{"id":10800,"date":"2023-08-02T19:18:35","date_gmt":"2023-08-02T11:18:35","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&#038;p=10800"},"modified":"2025-02-11T13:36:16","modified_gmt":"2025-02-11T05:36:16","slug":"dieu-tri-ung-thu-nhin-lai-mot-chang-duong","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/dieu-tri-ung-thu-nhin-lai-mot-chang-duong\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb ung th\u01b0: Nh\u00ecn l\u1ea1i m\u1ed9t ch\u1eb7ng \u0111\u01b0\u1eddng"},"content":{"rendered":"\n<p><strong>\u0110i\u1ec1u tr\u1ecb ung th\u01b0 \u1edf nh\u1eefng n\u0103m tr\u01b0\u1edbc 1900<\/strong><\/p>\n\n\n\n<p>Ung th\u01b0 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd hi\u1ec7n \u0111\u1ea1i, tuy nhi\u00ean g\u1ed1c r\u1ec5 c\u1ee7a c\u0103n b\u1ec7nh ung th\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh t\u1eeb tr\u01b0\u1edbc \u0111\u00e2y r\u1ea5t l\u00e2u. B\u1eb1ng ch\u1ee9ng c\u1ee7a ung th\u01b0 \u0111\u01b0\u1ee3c ghi nh\u1eadn t\u1eeb nh\u1eefng t\u00e0i li\u1ec7u c\u1ed5 x\u01b0a t\u1eeb th\u1eddi Ai C\u1eadp C\u1ed5 \u0111\u1ea1i v\u00e0 n\u1ec1n V\u0103n minh Hy L\u1ea1p&nbsp;<sup>1<\/sup>. C\u1ee5 th\u1ec3, v\u00e0o n\u0103m 300 tr\u01b0\u1edbc c\u00f4ng nguy\u00ean (TCN), b\u1eb1ng ch\u1ee9ng b\u1eb1ng ch\u1eef vi\u1ebft tr\u00ean gi\u1ea5y c\u00f3i (papyrus) \u0111\u00e3 ghi nh\u1eadn m\u1ed9t tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 v\u00fa v\u00e0 ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3&nbsp;<sup>2, 3<\/sup>. V\u00e0o n\u0103m 1500 TCN, di t\u00edch tr\u00ean gi\u1ea5y c\u00f3i c\u1ee7a Ebers, th\u00f4ng tin v\u1ec1 m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 nh\u01b0 ung th\u01b0 da, ung th\u01b0 t\u1eed cung, ung th\u01b0 d\u1ea1 d\u00e0y v\u00e0 ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi ch\u00e9p&nbsp;<sup>4<\/sup>.&nbsp;<\/p>\n\n\n\n<p>V\u00e0o n\u0103m 400 TCN, ung th\u01b0 \u0111\u01b0\u1ee3c nh\u1eadn bi\u1ebft nh\u01b0 m\u1ed9t b\u1ec7nh l\u00fd do nguy\u00ean nh\u00e2n sinh h\u1ecdc ri\u00eang bi\u1ec7t h\u01a1n l\u00e0 do c\u00e1c hi\u1ec7n t\u01b0\u1ee3ng si\u00eau nhi\u00ean. Hippocrates l\u00e0 nh\u00e0 khoa h\u1ecdc \u0111\u1ea7u ti\u00ean m\u00f4 t\u1ea3 ung th\u01b0 m\u1ed9t c\u00e1ch khoa h\u1ecdc. \u00d4ng \u0111\u00e3 c\u00e2n nh\u1eafc kh\u1ed1i u l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u01b0\u1ee3c g\u00e2y ra do s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa 4 y\u1ebfu t\u1ed1 ch\u00ednh c\u1ee7a c\u01a1 th\u1ec3 (i) m\u00e1u, (ii) \u0111\u1eddm, (iii) m\u1eadt \u0111en v\u00e0 (iv) m\u1eadt v\u00e0ng. Gi\u1ea3 thi\u1ebft n\u00e0y c\u1ee7a Hippocrates \u0111\u00e3 \u0111\u01b0\u1ee3c Galen \u2013 m\u1ed9t nh\u00e0 khoa h\u1ecdc s\u1ed1ng \u1edf th\u00e0nh Rome v\u00e0o kho\u1ea3ng n\u0103m 130 \u2013 200 sau c\u00f4ng nguy\u00ean (SCN) c\u1ea3i thi\u1ec7n b\u1eb1ng nh\u1eadn \u0111\u1ecbnh ung th\u01b0 l\u00e0 b\u1ec7nh l\u00fd kh\u00f4ng th\u1ec3 ch\u1eefa l\u00e0nh v\u00e0 nguy\u00ean nh\u00e2n l\u00e0 do s\u1ef1 bi\u1ebfn \u0111\u1ed5i c\u1ee7a m\u1eadt \u0111en. H\u01a1n n\u1eefa, Galen c\u0169ng \u0111\u00e3 \u0111\u1ecbnh ra chi\u1ebfn l\u01b0\u1ee3c ph\u1eabu thu\u1eadt \u0111\u1ea7u ti\u00ean cho vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0.&nbsp;<\/p>\n\n\n\n<p>M\u1ed9t v\u00e0i b\u1eb1ng ch\u1ee9ng kh\u1ea3o c\u1ed5 \u0111\u00e3 cho th\u1ea5y ung th\u01b0 xu\u1ea5t hi\u1ec7n tr\u00ean tr\u00e1i \u0111\u1ea5t tr\u01b0\u1edbc c\u1ea3 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a con ng\u01b0\u1eddi. \u1ede m\u1ed9t v\u00e0i m\u1eabu h\u00f3a th\u1ea1ch c\u1ee7a kh\u1ee7ng long v\u00e0 sinh v\u1eadt ti\u1ec1n s\u1eed \u0111\u00e3 cho th\u1ea5y b\u1eb1ng ch\u1ee9ng c\u1ee7a nh\u1eefng kh\u1ed1i u trong x\u01b0\u01a1ng (c\u00f3 th\u1ec3 l\u00e0 sarcina x\u01b0\u01a1ng ho\u1eb7c ung th\u01b0 di c\u0103n x\u01b0\u01a1ng)&nbsp;<sup>5, 6<\/sup>.