AASraw waxay soo saartaa budada NMN iyo NRC tiro badan!

Regorafenib

 

  1. Waa maxay Regorafenib?
  2. Waa maxay sababta Regorafenib u ansaxisay FDA?
  3. Sidee ayuu u shaqeeyaa Regorafenib?
  4. Maxaa loo adeegsadaa Regorafenib Main?
  5. Waa maxay Faa'iidooyinka Regorafenib lagu muujiyey Daraasadaha?
  6. Waa maxay Khataraha / Dhibaatooyinka ay keeni karto Regorafenib?
  7. Sideen u keydsadaa ama / ama u tuuraa Regorafenib?
  8. Jihooyinka mustaqbalka ee Regorafenib
  9. Gunaanad

 

waa maxay Regorafenib?

Regorafenib (CAS: 755037-03-7), oo lagu iibiyo magaca sumadda Stivarga iyo kuwa kale, waa hadal multi-kinase inhibitor oo ay soo saartay Bayer oo bartilmaameedsata angiogenic, stromal iyo receptor tyrosine kinase (RTK). Regorafenib waxay muujineysaa waxqabadka anti-angiogenic sababo laxiriira laba-geesoodka VEGFR2-TIE2 tyrosine kinase inhibition. Laga soo bilaabo 2009 waxaa loo bartay inay tahay xulasho daaweyn oo suurtagal ah noocyo badan oo buro ah. Sanadkii 2015 waxay laheyd laba ogolaansho Mareykan ah oo ku saabsan kansarka horumarsan.

 

Muxuu yahay Regorafenib Approved by FDA

The Hay'adda Dawooyinka Yurub go'aansaday in faa'iidooyinka Regorafenib ay ka badan yihiin halisteeda isla markaana ku talisay in loo oggolaado in loo isticmaalo Midowga Yurub. Guddigu wuxuu xusay in kansarka mindhicirka mindhicirka faa iidooyinka ku saabsan fidinta badbaadada bukaanku ay ahaayeen kuwo aad u yar, laakiin waxay tixgeliyeen inay ka miisaan weyn yihiin halista bukaanjiifka oo aysan jirin fursado kale oo daaweyn ah oo harsan. Si kastaba ha noqotee, marka la eego dhibaatooyinka soo raaca, CHMP waxay tixgelisay inay muhiim tahay in la helo siyaabo lagu garto koox-hoosaadyo kasta oo bukaanno ah oo ay u badan tahay inay ka jawaabaan Stivarga.

Marka laga hadlayo GIST iyo HCC, Guddidu waxay xustay in aragtidu ay liidato bukaannada cudurkoodu sii xumaanayo in kasta oo daaweyn hore loo qaatay. Stivarga ayaa la muujiyey inay dib u dhigeyso sii xumeynta cudurka ee bukaanadan. Bukaannada qaba HCC, tani waxay horseedday horumar laga sameeyay muddada bukaanku noolaa. Dhibaatooyinka soo raaca ee Stivarga waa la maareyn karaa.

 

Sidee Regorafenib Shaqo? 

Regorafenib waa xakamey yar oo molecule ah oo ka kooban xuubka xuubka xiniinyaha iyo intracellular ee ku lug leh shaqooyinka caadiga ah ee unugyada iyo hababka cudurada sida oncogenesis, tumor angiogenesis, iyo dayactirka burooyinka yar yar. In vitro biochemical or celllular assays, regorafenib ama dheef-shiid kiimikaadka firfircoon ee aadanaha M-2 iyo M-5 waxay joojiyeen waxqabadka RET, VEGFR1, VEGFR2, VEGFR3, KIT, PDGFR-alpha, PDGFR-beta, FGFR1, FGFR2, TIE2, DDR2, TrkA, Eph2A, RAF-1, BRAF, BRAFV600E, SAPK2, PTK5, iyo Abl uruurinta regorafenib oo caafimaad ahaan lagu guuleystay. Moodooyinka in vivo, regorafenib wuxuu muujiyey waxqabadka anti-angiogenic ee qaabka burooyinka jiirka, iyo kahortagga koritaanka burooyinka iyo sidoo kale waxqabadka kahortaga metastatic ee dhowr nooc oo xenograft mouse ah oo ay kujiraan qaar ka mid ah kansarka mindhicirka.

AASraw waa soo saaraha xirfadlaha ah ee Regorafenib.

