{"id":1587,"date":"2019-06-03T03:48:47","date_gmt":"2019-06-03T00:48:47","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=1587"},"modified":"2019-06-03T03:48:49","modified_gmt":"2019-06-03T00:48:49","slug":"kolorektal-kanser-tedavisinde-yeni-ilac-kombinasyonu-trametinip-ve-zoledronat","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/gunceller\/kolorektal-kanser-tedavisinde-yeni-ilac-kombinasyonu-trametinip-ve-zoledronat\/","title":{"rendered":"Kolorektal Kanser Tedavisinde Yeni \u0130la\u00e7 Kombinasyonu: Trametinip ve Zoledronat"},"content":{"rendered":"\n<p class=\"has-medium-font-size\">Kanser kaynakl\u0131 \u00f6l\u00fcmlerde kolorektal kanser ABD de 2. d\u00fcnyada ise 3. s\u0131rada yer al\u0131yor. Bu hastalar i\u00e7in tedavi se\u00e7enekleri artm\u0131\u015f olsa da hastalar\u0131n 5 y\u0131l sa\u011f kal\u0131m oran\u0131 %11 lerde. Ayr\u0131ca kolorektal kanser hastalar\u0131n\u0131n yakla\u015f\u0131k %30 \u2013 50 si onkojenik KRAS mutasyonu i\u00e7eriyor. Bu mutasyon tedaviyi daha da zorla\u015ft\u0131r\u0131yor.<\/p>\n\n\n\n<h4>KRAS geni nedir?<\/h4>\n\n\n\n<p class=\"has-medium-font-size\">KRAS geni, h\u00fccre b\u00fcy\u00fcmesinden sorumlu molek\u00fcllerden biri olan KRAS proteinini kodlar. Bu protein h\u00fccre d\u0131\u015f\u0131 sinyallerin \u00e7ekirde\u011fe iletilmesinde g\u00f6revlidir. Proteinin mutasyona u\u011framas\u0131 halinde h\u00fccre d\u0131\u015f\u0131 bir sinyal olmasa bile \u00e7ekirde\u011fe s\u00fcrekli \u201c\u00e7o\u011fal\u201d komutu verilir. Hastada KRAS mutasyonu olmas\u0131, onun tirozin kinaz inhibit\u00f6rleri ve monoklonal antikorlara yan\u0131t vermeyece\u011finin bir g\u00f6stergesidir. Ayr\u0131ca hasta metastaza daha yatk\u0131nd\u0131r. FDA onayl\u0131 pek \u00e7ok ila\u00e7 bu t\u00fcr hastalar\u0131 tedavi etmekte ba\u015far\u0131s\u0131z olman\u0131n yan\u0131nda bir\u00e7ok olumsuz etkiyi de beraberinde getirmi\u015ftir.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">Science Advance dergisinde yay\u0131mlanan makalede ise bu agresif kanser t\u00fcr\u00fc i\u00e7in yeni bir ila\u00e7 kombinasyonu geli\u015ftirildi\u011fi a\u00e7\u0131kland\u0131. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Yap\u0131lan \u00e7al\u0131\u015fmada ilk olarak hastan\u0131n kan\u0131ndan al\u0131nan normal DNA ile t\u00fcm\u00f6r h\u00fccrelerinden al\u0131nan DNA lar kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131 ve varyantlar tespit edildi. Sonras\u0131nda drosophila arka ba\u011f\u0131rsa\u011f\u0131 \u00fczerinde bulunan 9 ortolog gen, hastan\u0131n t\u00fcmoral genleri ile de\u011fi\u015ftirildi yani bir bak\u0131ma sinek kanser yap\u0131ld\u0131. Daha sonra bu model \u00fczerinde pek \u00e7ok ila\u00e7 kombinasyonu denendi. \u0130lk seferde Trametinip ile Ibandronat tedavi i\u00e7in uygun g\u00f6r\u00fclm\u00fc\u015ft\u00fc ancak sonra Ibandronat\u0131n \u00f6zofajite neden olma ihtimaline kar\u015f\u0131n Zoledronat kullan\u0131lmas\u0131na karar verildi. Bu ila\u00e7 kombinasyonunun, ila\u00e7lar\u0131n tek etkisine g\u00f6re daha g\u00fc\u00e7l\u00fc oldu\u011fu model \u00fczerinde yap\u0131lan deneylerle g\u00f6sterilmi\u015ftir.<\/p>\n\n\n\n<ul class=\"wp-container-2 wp-block-gallery-1 wp-block-gallery columns-1 is-cropped\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" width=\"1024\" height=\"306\" src=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-1024x306.jpg\" alt=\"\" data-id=\"1589\" data-link=\"https:\/\/blog.ulubat.org\/?attachment_id=1589\" class=\"wp-image-1589\" srcset=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-1024x306.jpg 1024w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-400x120.jpg 400w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-768x230.jpg 768w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-110x33.jpg 110w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-420x126.jpg 420w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732-770x230.jpg 770w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7732.jpg 1027w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"> \u00a0Bu a\u015famadan sonra  hasta tedavisine ge\u00e7ildi. Tedavi s\u0131ras\u0131nda akneiform d\u00f6k\u00fcnt\u00fcler ve y\u00fczde \u015fi\u015fme gibi yan etkiler g\u00f6r\u00fclse de hedeflenen t\u00fcm\u00f6rlerde %45 azalma g\u00f6zlendi. Klinik olarak beklenen etki daha y\u00fcksek olsa da \u00e7al\u0131\u015fman\u0131n birden \u00e7ok hasta \u00fczerinde yap\u0131lmas\u0131 do\u011fru bir yorumlama i\u00e7in daha iyi olacakt\u0131r. Ayr\u0131ca drosophila kullan\u0131m\u0131 kanser tedavisinin ki\u015fiselle\u015ftirilmesi a\u00e7\u0131s\u0131ndan \u00f6nemli bir uygulamad\u0131r.