&nbsp;<\/p>\n\n\n\n<p>T\u1eeb th\u1eddi Hy L\u1ea1p c\u1ed5 \u0111\u1ea1i v\u00e0 La M\u00e3 c\u1ed5 \u0111\u1ea1i cho \u0111\u1ebfn th\u1eddi hi\u1ec7n \u0111\u1ea1i, gi\u1ea3 thi\u1ebft c\u1ee7a Hippocrates v\u00e0 Galen v\u1eabn lu\u00f4n l\u00e0 gi\u1ea3 thi\u1ebft \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn nhi\u1ec1u nh\u1ea5t. H\u01a1n n\u1eefa, t\u1eeb th\u1eddi c\u00e1c tri\u1ec1u \u0111\u1ea1i Ai C\u1eadp cho \u0111\u1ebfn cu\u1ed1i th\u1ebf k\u1ef7 19, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u1eabn \u0111a s\u1ed1 d\u1ef1a tr\u00ean ch\u1ebf \u0111\u1ed9 \u0103n l\u00e0nh m\u1ea1nh, \u0111\u1ed1t v\u00e0 ph\u1eabu thu\u1eadt \u0111\u1ed1i v\u1edbi nh\u1eefng kh\u1ed1i u tr\u00ean b\u1ec1 m\u1eb7t. Nh\u1eefng kh\u1ed1i u s\u00e2u v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb, \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c gi\u1ea3m \u0111au b\u1eb1ng chi\u1ebft xu\u1ea5t t\u1eeb c\u00e2y thu\u1ed1c phi\u1ec7n.&nbsp;<\/p>\n\n\n\n<p>Ung th\u01b0 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd hi\u1ec7n \u0111\u1ea1i k\u1ec3 t\u1eeb n\u0103m 1970. L\u00fac b\u1ea5y gi\u1edd, c\u00e1c nh\u00e0 khoa h\u1ecdc b\u1eaft \u0111\u1ea7u nh\u1eefng nghi\u00ean c\u1ee9u \u0111\u1ea7u ti\u00ean v\u1ec1 m\u1ed9t s\u1ed1 h\u1ee3p ch\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ung th\u01b0 (ch\u1eb3ng h\u1ea1n nh\u01b0 thu\u1ed1c l\u00e1 ho\u1eb7c mu\u1ed9i than). K\u1ec3 t\u1eeb th\u1ebf k\u1ef7 16 cho \u0111\u1ebfn cu\u1ed1i th\u1ec3 k\u1ef7 19, \u0111\u00e3 c\u00f3 nhi\u1ec1u ti\u1ebfn b\u1ed9 trong y khoa, ph\u1eabu thu\u1eadt v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p can thi\u1ec7p nh\u1edd v\u00e0o nh\u1eefng kh\u00e1m ph\u00e1 quan tr\u1ecdng c\u1ee7a nhi\u1ec1u nh\u00e0 khoa h\u1ecdc trong l\u0129nh v\u1ef1c ung th\u01b0 v\u1ec1 c\u00e1c kh\u00eda c\u1ea1nh gi\u1ea3i ph\u1eabu, sinh h\u1ecdc, d\u1ecbch t\u1ec5 v\u00e0 \u0111i\u1ec1u tr\u1ecb. Nh\u1eefng ti\u1ebfn b\u1ed9 n\u00e0y b\u1eaft \u0111\u1ea7u t\u1eeb t\u1eeb nh\u1eefng kh\u00e1m ph\u00e1 c\u1ee7a Paracelsus (1493 \u2013 1541) khi \u0111\u1ea1t ra nh\u1eefng c\u00e2u h\u1ecfi v\u1ec1 gi\u1ea3 thi\u1ebft c\u1ee7a Hippocrates v\u00e0 Galen cho r\u1eb1ng kh\u1ed1i u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh do s\u1ef1 t\u00edch t\u1ee5 c\u1ee7a \u201cmu\u1ed1i\u201d trong m\u00e1u c\u1ee7a, cho \u0111\u1ebfn Percival Pott kh\u00e1m ph\u00e1 ra m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa ung th\u01b0 tinh ho\u00e0n v\u00e0 s\u1ef1 ph\u01a1i nhi\u1ec5m th\u01b0\u1eddng xuy\u00ean v\u1edbi mu\u1ed9i than \u1edf ng\u01b0\u1eddi l\u00e0m ngh\u1ec1 c\u1ea1o \u1ed1ng kh\u00f3i (1714 \u2013 1788), cho \u0111\u1ebfn nh\u1eadn \u0111\u1ecbnh v\u1ec1 ngu\u1ed3n g\u1ed1c c\u1ee7a kh\u1ed1i u \u1edf nh\u1eefng t\u1ebf b\u00e0o b\u1ecb bi\u1ebfn \u0111\u1ed5i c\u1ee7a Rudolf Virchow (1821 \u2013 1902) v\u00e0 cho \u0111\u1ebfn nh\u1eefng b\u01b0\u1edbc ti\u1ebfn \u0111\u1ea7u ti\u00ean c\u1ee7a con ng\u01b0\u1eddi trong x\u1ea1 tr\u1ecb nh\u1edd v\u00e0o ph\u00e1t hi\u1ec7n c\u1ee7a Maries Curie v\u00e0 Pierre Curie. Tuy nhi\u00ean, c\u0169ng c\u00f3 th\u1ec3 xem r\u1eb1ng ngu\u1ed3n g\u1ed1c c\u1ee7a x\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c xu\u1ea5t ph\u00e1t t\u1eeb cu\u1ed1i th\u1ebf k\u1ef7 19 v\u1edbi ph\u00e1t hi\u1ec7n c\u1ee7a Wilhelm Conrad R\u00f6ntgen v\u1ec1 x \u2013 ray.&nbsp;<\/p>\n\n\n\n<p>M\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 nhi\u1ec1u ph\u00e1t hi\u1ec7n quan tr\u1ecdng trong l\u0129nh v\u1ef1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 nh\u01b0ng tr\u01b0\u1edbc Chi\u1ebfn tranh Th\u1ebf gi\u1edbi L\u1ea7n th\u1ee9 2, c\u00e1ch ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u1eabn \u0111\u01a1n thu\u1ea7n nh\u1eb1m lo\u1ea1i b\u1ecf c\u0103n nguy\u00ean v\u00e0 ng\u0103n ch\u1eb7n kh\u1ed1i u di c\u0103n. Do v\u1eady, ph\u1eabu thu\u1eadt v\u1eabn lu\u00f4n l\u00e0 l\u1ef1a ch\u1ecdn duy nh\u1ea5t cho b\u1ec7nh nh\u00e2n ung th\u01b0 v\u00e0o th\u1eddi b\u1ea5y gi\u1edd b\u1ea5t ch\u1ea5p nh\u1eefng t\u00e1c \u0111\u1ed9ng b\u1ea5t l\u1ee3i c\u1ee7a bi\u1ec7n ph\u00e1p n\u00e0y. H\u00ecnh 1 t\u00f3m t\u1eaft nh\u1eefng b\u01b0\u1edbc ti\u1ebfn quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-78c1a617b7b4729d816c965c82e30e68.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>H\u00ecnh 1.