Fadlan halkan guji si aad u hesho macluumaadka xigashada: bannaanNala soo xiriir

 

waa maxay Regorafenib Ugu Muhiimsanaa?

Regorafenib waa dawo kansar ah oo ka kooban maaddada firfircoon regorafenib budo. Waxaa loo iskiis u isticmaalaa in lagu daaweeyo kansarka soo socda:

Kansarka malawadka (kansarka mindhicirka iyo malawadka) oo ku faafay qaybaha kale ee jirka;

Or Buro caloosha ku timaadda (GIST, kansar ku dhaca caloosha iyo mindhicirka) oo ku faafay ama aan qalliin looga saari karin;

Cin Hepatocellular carcinoma (HCC, kansar ku dhaca beerka).

Regorafenib waxaa loo isticmaalaa bukaanada horey loo daweeyay, ama aan la siin karin, daaweynta kale ee la heli karo. Kansarka mindhicirka mindhicirka, kuwaan waxaa ka mid ah daaweynta kiimiko ee ku saleysan daawooyinka loo yaqaan fluoropyrimidines iyo daaweynta kale kansarka daawooyinka loo yaqaan anti-‑ VEGF iyo daaweynta ‑ EGFR. Bukaannada qaba 'GIST' waxay ahayd inay isku dayaan daaweynta imatinib iyo sunitinib iyo bukaannada qaba HCC waa inay isku dayaan sorafenib kahor intaanay bilaabin daaweynta Regorafenib.

 

Regorafenib

 

Maxaa Faa'iido ah Regorafenib lagu muujiyey Daraasadaha?

 kansarka mindhicirka

Daraasad muhiim ah oo ku lug leh bukaanada 760 ee qaba kansarka mindhicirka mindhicirka ee horay u socday ka dib daaweynta caadiga ah, Regorafenib waxaa lala barbardhigay placebo (daaweynta qashinka ah) iyo cabirka ugu muhiimsan ee waxtarka wuxuu ahaa guud ahaan badbaadada (muddada ay bukaanku noolaayeen). Dhammaan bukaanada waxay sidoo kale heleen daryeel taageero ah, oo ay kujiraan dawooyinka xanuunka iyo daaweynta cudurada. Daraasadu waxay muujisay in Regorafenib uu wanaajiyay badbaadada, iyadoo bukaanada la daweeyay ay ku noolaayeen celcelis ahaan 6.4 bilood, marka loo barbardhigo 5 bilood kuwa la siiyay placebo.

 

 GIST(Burooyinka Stromal ee caloosha ku jira ee horumarsan)

Daraasad kale oo muhiim ah, Regorafenib waxaa lala barbardhigay placebo 199 bukaan ah oo qaba GIST oo faafay ama aan shaqeyn karin oo waliba lasiiyay daryeel taageero fiican. Daryeelka taageerada ah waxaa ka mid ahaa daaweyn sida xanuun joojiye, antibiyootiko, iyo dhiig lagu shubo oo caawiya bukaanka laakiin aan daaweynin kansarka. Daraasadu waxay muujisay in Regorafenib oo leh daryeel taageero ah uu waxtar u leeyahay kordhinta waqtiga bukaanku noolaa iyada oo cudurkoodu uusan ka sii darin. Bukaannada lagu daaweeyay Regorafenib waxay ku noolaayeen celcelis ahaan 4.8 bilood iyada oo cudurkoodu uusan ka sii darin marka la barbar dhigo 0.9 bilood ee bukaanada qaata placebo iyo daryeelka taageerada ah.

 

 HCC(Cudurka Kansarka 'Hepatocellular Carcinoma')

Daraasad muhiim ah oo ku lug leh 573 bukaan ah oo qaba HCC oo ka sii dartay ka dib daaweynta sorafenib, Regorafenib waxaa lala barbardhigay placebo iyo cabirka ugu muhiimsan ee waxtarka wuxuu ahaa badbaadada guud. Dhammaan bukaanada waxay sidoo kale heleen daryeel taageero ah. Daraasadu waxay muujisay in Stivarga uu kordhiyay mudada ay bukaanku guud ahaan noolaayeen, iyadoo bukaanada lagu daaweeyay Regorafenib ay ku noolyihiin celcelis ahaan 10.6 bilood, marka la barbardhigo 7.8 bilood kuwa la siiyay placebo.

