#duct of bellini

[cancersfakianakis1]

Safety and Efficacy of Cabozantinib for Metastatic Nonclear Renal Cell Carcinoma: Real-world Data From an Italian Managed Access Program

Objective: The activity of cabozantinib in nonclear cell histologies has not been evaluated. Materials and Methods: Data were collected across 24 Italian hospitals. Patients were aged 18 years and older with advanced nonclear cell renal cell carcinoma (RCC), with an Eastern Cooperative Oncology Group Performance Status 0 to 2, who had relapsed after previous systemic treatments for metastatic disease. Cabozantinib was administered orally at 60 mg once a day in 28 days cycles. Dose reductions to 40 or 20 mg were made due to toxicity. Adverse events (AEs) were monitored using CTCAE version 4.0. Results: Seventeen patients were enrolled. Three (18%) patients were diagnosed type I papillary RCC, 9 (53%) type II papillary, 3 (18%) chromophobe, and 2 (11%) with Bellini duct carcinoma. In total, 11 patients started with 60 mg. Six patients started a lower dose of 40 mg. Median progression-free survival was 7.83 months (0.4 to 13.4 mo), while median overall survival was not reached but 1-year overall survival was about 60%. Six patients (35%) experienced a partial response to treatment and 6 patients (35%) showed a stable disease. In the remaining 5 (30%), we observed a progressive disease. Grade 3 and 4 AEs were observed in 41% of patients. Among 20 patients, only 1 (6%) discontinued treatment due to AEs. Asthenia (41%), diarrhea (35%), aminotransferase increasing (35%), mucosal inflammation (35%), hand and foot syndrome (24%), and hypothyroidism (24%) were the most frequently AEs. Conclusions: Our data showed that, cabozantinib is a active and feasible treatment in patient with nonclear cell RCC. http://bit.ly/2rQ7hab

[staygoldies]

Physio evals ch36 to 38 Sweat loss per day 550ml Not part of distal tubule Pct Glucose transport on apocal Fascilitated diffusion Active Passive None Urra transport Where is urea reabsorbed Pct Tdlh Cct Where is potassium mostly reabsorbed Dct Countercurrent exchange multiplier Vasa recta Loop of henle All true about medullary trapping except Tdlh secretes Tdlh absorbs Ict and cct secretes Mct absorbs Duct of bellini Absorbs na Secretes na How much Urea is secreted in tubules? 50% Most common cause of impairment k secretion or high ba yung k secretion (forgot) Hypoaldosteronism Chronic renal failure Acute renal failure High doses of diuretic None of the above Adh will cause Hypokalemia Cause k secretion except Epinephrine Aldosterone ... Urea apical transporter Uta1 Uta2 Uta3 Urea transporter in tal ba yung or cct Uta1 Uta2 Uta3 All of the above Main k absober is nkcc2 TAL Makes urine very solute TAL Glucose transporter in late pct basolateral Glut2 Absorbs water TAL normal diet, what is the concentration of urine? 300 mosm 400 mosm Osmolality of renal interstitium 300mosm 600mosm Free water clearance is positive Urine is dilute Hyperosmotic urine is more concentrated than plasma Highest k conc in body Muscle Hyperpolarization occurs in High plasma k Low plasma k High ki/ko ratio Low ki/ko ratio