<\/strong>&nbsp;T\u00f3m t\u1eaft ch\u1eb7ng \u0111\u01b0\u1eddng ph\u00e1t tri\u1ec3n c\u1ee7a \u0111i\u1ec1u tr\u1ecb ung th\u01b0<\/p>\n\n\n\n<p><strong>S\u1ef1 ra \u0111\u1eddi v\u00e0 ti\u1ebfn b\u1ed9 c\u1ee7a h\u00f3a tr\u1ecb li\u1ec7u trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0<\/strong><\/p>\n\n\n\n<p>Sau s\u1ef1 khai ph\u00e1 v\u00e0 \u00e1p d\u1ee5ng c\u1ee7a x \u2013 ray trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 kh\u1ed1i u, nghi\u00ean c\u1ee9u v\u00e0 ph\u00e1t tri\u1ec3n v\u1ec1 nh\u1eefng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi trong l\u0129nh v\u1ef1c ung th\u01b0 \u0111\u00e3 c\u00f3 m\u1ed9t s\u1ed1 s\u1ef1 ng\u01b0ng tr\u1ec7 nh\u1ea5t \u0111\u1ecbnh. M\u00e3i cho \u0111\u1ebfn nh\u1eefng n\u0103m 40 c\u1ee7a th\u1ebf k\u1ef7 20, m\u1ed9t ph\u00e1t hi\u1ec7n l\u1edbn trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u00e3 ra \u0111\u1eddi trong giai \u0111o\u1ea1n Chi\u1ebfn tranh Th\u1ebf gi\u1edbi L\u1ea7n th\u1ee9 2 \u2013 \u0111\u00f3 l\u00e0 s\u1ef1 ph\u00e1t hi\u1ec7n ra t\u00e1c nh\u00e2n alkyl h\u00f3a DNA (DNA alkylating agent)<sup>&nbsp;7<\/sup>.&nbsp;<\/p>\n\n\n\n<p><em><strong>T\u00e1c nh\u00e2n alkyl h\u00f3a<\/strong><\/em><\/p>\n\n\n\n<p>T\u00e1c nh\u00e2n alkyl h\u00f3a \u0111\u1ea7u ti\u00ean (nitrogen m\u00f9 t\u1ea1t) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch l\u00e2m s\u00e0ng l\u00e0 mechlorethamine, t\u00e1c nh\u00e2n n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng g\u1eafn k\u1ebft v\u1edbi nitrogen th\u1ee9 7 c\u1ee7a guanine v\u00e0 \u1ee9c ch\u1ebf s\u1ef1 nh\u00e2n \u0111\u00f4i c\u1ee7a DNA. Tuy nhi\u00ean, nh\u1eefng th\u1ebf h\u1ec7 nitrogen m\u00f9 t\u1ea1t \u0111\u1ea7u ti\u00ean kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng do \u0111\u1ed9c t\u00ednh cao v\u00e0 t\u1ebf b\u00e0o ung th\u01b0 h\u00ecnh th\u00e0nh c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng d\u01b0\u1ee3c l\u00fd. Hi\u1ec7n nay, nitrogen m\u00f9 t\u1ea1t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ch\u1ee7 y\u1ebfu trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 l\u00e0 cyclophosphamide.&nbsp;<\/p>\n\n\n\n<p>T\u00e1c nh\u00e2n alkyl h\u00f3a kh\u00e1c bao g\u1ed3m carmustine, lomustine, semustin, streptozocin, nimustine, tallimustine, photemustine, m\u1ed9t s\u1ed1 alkyl sulfate nh\u01b0 busulfan, treosulfan, mannosulfan, d\u1eabn ch\u1ea5t c\u1ee7a ethyleneimine nh\u01b0 thiotepa, triazichinone, epoxide nh\u01b0 etoglucide, nh\u00f3m triazene nh\u01b0 dacarbazine, temozolomide v\u00e0 m\u1ed9t s\u1ed1 mu\u1ed1i kim lo\u1ea1i nh\u01b0 cisplatin, carboplatin, oxaliplatin v\u00e0 satraplatin. Trong s\u1ed1 nh\u1eefng h\u1ee3p ch\u1ea5t k\u1ec3 tr\u00ean, dacarbazine v\u00e0 h\u1ee3p ch\u1ea5t c\u1ee7a platinum l\u00e0 nh\u1eefng t\u00e1c nh\u00e2n alkyl h\u00f3a v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u01b0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay v\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng hai cho m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0. Dacarbazin l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p b\u1edfi Shealy v\u00e0o n\u0103m 1962 v\u00e0 \u0111\u01b0\u1ee3c C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 ch\u1ea5p thu\u1eadn v\u00e0o n\u0103m 1975 cho ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ung th\u01b0 h\u1eafc t\u1ed1 da v\u00e0 u lympho.&nbsp;<\/p>\n\n\n\n<p><em><strong>Nh\u00f3m ch\u1ea5t \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a<\/strong><\/em><\/p>\n\n\n\n<p>R\u1ea5t nhanh sau Chi\u1ebfn tranh Th\u1ebf gi\u1edbi L\u1ea7n 2, c\u00e1ch ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb m\u1edbi trong l\u0129nh v\u1ef1c ung th\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n, d\u1ef1a tr\u00ean vi\u1ec7c s\u1eed d\u1ee5ng nh\u1eefng ph\u00e2n t\u1eed b\u1eaft ch\u01b0\u1edbc c\u1ea5u tr\u00fac c\u1ee7a c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a sinh l\u00fd. Ch\u1ea5t \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a ch\u00ednh bao g\u1ed3m folate analog, purine analog v\u00e0 pyrimidine analog.&nbsp;<\/p>\n\n\n\n<p>Antifolate l\u00e0 th\u1ebf h\u1ec7 \u0111\u1ea7u ti\u00ean c\u1ee7a nh\u00f3m ch\u1ea5t \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. Trong \u0111\u00f3, aminopterin l\u00e0 ch\u1ea5t folic acid analog \u0111\u1ea7u ti\u00ean c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 sinh s\u00f4i c\u1ee7a t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 ph\u1ee5c h\u1ed3i s\u1ef1 c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4i c\u1ee7a t\u1ee7y x\u01b0\u01a1ng&nbsp;<sup>8<\/sup>. Trong s\u1ed1 nh\u1eefng d\u1eabn ch\u1ea5t nh\u00f3m antifolate \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u, methotrexate l\u00e0 m\u1ed9t trong nh\u1eefng thu\u1ed1c v\u1eabn \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.