 

Waa maxay Khataraha / Dhibaatooyinka ay keento Regorafenib Ma Keeni Karaa?

Icaabuq Regorafenib waxay u horseedi kartaa halista sare ee infekshinka gaar ahaan marinka kaadi mareenka, sanka, cunaha iyo sambabka. Regorafenib waxay u horseedi kartaa halista sare ee infekshannada fungal ee xuubka xabka, maqaarka ama jirka. U sheeg dhakhtarkaaga isla markiiba haddii aad qandho hesho, qufac daran oo leh ama aan kordhin kororka xabka (xaakada), cunaha oo aad u daran, neefta oo ku qabata, gubasho ama xanuun marka aad kaadido, dheecaan aan caadi ahayn oo ka yimaada xubinta taranka haweenka ama cuncun, casaan, barar ama xanuun qayb kasta oo jirka ka mid ah

Sdhiig bax daran. Regorafenib wuxuu sababi karaa dhiigbax, oo noqon kara mid culus oo mararka qaarkood u horseeda dhimasho. U sheeg daryeel caafimaad bixiyahaaga haddii aad isku aragto wax calaamado dhiigbax ah inta aad qaadanaysid Regorafenib, oo ay ka mid yihiin: matagid dhiig ama haddii mataggaagu u eg yahay qaxwada, kaadi casaan ama bunni, casaan ama madow (u eg saxaro) saxarada, qufacaya dhiig ama xinjirowga dhiigga, dhiigbaxa caadada oo ka culus kan caadiga ah, dhiigbax aan caadi ahayn oo siilka ah, sanka oo dhiig baxa badanaa dhaca, nabar, iyo madax xanuun.

A jeexjeex calooshaada ama gidaarka mindhicirka (daloolka mindhicirka). Regorafenib wuxuu sababi karaa jeex calooshaada ama gidaarka mindhicirka oo noqon kara mid culus oo mararka qaar u horseeda dhimasho. La xiriir dhaqtarkaaga daryeelka caafimaadka isla markiiba haddii aad dareento xanuun daran ama barar ku dhaca aagga calooshaada (caloosha), qandho, dhaxan, lallabbo, matag, ama fuuqbax.

A dhibaatada maqaarka ee loogu yeero falcelinta maqaarka lugta-lugta iyo finanka maqaarka ee daran. Falcelinta maqaarka lugta lugta waa caadi oo mararka qaarkood waxay noqon kartaa mid daran. U sheeg dhakhtarkaaga isla markiiba haddii aad yeelato casaan, xanuun, finan, dhiig bax, ama barar ku dhaca calaacasha gacmahaaga iyo cagahaaga, ama finan daran.

Hcadaadiska dhiigga ee igh. Cadaadiska dhiiggaaga waa in la hubiyaa toddobaad kasta illaa 6da toddobaad ee ugu horreeya ee bilaabista Regorafenib. Cadaadiska dhiiggaaga waa in si joogto ah loo hubiyaa wixii dhiig kar ahna waa in la daaweeyaa inta aad qaadaneyso Regorafenib. U sheeg daryeel caafimaad bixiyahaaga haddii aad isku aragto madax-xanuun daran, madax-fudayd, ama isbeddel ku yimaad araggaaga.

Dqulqulka dhiigga qulqulaya wadnaha iyo wadna qabadka. U hel gargaar deg-deg ah haddii aad feedho xanuun leedahay, neef-qabad leedahay, ama aad dawakhsan tahay, ama aad dareento inaad ku sii socoto.

A xaalad loo yaqaan 'leukoencephalopathy syndrome' oo dib loo rogi karo (RPLS). Isla markiiba wac daryeel caafimaad bixiyahaaga haddii aad isku aragto madax-xanuun daran, suuxdin, wareer, aragtida isbeddel, ama dhibaatooyin xagga fikirka ah

Risk dhibaatooyinka dhibaatooyinka bogsashada. Nabaradu si fiican uma bogsan karaan inta lagu jiro daaweynta Regorafenib. U sheeg daryeel bixiyahaaga haddii aad qorsheyneyso inaad sameyso wax qalliin ah ka hor inta aadan bilaabin ama aad ku guda jirtid daaweynta Regorafenib.

▪ Waa inaad joojisaa qaadashada Regorafenib ugu yaraan 2 toddobaad kahor qalliinka qorshaysan.

