiliriz” diyor. <\/span>“\u00d6rne\u011fin, bir HER-2 mutasyonu meme kanseri ile yak\u0131ndan ili\u015fkilidir, ancak bu anormalli\u011fin varl\u0131\u011f\u0131, anti-HER-2 tedavisinin do\u011fal olarak mevcut olmad\u0131\u011f\u0131 kanser i\u00e7in etkili bir tedavi yakla\u015f\u0131m\u0131n\u0131n belirlenmesine yard\u0131mc\u0131 olabilir. Standart bir tedavi d\u00fc\u015f\u00fcn\u00fcn.” Hedefe y\u00f6nelik bir terapi ilac\u0131 \u00fczerinde \u00e7al\u0131\u015f\u0131yorlar Trastuzumab (Herceptin <\/span><\/span>\u00ae<\/span><\/span><\/sup> ), genellikle meme kanseri pozitif HER2’nin tedavisi i\u00e7in , <\/span>t\u00fck\u00fcr\u00fck kanal\u0131 kanseri ve rahim kanseri serumu i\u00e7in potansiyel bir tedavi olarak re\u00e7ete edilir ve nadir kanserler ve agresif i\u00e7erebilen . pozitif HER2 mutasyonlar\u0131.<\/span><\/span><\/p>\n

    Hassas t\u0131p \u00e7a\u011f\u0131na damgas\u0131n\u0131 vuran bu yeni ke\u015fifler, nadir g\u00f6r\u00fclen kanserler i\u00e7in yeni tedavilere ve potansiyel tedavilere yol a\u00e7t\u0131. <\/span>2017 y\u0131l\u0131nda, kontrol noktas\u0131 inhibit\u00f6rleri olarak bilinen imm\u00fcnoterapi ila\u00e7lar\u0131, son derece nadir bir cilt kanseri t\u00fcr\u00fc olan Merkel h\u00fccreli karsinomu ve nadir bir kan kanseri olan Hodgkin lenfomas\u0131n\u0131 tedavi etmek i\u00e7in onayland\u0131. <\/span>\u0130mm\u00fcnoterapi ayr\u0131ca timik karsinom ve mezotelyoma gibi di\u011fer nadir kanser t\u00fcrleri i\u00e7in potansiyel bir tedavi olarak ara\u015ft\u0131r\u0131lmaktad\u0131r.<\/span><\/span><\/p>\n

    Nadir Kanser M\u00fccadelesi<\/span><\/span><\/h2>\n

    Bununla birlikte, nadir g\u00f6r\u00fclen kanserler, klinisyenler ve hastalar i\u00e7in hala zorluk te\u015fkil etmektedir. <\/span>Amerikan Kanser Derne\u011fi’nin 2017 tarihli bir ara\u015ft\u0131rmas\u0131na g\u00f6re:<\/span><\/span><\/p>\n

      \n
    • Nadir kanserlerin y\u00fczde 59’u, yayg\u0131n kanserlerin y\u00fczde 45’ine k\u0131yasla ileri bir a\u015famada te\u015fhis edilir.<\/span><\/span><\/li>\n
    • Nadir kanserli erkekler i\u00e7in be\u015f y\u0131ll\u0131k sa\u011fkal\u0131m oran\u0131, yayg\u0131n kanserler i\u00e7in y\u00fczde 75’e k\u0131yasla y\u00fczde 55’tir.<\/span><\/span><\/li>\n
    • Nadir kanserli kad\u0131nlar i\u00e7in be\u015f y\u0131ll\u0131k sa\u011fkal\u0131m oran\u0131, yayg\u0131n kanserler i\u00e7in y\u00fczde 74’e k\u0131yasla y\u00fczde 60’t\u0131r.<\/span><\/span><\/li>\n<\/ul>\n