&nbsp;<\/p>\n\n\n\n<p>Trong nh\u1eefng n\u0103m 50, nhi\u1ec1u h\u1ee3p ch\u1ea5t \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a kh\u00e1c \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p v\u00e0 v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho \u0111\u1ebfn hi\u1ec7n t\u1ea1i. Trong s\u1ed1 \u0111\u00f3, 6 \u2013 mercaptopurine v\u00e0 5 \u2013 flourouracil v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng ung th\u01b0.&nbsp;<\/p>\n\n\n\n<p><em><strong>Antimitotic c\u00f3 ngu\u1ed3n g\u1ed1c t\u1ef1 nhi\u00ean<\/strong><\/em><\/p>\n\n\n\n<p>T\u00e1c nh\u00e2n antimitotic \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c khai ph\u00e1 v\u00e0o cu\u1ed1i nh\u1eefng n\u0103m 50 \u0111\u01b0\u1ee3c chi\u1ebft xu\u1ea5t t\u1eeb c\u00e2y hoa d\u1eeba c\u1ea1n (Catharanthus roseus) v\u1edbi t\u00ean Vinca alkaloid. Vinca alkaloid ban \u0111\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, tuy nhi\u00ean, nghi\u00ean c\u1ee9u c\u1ee7a Noble v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 cho th\u1ea5y kh\u1ea3 n\u0103ng l\u00e0m ch\u1eadm s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a kh\u1ed1i u c\u1ee7a h\u1ee3p ch\u1ea5t n\u00e0y. Do v\u1eady, sau \u0111\u00f3 nhi\u1ec1u d\u1eabn xu\u1ea5t c\u1ee7a Vinca \u0111\u00e3 \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p. Trong s\u1ed1 nh\u1eefng h\u1ee3p ch\u1ea5t n\u00e0y, vinblastine, vincristine, vinorelbine, vindesine l\u00e0 nh\u1eefng c\u1ea5u tr\u00fac c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb l\u1edbn nh\u1ea5t.&nbsp;<\/p>\n\n\n\n<p>Nhi\u1ec1u t\u00e1c nh\u00e2n antimitotic kh\u00e1c \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a t\u1eeb c\u00e2y t\u00e1o ma (Podophyllum peltatum), trong \u0111\u00f3 c\u00f3 podophyllin l\u00e0 h\u1ee3p ch\u1ea5t ban \u0111\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 v\u00e0 sarcomas. Nh\u1eefng d\u1eabn xu\u1ea5t kh\u00e1c c\u1ee7a Podophyllum (epidodophyllotoxin) c\u00f3 th\u1ec3 l\u00e0m ng\u01b0ng qu\u00e1 tr\u00ecnh t\u0103ng sinh c\u1ee7a t\u1ebf b\u00e0o b\u1eb1ng vi\u1ec7c ch\u1eb9n topoisomerase II&nbsp;<sup>9<\/sup>.&nbsp;<\/p>\n\n\n\n<p>Nh\u00f3m t\u00e1c nh\u00e2n antimitotic bao g\u1ed3m ch\u1ea5t \u1ee9c ch\u1ebf topoisomerase I (topotecan, irinotecan) v\u00e0 c\u00e1c ph\u00e2n t\u1eed \u1ed5n \u0111\u1ecbnh vi \u1ed1ng, bao g\u1ed3m taxane (paclitaxel, docetaxel, cabazitaxel). K\u1ec3 t\u1eeb n\u0103m 1996, irinotecan \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn cho ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ec3u m\u00f4 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng (\u0111\u01a1n tr\u1ecb ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi 5 \u2013 fluorouracil ho\u1eb7c h\u1ee3p ch\u1ea5t ch\u1ee9a platinum), sau \u0111\u00f3 irinotecan c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf v\u00e0 ung th\u01b0 bu\u1ed3ng tr\u1ee9ng&nbsp;<sup>10<\/sup>.<\/p>\n\n\n\n<p>V\u00e0o n\u0103m 1971, c\u1ea5u tr\u00fac ph\u00e2n t\u1ee7 c\u1ee7a taxol \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 (antimiotic t\u1ef1 nhi\u00ean chi\u1ebft xu\u00e2t t\u1eeb c\u00e2y l\u00e1 kim Taxus brevifolia. Tuy nhi\u00ean, cho \u0111\u1ebfn 8 n\u0103m sau \u0111\u00f3, Horwitz v\u00e0 c\u1ed9ng s\u1ef1 m\u1edbi m\u00f4 t\u1ea3 \u0111\u01b0\u1ee3c c\u01a1 ch\u1ebf ho\u1eb7c \u0111\u1ed9ng c\u1ee7a taxol. C\u00f3 nhi\u1ec1u ho\u1ea1t ch\u1ea5t \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a t\u1eeb taxol, bao g\u1ed3m paclitaxel, docetaxel (th\u1ebf h\u1ec7 t\u1ee9 hai) v\u00e0 cabazitaxel (th\u1ebf h\u1ec7 th\u1ee9 3) \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n. T\u1ea5t c\u1ea3 nh\u1eefng h\u1ee3p ch\u1ea5t n\u00e0y l\u00e0 m\u1ed9t c\u1ed9t m\u1ed1c quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u lo\u1ea1i u \u0111\u1eb7c bao g\u1ed3m ung th\u01b0 v\u00fa di c\u0103n, ung th\u01b0 t\u1ee5y (pancreatic adenocarcinoma), ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, ung th\u01b0 v\u00f9ng \u0111\u1ea7u \u2013 c\u1ed5, ung th\u01b0 d\u1ea1 d\u00e0y v\u00e0 ung th\u01b0 tuy\u1ebfn ti\u1ec1n li\u1ec7t.