Provider Bixiyaha xanaanada caafimaadkaaga waa inuu kuu sheegaa goorta aad bilaabi karto inaad mar labaad qaadatid Regorafenib qalitaanka ka dib.

Saameynaha ugu caansan ee Regorafenib waxaa ka mid ah xanuun ay ka mid yihiin aagga caloosha (caloosha); daal, daciifnimo, daal; shuban (saxaro joogto ah ama dabacsan); rabitaanka cuntada oo yaraaday; caabuq; codka oo isbeddela ama xabeeb; kordhinta baaritaanka shaqada beerka qaarkood; qandho; barar, xanuun, iyo guduudasho maqaarka ku yaal afkaaga, cunaha, caloosha, iyo xiidmaha (xabka); iyo miisaan lumis.

AASraw waa soo saaraha xirfadlaha ah ee Regorafenib.

Fadlan halkan guji si aad u hesho macluumaadka xigashada: bannaanNala soo xiriir

 

Sideen u keydsadaa ama / ama u tuuraa Regorafenib?

Tablets Ku keydi kiniiniga weelka asalka ah heerkulka qolka. Furka si adag u xir. Ha soo qaadin santuuqa 'antimoisture cube' ama baakadda.

Row Tuur qayb kasta oo aan la isticmaalin 7 toddobaad ka dib furitaanka dhalada.

Ku keydi meel qalalan. Ha dhigin musqusha.

Drugs Dhammaan daroogooyinka dhig meel aamin ah. Ka ilaali dhammaan daroogada meel aysan gaari karin carruurta iyo xayawaanku.

Tuur dawooyinka aan la isticmaalin ama dhacay. Musqusha ha ku shubin ama ha ku shubin biyo mareenkaaga ilaa laguu sheego mooyee. Ka hubso farmashiistahaaga haddii aad su'aalo ka qabtid habka ugu wanaagsan ee daroogada loo tuuro. Waxa laga yaabaa inay jiraan barnaamijyo dib-u-soo-celinta daroogada ah oo ka jira deegaankaaga.

 

Regorafenib

 

Tilmaamaha mustaqbalka of Regorafenib

Shan sano kadib markii la ansixiyay, regorafenib wali waa daroogo leh daryeel caafimaad oo xadidan. Isticmaalka la oggol yahay ee kansarka mindhicirka, GIST iyo HCC waxaa loogu talagalay oo keliya cudurka metastatic ee horumarsan. Marka lagu daro kharashka badan, waxaa jira waxtar yar oo bukaan socod eegtada bukaanka ah. Intaa waxaa dheer, tijaabooyin kala duwan ayaa la qabtaa si loo qeexo inay tahay ikhtiyaar daaweyn cusub. Jihooyinka mustaqbalka ee dawadan waxaa ka mid ah maareynta cudurka loo yaqaan 'osteosarcoma'. Maxkamadeyntii dhowaan la xakameynayo, laba-indhoole indhoole ah ee Faransiiska ayaa muujisay kororka sii-noolaanshaha bilaashka ah ee walxaha 3 ee bukaanada qaba osteosarcoma metastatic kuwaas oo ku fashilmay khad kasta oo daaweyn ah. Qasab ahaan, xogtan cusubi waxay muujinayaan faa'iido ku saabsan cudurka metastatic ee horumarsan ee ugu dambeeya, si la mid ah dhammaan adeegsiga hadda la oggolaaday.

Xogta ugu dambeysa waxay soo jeedineysaa saameyn isku dhafan oo udhaxeysa regorafenib iyo kuwa xakameynaya isbaarooyinka, sida lagu muujiyey tijaabada REGONIVO. (38% kansarka caloosha iyo 44% kansarka mindhicirka malawadka) iyo saamayn taban oo loo dulqaadan karo kooxda isku dhafan. Faa'iidadan xiisaha leh waxaa laga yaabaa inay sabab u tahay yareynta macrophages-ka burooyinka la xiriira ee regorafenib, iyadoo kordhinaysa xasaasiyadda tumour ee nivolumab. Waqtigaan la joogo, tijaabada wajiga labaad ee 'REGONIVO' ayaa socota waxayna dhawaan cadeyn kartaa mala-awaalkan. Intaa waxaa sii dheer, tijaabada labaad ee tijaabada labaad ayaa muujisay in regorafenib uu ka sareeyo lomustine-ka horumarsan iyo dib u soo noqoshada glioblastoma. Tijaabada REGOMA, ee Talyaaniga, waxay muujisay horumar weyn oo ku saabsan badbaadada guud (saamiga halista 36; 0.50% kalsoonida udhaxeysa 95-0.33; log-rank p = 0.75) marka la barbar dhigo daaweynta lomustine.

