Meme Kanseri Tedavisinde İlaç Antikor Konjugatları
Özet
İlaç antikor konjugatları (ADC), monoklonal antikorlar aracılığıyla sitotoksik ajanların doğrudan tümör hücresine taşınmasını sağlayan, hedefe yönelik yeni nesil tedavilerdir. Böylece sağlıklı dokuların daha az etkilenmesi ve tedavi etkinliğinin artması amaçlanır. Her biri, hedef antikor, sitotoksik yük ve bağlayıcıdan oluşur. Her2 pozitif meme kanseri tedavisinde ilk etkin sonuçlar T-DM1 ile elde edilmiş; metastatik hastalıkta sağkalım avantajı sağlamasının ardından rezidü hastalık varlığında adjuvan tedavide de standart haline gelmiştir. Daha sonra geliştirilen trastuzumab deruxtekan (T-DX), hem Her2 pozitif hem de Her2-low meme kanserlerinde anlamlı progresyonsuz ve genel sağkalım katkıları ile önemli bir tedavi seçeneği olmuştur. Trop-2 hedefli sacituzumab govitekan ise triple negatif ve hormon pozitif ileri evre meme kanserlerinde sağkalım avantajı sağlayarak kılavuzlarda yerini almıştır. Çalışmaları devam eden çok sayıda yeni ADC molekülü bulunmaktadır. ADC’ler meme kanserinin tedavisinde devrim yaratmış olup, tedavi sıralaması, kombinasyon stratejileri ve direnç mekanizmalarına yönelik araştırmalar sürmektedir.
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