&nbsp;<\/p>\n\n\n\n<p><em><strong>Cytotoxic Antibiotic v\u00e0 h\u1ee3p ch\u1ea5t li\u00ean quan<\/strong><\/em><\/p>\n\n\n\n<p>Trong s\u1ed1 nh\u1eefng thu\u1ed1c h\u00f3a tr\u1ecb li\u1ec7u ti\u00eau chu\u1ea9n, c\u00f3 m\u1ed9t s\u1ed1 kh\u00e1ng sinh v\u00e0\/ho\u1eb7c d\u1eabn xu\u1ea5t c\u1ee7a kh\u00e1ng sinh c\u00f3 ho\u1ea1t t\u00ednh g\u00e2y \u0111\u1ecdc t\u1ebf b\u00e0o, nh\u1edd v\u1eady, nh\u1eefng ho\u1ea1t ch\u1ea5t n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0&nbsp;<sup>11<\/sup>. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng ch\u1ee7 y\u1ebfu c\u1ee7a nh\u00f3m ch\u1ea5t n\u00e0y l\u00e0 t\u1ea1o li\u00ean k\u1ebft \u0111\u1ed3ng h\u00f3a tr\u1ecb v\u1edbi acid nucleic v\u00e0 g\u00e2y tr\u1edf ng\u1ea1i cho qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p DNA. H\u1ee3p ch\u1ea5t \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u1ee7a nh\u00f3m thu\u1ed1c n\u00e0y l\u00e0 puromycin, tuy nhi\u00ean, puromycin kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i v\u00ec kh\u00f4ng ch\u1ecdn l\u1ecdc v\u00e0 \u0111\u1ed9c t\u00ednh cao.&nbsp;<\/p>\n\n\n\n<p>V\u00e0o n\u0103m 1960, daunomycin \u0111\u01b0\u1ee3c ph\u00e2n l\u1eadp t\u1eeb ch\u1ee7ng Streptomyces. Daunomycin c\u00f3 hi\u1ec7u l\u1ef1c cao so v\u1edbi c\u00e1c ho\u1ea1t ch\u1ea5t c\u00e1c \u1edf b\u1ec7nh nh\u00e2n t\u0103ng sinh lympho. Sau \u0111\u00f3, v\u00e0o n\u0103m 1968, m\u1ed9t c\u00f4ng th\u1ee9c m\u1edbi \u0111\u01b0\u1ee3c ph\u00e2n l\u1eadp t\u1eeb Streptomyces peucetius b\u1ecb \u0111\u1ed9t bi\u1ebfn \u2013 adriamycin (doxorubicin). Ho\u1ea1t ch\u1ea5t n\u00e0y c\u00f3 hi\u1ec7u l\u1ef1c cao trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u1edf chu\u1ed9t, tuy nhi\u00ean l\u1ea1i c\u00f3 \u0111\u1ed9c t\u00ednh cao \u0111\u1ed1i v\u1edbi tim m\u1ea1ch.&nbsp;<\/p>\n\n\n\n<p>V\u00e0o kho\u1ea3ng gi\u1eefa nh\u1eefng n\u0103m 50, ho\u1ea1t ch\u1ea5t actinomycin D \u0111\u01b0\u1ee3c ph\u00e2n t\u1eadp t\u1eeb Streptomyces griseus. Cu\u1ed1i c\u00f9ng, m\u1ed9t ho\u1ea1t ch\u1ea5t kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb ung th\u01b0 kh\u00e1c \u0111\u01b0\u1ee3c ph\u00e2n l\u1eadp \u1edf Nh\u1eadt B\u1ea3n v\u00e0o 1966 v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho \u0111\u1ebfn ng\u00e0y h\u00f4m nay \u2013 bleomycin.<\/p>\n\n\n\n<p><em><strong>Ch\u1ea5t \u1ee9c ch\u1ebf polyamine v\u00e0 ch\u1ea5t \u0111i\u1ec1u bi\u1ebfn s\u1eaft<\/strong><\/em><\/p>\n\n\n\n<p>S\u1ef1 t\u0103ng sinh c\u1ee7a t\u1ebf b\u00e0o v\u00e0 t\u0103ng tr\u01b0\u1edfng c\u1ee7a kh\u1ed1i u \u0111\u01b0\u1ee3c th\u00fac \u0111\u1ea9y b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1, bao g\u1ed3m c\u1ea3 polyamine. Do v\u1eady, v\u00e0o n\u0103m 1970, ch\u1ea5t \u1ee9c ch\u1ebf polyamine \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p v\u00e0 s\u1eed d\u1ee5ng trong th\u1ef1c h\u00e0nh l\u1ea7n \u0111\u1ea7u v\u00e0o n\u0103m 1980.&nbsp;<\/p>\n\n\n\n<p>C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 kh\u00e1c \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 \u0111i\u1ec1u bi\u1ebfn n\u1ed3ng \u0111\u1ed9 s\u1eaft n\u1ed9i b\u00e0o. S\u1eaft l\u00e0 nguy\u00ean t\u1ed1 vi l\u01b0\u1ee3ng c\u1ed1t l\u00f5i cho s\u1ef1 c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4i c\u1ee7a t\u1ebf b\u00e0o. Thi\u1ebfu h\u1ee5t s\u1eaft th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn thi\u1ebfu m\u00e1u, trong khi d\u01b0 th\u1eeba s\u1eaft d\u1eabn \u0111\u1ebfn stress oxy h\u00f3a \u1edf m\u00f4, d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng vi\u00eam, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng h\u1ec7 th\u1ed1ng v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng bi\u1ebfn \u0111\u1ed5i v\u1ec1 m\u1eb7t di truy\u1ec1n. Do v\u1eady, \u0111\u00e3 c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 ph\u00e1t tri\u1ec3n c\u00e1c y\u1ec3u t\u1ed1 \u0111i\u1ec1u bi\u1ebfn s\u1eaft trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0. M\u1ed9t s\u1ed1 v\u00ed d\u1ee5 cho nh\u00f3m ho\u1ea1t ch\u1ea5t n\u00e0y bao g\u1ed3m desferrioxamine, di-2-pyridylketone-4,4,-dimethyl-3-thiosemicarbazone (Dp44mT), ciclopirox v\u00e0 triapine. Triapine l\u00e0 m\u1ed9t trong nh\u1eefng s\u1eaft chelate \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 tr\u00ean l\u00e2m s\u00e0ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nh\u1eefng kh\u1ed1i u \u0111\u1eb7c.