Daraasadaha 'REVERSE' waxaa lagu sameeyay 'regorafenib' iyo 'cetuximab' oo lagu daweeyo kansarka mindhicirka weyn ee 'metastatic cancer'. Natiijooyinka laga helay taxanaha isticmaalka daroogooyinka noocaas ah ee daaweynta kansarkaan waxay soo jeedinayaan in amarka ugu habboon uu noqon doono maamulka bilowga ah ee regorafenib oo ay ku xigto cetuximab, oo ka duwan borotokoolka caadiga ah ee hadda la isticmaalo. Natiijooyinka waxay muujiyeen badbaadin guud ee badbaadada bukaanka waxaana faa'iidada u muuqatay in lagu riixo inta badan waxqabadka weyn ee cetuximab marka loo eego regorafenib oo ah daaweynta labaad.

INTEGRATE tijaabada regorafenib daaweynta monotherapy ee kansarka caloosha ayaa muujisay in daawadan si wanaagsan loo dulqaatay oo aysan jirin wax dhaawac ah oo ku yimid tayada nolosha bukaanka marka loo eego kuwa helay placebo iyo in aysan u muuqan inay saameyn xun ku yeelatay xuduudahaas sunta. Mashaariicda cilmi baarista waxay muujiyeen in heerarka aasaasiga ah ee xanuunka, rabitaanka cuntada, calool istaagga, iyo shaqeynta jir ahaaneed lagu ogaaday inay yihiin qodobo muhiim u ah badbaadada. Sidoo kale, tijaabadani waxay muujisay in regorafenib uu lahaa waxqabad aad u badan oo ku saabsan halka ugu horaysa ee badbaadada aan xorta ahayn. Tijaabada REDOS waxaa la sameeyay laga soo bilaabo 2015-2018 qorayaashuna waxay muujiyeen in istiraatiijiyad qaadista xaddiga kordhinta ee loo yaqaan 'regorafenib' ay tahay bedel lagu guuleysan karo oo loogu talagalay istiraatiijiyadda qiyaasta daawada ee loo yaqaan 'regorafenib dosing of 160 mg / day, gaar ahaan bukaanada qaba kansarka mindhicirka weyn. Waxaa sidoo kale la ogaaday in bukaanada lagu daweeyay qiyaasta sii kordheysa ay leeyihiin soo noqnoqosho badan oo daaweynta post-horumarka ah iyo tiro ahaan guud ahaan badbaadada.

Marka loo eego dulqaadka regorafenib markii loo shaqeynayo daaweynta kansarka mindhicirka, xog kooban ayaa laga heli karaa dulqaadka dadka buka ee waayeelka ah, waana in go'aanka la qaataa iyadoo la tixgelinayo faa'iidada ugu yar ee badbaadada iyo astaanta sumowga. Iyadoo la tixgelinayo daroogada daaweynta HCC, mashaariicda cilmi baarista waxay xooga saarayaan inay jiraan muuqaal dulqaad leh oo la aqbali karo iyo in regorafenib ay bixiso faa'iido badbaado. Daaweynta GIST, qorayaal dhowr ah ayaa sheegaya in regorafenib si wanaagsan loogu dulqaatay iyada oo aan lahayn sun sun ah.

Cilmi-baaris dheeri ah ayaa loo baahan yahay si loo go'aamiyo bukaan-socodka ka faa'iideysan kara daawadan. Laga soo bilaabo 2019, tijaabooyinka socda waxay tijaabinayaan in regorafenib uu horumarin karo natiijooyinka unugyada jilicsan ee jilicsan, sida osteogenic sarcoma, liposarcoma, Ewing sarcoma iyo rhabdomyosarcoma.