      \u00c7al\u0131\u015fma yazar\u0131 Carol DeSantis, MPH, “En \u00f6nemli bulgu, toplu olarak nadir g\u00f6r\u00fclen kanserlerin daha sonraki a\u015famalarda te\u015fhis edilme olas\u0131l\u0131\u011f\u0131n\u0131n daha y\u00fcksek oldu\u011fu ve genel sa\u011fkal\u0131m oran\u0131n\u0131n d\u00fc\u015f\u00fck oldu\u011fu bilgisiydi” dedi. <\/span><\/span>T\u0131p<\/span><\/span><\/em> Dergisi. <\/span>Bu kadar b\u00fcy\u00fck oranlarla y\u00fczle\u015fmek hastalar i\u00e7in y\u0131k\u0131c\u0131 olabilir. <\/span>Ancak Phoenix Hastanesi’nde yerle\u015ftirme ve birinci basamak hekimi olan Stephen Lynch, hastalar\u0131 te\u015fhislerini kontrol alt\u0131na almaya ve kanser hakk\u0131nda \u00f6\u011frenebilecekleri her \u015feyi \u00f6\u011frenmeye te\u015fvik ediyor. <\/span>Dr. Lynch, “Genellikle, ister yayg\u0131n bir kanser olsun, isterse \u00e7ok nadir olsun, bir\u00e7ok hasta bunu ger\u00e7ekten anlam\u0131yor” diyor. <\/span>Onlara meme kanseri olduklar\u0131 s\u00f6ylendi. <\/span>Eh, meme kanserinin bir\u00e7ok farkl\u0131 hastal\u0131\u011f\u0131 vard\u0131r. <\/span>Akci\u011fer kanseri olduklar\u0131 s\u00f6ylendi. <\/span>Bir\u00e7ok farkl\u0131 hastal\u0131k var. <\/span>Dolay\u0131s\u0131yla ilk ve en \u00f6nemli \u015fey, hastan\u0131n hastal\u0131\u011f\u0131n\u0131n nedenlerini anlamas\u0131na yard\u0131mc\u0131 olmakt\u0131r.\u201d<\/span><\/span><\/p>\n

      Bilim adamlar\u0131 ve ara\u015ft\u0131rmac\u0131lar, her kanserin genomik yap\u0131s\u0131n\u0131 ara\u015ft\u0131rd\u0131k\u00e7a, her kanserin, her hasta gibi, genellikle bireysel tedaviler gerektiren benzersiz \u00f6zelliklere sahip oldu\u011funu ke\u015ffediyorlar. <\/span>Dr. Lynch, yayg\u0131n veya nadir olarak kategorize edilmesine ra\u011fmen, hastalar\u0131 belirli kanserlerinin i\u015fe yarad\u0131\u011f\u0131 konusunda e\u011fitmenin \u00f6nemli oldu\u011funu s\u00f6yl\u00fcyor. <\/span>“Bu tan\u0131y\u0131 derinlemesine incelemek ve hastalar\u0131n t\u00fcm\u00f6rlerinin benzersiz molek\u00fcler y\u00f6nlerini \u00f6\u011frenmelerine yard\u0131mc\u0131 olmak, onlar\u0131n neyle u\u011fra\u015ft\u0131klar\u0131n\u0131 ve hangi sorular\u0131 sormalar\u0131 gerekti\u011fini daha iyi anlamalar\u0131na yard\u0131mc\u0131 olacakt\u0131r” diyor.<\/span><\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

      Hassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor Kansere sahip olmak yeterince zordur, ancak nadir g\u00f6r\u00fclen kanser te\u015fhisine genellikle ek zorluklar e\u015flik eder. Nadir g\u00f6r\u00fclen bir\u00e7ok kanserin tan\u0131mlanmas\u0131 zordur, bu da gecikmi\u015f bir tan\u0131ya veya tan\u0131 kayb\u0131na neden olabilir. Bu hastal\u0131klar\u0131 tedavi etme konusunda deneyimli doktorlar bulmak da zordur ve genellikle onlar hakk\u0131nda \u00e7ok az …<\/p>\n","protected":false},"author":1,"featured_media":23478,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25],"tags":[],"class_list":["post-24087","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"\nHassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor - zdmaa<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/zdmaa.com\/tr\/precision-medicine-is-redefining-what-makes-a-cancer-rare\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor - zdmaa\" \/>\n<meta property=\"og:description\" content=\"Hassas t\u0131p, kanseri nadir yapan \u015feyi yeniden tan\u0131ml\u0131yor Kansere sahip olmak yeterince zordur, ancak nadir g\u00f6r\u00fclen kanser te\u015fhisine genellikle ek zorluklar e\u015flik eder. Nadir g\u00f6r\u00fclen bir\u00e7ok kanserin tan\u0131mlanmas\u0131 zordur, bu da gecikmi\u015f bir tan\u0131ya veya tan\u0131 kayb\u0131na neden olabilir. 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