&nbsp;<\/p>\n\n\n\n<p><em><strong>H\u00f3a tr\u1ecb li\u1ec7u ph\u1ed1i h\u1ee3p trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0<\/strong><\/em><\/p>\n\n\n\n<p>Trong nh\u1eefng n\u0103m 60 v\u00e0 nh\u1eefng n\u0103m 70, nhi\u1ec1u quy tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p s\u1eed d\u1ee5ng nhi\u1ec1u thu\u1ed1c h\u00f3a tr\u1ecb li\u1ec7u v\u1edbi nhi\u1ec1u c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng h\u00e1c nhau b\u1eaft \u0111\u1ea7u \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. V\u00e0o n\u0103m 1964, Vincent De Vita v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 \u0111\u1ec1 ngh\u1ecb ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 (c\u1ee5 th\u1ec3 l\u00e0 Hodgkin\u2019s lymphoma) l\u1ea7n \u0111\u1ea7u ti\u00ean. Ph\u1ed1i h\u1ee3p \u0111\u1ea7u ti\u00ean n\u00e0y c\u00f3 t\u00ean l\u00e0 MOPP (mechlorethamine &#8211; vincristine \u2013 procarbazine v\u00e0 prednisone). Ph\u1ed1i h\u1ee3p n\u00e0y \u0111\u00e3 \u0111\u1ea1 \u0111\u01b0\u1ee3c nhi\u1ec1u k\u1ebft qu\u1ea3 quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb v\u00e0 tr\u1edf th\u00e0nh m\u1ed9t c\u1ed9t m\u1ed1c quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0.&nbsp;<\/p>\n\n\n\n<p>Trong nh\u1eefng n\u0103m sau \u0111\u00f3, k\u1ebft qu\u1ea3 nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y h\u00f3a tr\u1ecb li\u1ec7u c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb nh\u1eefng kh\u1ed1i u nh\u1ecf v\u00e0 khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p. V\u00e0o n\u0103m 1972, m\u1ed9t ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb kh\u00e1c \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t b\u1edfi Gianni Bonadonna v\u00e0 Umberto Veronesi, ph\u1ed1i h\u1ee3p n\u00e0y bao g\u1ed3m cyclophosphamide, methotrexate v\u00e0 fluorouracil (CMF). V\u00e0o n\u0103m 1973, Bonadonna v\u00e0 nh\u00f3m c\u1ed9ng s\u1ef1 \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t ph\u1ed1i h\u1ee3p ABVD (adriamycine \u2013 belomycin \u2013 vinblastine \u2013 dacarbazine) trong \u0111i\u1ec1u tr\u1ecb Hodgkin\u2019s lymphoma.&nbsp;<\/p>\n\n\n\n<p><strong>S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a \u0111i\u1ec1u tr\u1ecb nh\u1eafm \u0111\u00edch: ch\u1ea5t \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc kinase v\u00e0 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng<\/strong><\/p>\n\n\n\n<p>V\u00e0o th\u1eddi gian \u0111\u1ea7u c\u1ee7a nh\u1eefng n\u0103m 80, ph\u00e1t hi\u1ec7n m\u1edbi trong l\u0129nh v\u1ef1c mi\u1ec5n d\u1ecbch, sinh h\u1ecdc t\u1ebf b\u00e0o v\u00e0 sinh h\u1ecdc ph\u00e2n t\u1eed \u0111\u00e3 cho ph\u00e9p nh\u1eefng nh\u00e0 nghi\u00ean c\u1ee9u kh\u1ea3o s\u00e1t c\u01a1 ch\u1ebf ph\u00e2n t\u1eed li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o ung th\u01b0, t\u1eeb \u0111\u00f3 x\u00e1c \u0111\u1ecbnh ph\u00e2n t\u1eed \u0111\u00edch m\u1edbi \u0111\u1ec3 ch\u1eb9n b\u1eb1ng nh\u1eefng h\u1ee3p ch\u1ea5t \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc ho\u1eb7c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng. N\u1ebfu nh\u01b0 nh\u1eefng bi\u1ec7n ph\u00e1p h\u00f3a tr\u1ecb li\u1ec7u t\u00e1c \u0111\u1ed9ng tr\u00ean c\u1ea3 t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng v\u00e0 t\u1ebf b\u00e0o ung th\u01b0, th\u00ec c\u00e1c bi\u1ec7n ph\u00e1p nh\u1eafm \u0111\u00edch ch\u1ec9 can thi\u1ec7p tr\u00ean nh\u1eefng gen ung th\u1ecb c\u1ed1t l\u00f5i ho\u1eb7c nh\u1eefng gen \u1ee9c ch\u1ebf s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a kh\u1ed1i u. Ng\u00e0y nay, thu\u1eadt ng\u1eef tr\u1ecb li\u1ec7u nh\u1eafm \u0111\u00edch \u0111\u01b0\u1ee3c d\u00f9ng cho to\u00e0n b\u1ed9 nh\u1eefng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u1ec9 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ed9t ph\u00e2n t\u1eed \u0111\u00edch c\u1ee5 th\u1ec3.&nbsp;<\/p>\n\n\n\n<p>V\u00e0o n\u0103m 1980, Nadler v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n non-Hodgkin&#8217;s lymphoma (HDL) b\u1eb1ng kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng c\u1ee7a chu\u1ed9t AB89, nh\u01b0ng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y kh\u00f4ng g\u00e2y ra nh\u1eefng \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng c\u00f3 \u00fd ngh\u0129a. \u0110\u00e2y c\u0169ng l\u00e0 l\u1ea7n \u0111\u1ea7u ti\u00ean con ng\u01b0\u1eddi n\u1ed7 l\u1ef1c s\u1eed d\u1ee5ng kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0&nbsp;<sup>12<\/sup>.