 

Gunaanad

In kasta oo 5 sano oo oggolaansho ah iyo rajo-gelinta farmasiga leh, regorafenib ay muujisay xaddidan, haddana tirakoob ahaan muhiim u ah, faa'iidooyinka noocyada kala duwan ee burooyinka adag. Tilmaamaha calaamadeysan waxay ka kooban yihiin kansarka mindhicirka, GIST iyo HCC. Tijaabooyin heer sare ah oo tijaabo ah ayaa muujiyey horumarin la taaban karo oo ku saabsan badbaadada kansarka caloosha, glioblastoma iyo osteosarcoma, oo laga yaabo inay muujiso ka mid noqoshada mustaqbalka calaamadaha calaamadaha leh.

Daaweynta isku dhafka ah ee ka hortagayaasha isbaarada difaaca jirka ayaa loo muujiyey inay faa'iido u leedahay tijaabooyinka wajiga koowaad, iyo tijaabooyinka wajiga II ayaa la qabtaa. Xilligan, regorafenib waxaa laga baarayaa kansarro kale sidoo kale. Dhibaatooyin badan oo dhinaca shaqsiga ah ayaa loo isticmaali karaa astaamo ahaan natiijooyinka wanaagsan ee daaweynta. Kuwaas waxaa ka mid ah, cudurka cilladda-cagta iyo hypothyroidism ayaa ah kuwa ugu badan ee la xiriira badbaadada nolosha. Isku soo wada duuboo, daraasaduhu waxay muujiyeen in regorafenib ay si weyn kor ugu qaadi karto badbaadada iyadoo loo dulqaadan karo noocyo badan oo burooyin adag ah.

AASraw waa soo saaraha xirfadlaha ah ee Regorafenib.

Fadlan halkan guji si aad u hesho macluumaadka xigashada: bannaanNala soo xiriir

 

Tixraaca

[1] Krishnamoorthy SK, Relias V, Sebastian S, iyo al. Maareynta sunta la xiriirta regorafenib: dib u eegis. Ther Adv Gastroenterol. 2015; 8: 285–97.

[2] Thangaraju P, Singh H, Chakrabarti A. Regorafenib: sheeko-yare tyrosine kinase inhibitor ah: dib-u-eegis kooban oo ku saabsan awooddeeda daaweynta ee daaweynta kansarka mindhicirka weyn iyo burooyinka caloosha ee caloosha ku jira. Kansarka J Indian. 2015; 52: 257-60.

[3] Grünewald FS, Prota AE, Giese A, Ballmer-Hofer K. Falanqaynta qaabdhismeedka waxqabadka VEGF soo-dhoweynta iyo doorka xudunta u ah calaamadaha angiogenic. Biochim Biophys Acta Borotiinada Proteomics. 2010; 1804: 567-80.

[4] Shinkai A, Ito M, Anazawa H, et al. Khariidaynta boggaga ku lug leh isugeynta ligand iyo kala-goynta qaybta ka-baxsan unugyada ee kinase insert domain-containing receptor for factor of vascular growth endothelial. J Biol Chem. 1998; 273: 31283-8.

[5] Fuh G, Li B, Crowley C, iyo al. Shuruudaha loogu talagalay xiritaanka iyo calaamadaha qanjirka 'kinase domain reseptor' ee cunsuriyadda kobaca xididdada xididdada dhiigga. J Biol Chem. 1998; 273: 11197–204.

[6] Eriksson A, Cao R, Roy J, et al. Cudurka borotiinka yar ee GTP-ku xidha Rac waa dhexdhexaadiye lagama maarmaan u ah koritaanka xididada xididada xididada dhiigga ee keena cuncunka endothelial iyo marinka xididdada. Wareegga. 2003; 107: 1532-8.

[7] Ascierto PA, Kirkwood JM, Grob JJ, et al. Doorka isbadalka BRAF V600 ee melanoma. J Transl Med. 2012; 10: 85.

[8] Emuss V, Garnett M, Mason C, Marais R. Is-beddelka C-RAF waa ku yar yihiin kansarka dadka maxaa yeelay C-RAF waxay leedahay waxqabad hoose oo asal ah marka loo eego B-RAF. Kansarka Res. 2005; 65: 9719–26.

[9] Bruix J, Qin S, Merle P, iyo al. Regorafenib loogu talagalay bukaanada qaba cudurka kansarka 'hepatocellular carcinoma' ee ku soo kordhay daaweynta sorafenib (RESORCE): tijaabin, laba-indhoole, xakameyn placebo, wajiga 3. Lancet. 2017; 389: 56-66.

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