<\/p>\n\n\n\n<ul class=\"wp-container-4 wp-block-gallery-3 wp-block-gallery columns-1 is-cropped\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" width=\"1024\" height=\"1024\" src=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-1024x1024.jpg\" alt=\"\" data-id=\"1590\" data-link=\"https:\/\/blog.ulubat.org\/?attachment_id=1590\" class=\"wp-image-1590\" srcset=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-1024x1024.jpg 1024w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-150x150.jpg 150w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-250x250.jpg 250w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-125x125.jpg 125w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-110x110.jpg 110w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/IMG_E7737-420x420.jpg 420w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>haftalara g\u00f6re hastan\u0131n t\u00fcm\u00f6rlerinde g\u00f6zlenen de\u011fi\u015fim<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n<h4>Mevcut Tedavilerden Baz\u0131lar\u0131:<\/h4>\n\n\n\n<p class=\"has-medium-font-size\">Radyoterapi: ba\u011f\u0131rsak segment hareketleriyle k\u0131s\u0131tlanmaktad\u0131r. %4 ile %8 aras\u0131 bir toksisite beklentisi vard\u0131r. Diyabetiklerde, \u00f6nceki ameliyatlar sonucunda yap\u0131\u015f\u0131kl\u0131\u011f\u0131 olanlarda ve daha \u00f6ncesinde 5-FU tedavisi alanlarda (kemoterapi ajan\u0131) komplikasyon olas\u0131l\u0131\u011f\u0131 daha y\u00fcksektir. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Adjuvan Kemoterapi: Levamizol ve 5-FU ile yap\u0131lan tedavilerde genel kanser mortalitesinde %33 l\u00fck bir d\u00fc\u015f\u00fc\u015f saptanm\u0131\u015ft\u0131r. Ancak \u00fc\u00e7l\u00fc ila\u00e7 kombinasyonlar\u0131n\u0131n sadece toksisiteyi art\u0131rd\u0131\u011f\u0131 belirtilmi\u015ftir.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">\u0130mm\u00fcnoterapi: bir monoklonal antikor olan edrekolomab ile yap\u0131lan tedavilerde mortalitede %30 d\u00fc\u015f\u00fc\u015f g\u00f6zlenmi\u015f ve kemoterapi ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda hastalar lehine bir sa\u011f kal\u0131m avantaj\u0131 ileri s\u00fcr\u00fclm\u00fc\u015ft\u00fcr. <\/p>\n\n\n\n<p><\/p>\n\n\n\n<h4>Kaynak\u00e7a:<\/h4>\n\n\n\n<ul><li><a href=\"http:\/\/advances.sciencemag.org\/content\/5\/5\/eaav6528\">http:\/\/advances.sciencemag.org\/content\/5\/5\/eaav6528<\/a><\/li><li> https:\/\/docplayer.biz.tr\/12515555-Kolorektal-kanser-okan-kuzhan.html <\/li><li> https:\/\/www.drozdogan.com\/kras-mutasyonu-nedir-kolon-ve-diger-kanserlerde-kras-pozitifligi\/ <\/li><li> <a href=\"https:\/\/health.clevelandclinic.org\/what-you-can-do-to-catch-colon-cancer-early\/\">https:\/\/health.clevelandclinic.org\/what-you-can-do-to-catch-colon-cancer-early\/<\/a> <\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Kanser kaynakl\u0131 \u00f6l\u00fcmlerde kolorektal kanser ABD de 2. d\u00fcnyada ise 3. s\u0131rada yer al\u0131yor. Bu hastalar i\u00e7in tedavi se\u00e7enekleri artm\u0131\u015f<\/p>\n","protected":false},"author":57,"featured_media":1604,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[165],"tags":[188],"acf":[],"views":1263,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1587"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/57"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=1587"}],"version-history":[{"count":8,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1587\/revisions"}],"predecessor-version":[{"id":1605,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1587\/revisions\/1605"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/1604"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=1587"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=1587"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=1587"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}