<\/p>\n\n\n\n<p>Cho \u0111\u1ebfn nh\u1eefng n\u0103m 90, nh\u1eefng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u1eafm \u0111\u00edch m\u1edbi cho th\u1ea5y hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb. Nh\u1edd nh\u1eefng nghi\u00ean c\u1ee9u v\u1ec1 genome c\u1ee7a ng\u01b0\u1eddi v\u00e0 nh\u1eefng ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt gi\u1ea3i tr\u00ecnh t\u1ef1 DNA, genomic, transcriptomic v\u00e0 proteomic, con ng\u01b0\u1eddi \u0111\u00e3 c\u00f3 nh\u1eefng b\u01b0\u1edbc \u0111\u1ed9t ph\u00e1 trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0.&nbsp;<\/p>\n\n\n\n<p><strong>\u1ee8c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch (Immune Checkpoint Inhibitor)<\/strong><\/p>\n\n\n\n<p>Mi\u1ec5n d\u1ecbch tr\u1ecb li\u1ec7u trong ung th\u01b0 \u0111\u00e3 c\u00f3 nhi\u1ec1u b\u01b0\u1edbc ti\u1ebfn \u0111\u00e1ng k\u1ec3 trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y. Sau n\u0103m 2010, kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng m\u1edbi \u0111\u1ecbnh h\u01b0\u1edbng kh\u00e1ng nguy\u00ean kh\u1ed1i u ho\u1eb7c th\u1ee5 th\u1ec3 T-cell protein c\u00f3 th\u1ec3 gi\u1ea3m \u0111i\u1ec1u h\u00f2a \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n&nbsp;<sup>13<\/sup>. Nh\u1eefng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch v\u00e0 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng anti-cytotoxic T-lymphocyte-associated antigen 4 v\u00e0 kh\u00e1ng kh\u00e1ng th\u1ec3 anti-programmed cell death protein 1<sup>14<\/sup>.&nbsp;<\/p>\n\n\n\n<p>Ch\u1ea5t \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn l\u00e0 ipilimumab v\u00e0o n\u0103m 2011. Hi\u1ec7n nay, ipilimumab \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n tr\u1ecb ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi nivolumab \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 t\u1ebf b\u00e0o h\u1eafc t\u1ed1 di c\u0103n ho\u1eb7c kh\u00f4ng th\u1ec3 c\u1eaft b\u1ecf.&nbsp;<\/p>\n\n\n\n<p>Sau \u0111\u00f3, 2 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch nivolumab v\u00e0 pembrolizumab \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, ung th\u01b0 t\u1ebf b\u00e0o h\u1eafc t\u1ed1 di c\u0103n, NHL&nbsp; v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u khi nh\u1eefng kh\u1ed1i u v\u1eabn c\u00f2n d\u01b0\u01a1ng t\u00ednh v\u1edbi PD \u2013 L1. V\u00e0o n\u0103m 2018, durvalumab \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n m\u1eafc ung th\u01b0 bi\u1ec3u m\u00f4 \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u di c\u0103n ho\u1eb7c ti\u1ebfn tri\u1ec3n.&nbsp;<\/p>\n\n\n\n<p>Nh\u1eefng ch\u1ea5t \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p v\u1edbi nhau ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi nh\u00f3m thu\u1ed1c h\u00f3a tr\u1ecb li\u1ec7u kh\u00e1c<sup>15<\/sup>.&nbsp;<\/p>\n\n\n\n<p><strong>B\u00e0n lu\u1eadn<\/strong><\/p>\n\n\n\n<p>\u0110i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u00e3 c\u00f3 nhi\u1ec1u b\u01b0\u1edbc ti\u1ebfn mang t\u00ednh l\u1ecbch s\u1eed, thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u1eabn kh\u00f4ng ng\u1eebng \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u v\u00e0 ph\u00e1t tri\u1ec3n. T\u1eeb sau Chi\u1ebfn tranh Th\u1ebf gi\u1edbi L\u1ea7n 2 cho \u0111\u1ebfn th\u1eddi \u0111i\u1ec3m hi\u1ec7n t\u1ea1i, nh\u1eefng nh\u00e0 nghi\u00ean c\u1ee9u v\u1eabn kh\u00f4ng ng\u1eebng \u0111\u1ec1 xu\u1ea5t nh\u1eefng bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi, cung c\u1ea5p th\u00eam l\u1ef1a ch\u1ecdn cho b\u1ec7nh nh\u00e2n ung th\u01b0. Trong nhi\u1ec1u n\u0103m t\u1edbi, s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 ch\u1ea5p thu\u1eadn c\u1ee7a nhi\u1ec1u thu\u1ed1c h\u00f3a h\u1ecdc, sinh h\u1ecdc v\u00e0 c\u00f4ng ngh\u1ec7 sinh h\u1ecdc \u0111\u01b0\u1ee3c mong ch\u1edd.&nbsp;<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Sudhakar, A. (2009). History of cancer, ancient and modern treatment methods. J. Cancer Sci. Ther. 1, 1\u20134. doi: 10.4172\/1948-5956.100000e2<\/li>\n\n\n\n<li>Breasted, J. H. (1930). The Edwin Smith Surgical Papyrus. Chicago, IL: University of Chicago Press.<\/li>\n\n\n\n<li>Sanchez, G. M., and Meltzer, E. S. (2012). The Edwin Smith Papyrus: Updated Translation of the Trauma Treatise and Modern Medical Commentaries. Atlanta, GA: Lockwood Press.<\/li>\n\n\n\n<li>Kelly, J., and Mahalingam, S. (2015). Surgical treatment of head and neck cancers in the ancient world. J. Laryngol. Otol. 129, 535\u2013539. doi: 10.1017\/S0022215115001218<\/li>\n\n\n\n<li>Rothschild, B. M., Tanke, D. H., Helbling, M., and Martin, L. D. (2003). Epidemiologic study of tumors in dinosaurs. Naturwissenschaften 90, 495\u2013500. doi: 10.1007\/s00114-003-0473-9<\/li>\n\n\n\n<li>Dumbravbrevea, M. D., Rothschild, B. M., Weishampel, D. B., Csiki-Sava, Z., Andrei, R. A., Acheson, K. A., et al. (2016). A dinosaurian facial deformity and the first occurrence of ameloblastoma in the fossil record. Sci. Rep. 6:29271. doi: 10.1038\/srep29271<\/li>\n\n\n\n<li>Brookes, P. (1990). The early history of the biological alkylating agents, 1918\u20131968. Mutat. Res. 233, 3\u201314.&nbsp;<\/li>\n\n\n\n<li>Farber, S., Diamond, L. K., Mercer, R. D., Sylvester, R. F., and Wolff, J. A. (1948). Temporary remissions in acute leukemia in children produced by folic antagonist, 4-aminopteroylglutamic acid (aminopterin). N. Engl. J. Med. 238, 787\u2013793.<\/li>\n\n\n\n<li>Imbert, T. F. (1998). Discovery of podophyllotoxins. Biochimie 80, 207\u2013222.<\/li>\n\n\n\n<li>Rothenberg, M. L. (1996). The current status of irinotecan (CPT-11) in the United States. Ann. N. Y. Acad. Sci. 803, 272\u2013281.<\/li>\n\n\n\n<li>Weiss, R. B. (1992). The anthracyclines: will we ever find a better doxorubicin? Semin. Oncol. 19, 670\u2013686.<\/li>\n\n\n\n<li>Nadler, L. M., Stashenko, P., Hardy, R., Kaplan, W. D., Button, L. N., Kufe, D. W., et al. (1980). Serotherapy of a patient with a monoclonal antibody directed against a human lymphoma-associated antigen. Cancer Res. 40, 3147\u20133154.<\/li>\n\n\n\n<li>Haanen, J. B., and Robert, C. (2015). Immune checkpoint inhibitors. Prog. Tumor Res. 42, 55\u201366. doi: 10.1159\/000437178<\/li>\n\n\n\n<li>Seidel, J. A., Otsuka, A., and Kabashima, K. (2018). Anti-PD-1 and Anti-CTLA-4 therapies in cancer: mechanisms of action, efficacy, and limitations. Front. Oncol. 8:86. doi: 10.3389\/fonc.2018.00086<\/li>\n\n\n\n<li>Falzone L, Salomone S, Libra M. Evolution of Cancer Pharmacological Treatments at the Turn of the Third Millennium. Front Pharmacol. 2018 Nov 13;9:1300. doi: 10.3389\/fphar.2018.01300.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>\u0110i\u1ec1u tr\u1ecb ung th\u01b0 \u1edf nh\u1eefng n\u0103m tr\u01b0\u1edbc 1900 Ung th\u01b0 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd hi\u1ec7n \u0111\u1ea1i, tuy nhi\u00ean g\u1ed1c r\u1ec5 c\u1ee7a c\u0103n b\u1ec7nh ung th\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh t\u1eeb tr\u01b0\u1edbc \u0111\u00e2y r\u1ea5t l\u00e2u. B\u1eb1ng ch\u1ee9ng c\u1ee7a ung th\u01b0 \u0111\u01b0\u1ee3c ghi nh\u1eadn t\u1eeb nh\u1eefng t\u00e0i li\u1ec7u c\u1ed5 x\u01b0a t\u1eeb th\u1eddi Ai C\u1eadp &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/docquity.com\/vi\/articles\/dieu-tri-ung-thu-nhin-lai-mot-chang-duong\/\"> <span class=\"screen-reader-text\">\u0110i\u1ec1u tr\u1ecb ung th\u01b0: Nh\u00ecn l\u1ea1i m\u1ed9t ch\u1eb7ng \u0111\u01b0\u1eddng<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":123,"featured_media":10804,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1438],"articles_languages":[1375],"articles_filters":[],"class_list":["post-10800","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/10800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=10800"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/10800\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/10804"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=10800"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=10800"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=10800"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=10800"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=10800"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=10800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}