M\u00e5lriktad cancerbehandling \u00e4r l\u00e4kemedel som blockerar, f\u00f6rst\u00f6r eller st\u00f6r specifika signalv\u00e4gar\/egenskaper\/m\u00e5l i cancerceller som beh\u00f6vs f\u00f6r att cancerceller ska v\u00e4xa och sprida sig. Det finns tv\u00e5 huvudtyper:<\/p>\n<\/div>\n<\/section>\n<\/div>\n
Mutation eller metylering av VHL imiterar ett hypoxiskt tillst\u00e5nd (syrebrist) i k\u00e4rnan s\u00e5 att proteinkomplexet pVHL inte bildas och\/eller inte kan bryta ned hypoxi-inducerbara faktorer (HIF-1\u03b1, HIF-2\u03b1 och HIF-3\u03b1), vilket resulterar i ackumulering av HIF i cellen. Detta leder till \u00f6kad \u00b0transkription \u00b0av flera gener som \u00e4r viktiga f\u00f6r:<\/p>\n<\/div>\n<\/section>\n<\/div>\n
Njurcancer k\u00e4nnetecknas av onormalt stor bildning av nya blodk\u00e4rl (angiogenes).<\/span><\/p>\n<\/div><\/div>Types of targeted therapy in mRCC<\/h4><\/div><\/span><\/div><\/div><\/span><\/div>K\u00e4lla: 6<\/sup><\/small><\/p>\n<\/div><\/div>Tyrosinkinash\u00e4mmare<\/h4><\/div>Tyrosinkinasreceptorer (TKR) finns i cellmembranet och \u00e4r viktiga regulatorer f\u00f6r celltillv\u00e4xt och differentiering. De har en extracellul\u00e4r del till vilken liganden\/signalmolekylen binds och en cytoplasmatisk del som fungerar som ett enzym som kan aktivera andra enzymer i cellen. Kinaser \u00e4r enzymer som fosforylerar, dvs. \u00f6verf\u00f6r en fosfatgrupp. Exempel p\u00e5 TKR: VEGFR, EGFR, PDGFR, insulinreceptor osv.<\/p>\nGenom att binda en ligand (signalmolekyl) till tyrosinkinasreceptorn (TKR) p\u00e5 cellens utsida -> bildar tv\u00e5 TKR tillsammans en dimer –> de tv\u00e5 TKR-svansarna fosforylerar varandras tyrosin -> TKR aktiv -> aktivering av intracellul\u00e4ra signalv\u00e4gar –> cellsvar.<\/span><\/p>\n<\/div>Tyrosinkinash\u00e4mmares effekt vid mRCC1,4<\/sup><\/h4><\/div>Tyrosinkinash\u00e4mmare (TKI) \u00e4r sm\u00e5 molekyler som blockerar effekten av TKR genom att h\u00e4mma kinaset p\u00e5 insidan av receptorn. Tyrosinkinash\u00e4mmare som anv\u00e4nds vid behandling av mRCC h\u00e4mmar VEGF-receptorn (och eventuellt andra tyrosinkinasreceptorer) som finns p\u00e5 endotel- och tum\u00f6rceller och h\u00e4mmar:<\/p>\n\nBildning av nya blodk\u00e4rl (angiogenes)<\/li>\nTum\u00f6rproliferation<\/li>\n<\/ul>\n<\/div><\/span><\/div><\/div>\n\n\nTKI kan h\u00e4mma andra TKR, d\u00e4ribland trombocytderiverad tillv\u00e4xtfaktorreceptor (PDGFR), rearrangemang under transfektion (RET), FMS-liknande tyrosinkinas (FLT3), fibroblasttillv\u00e4xtfaktorreceptor (FGFR) och KIT, som alla \u00e4r viktiga regulatorer f\u00f6r normala cellul\u00e4ra processer, men \u00e4ven har en avg\u00f6rande roll i utvecklingen och progressionen av m\u00e5nga typer av cancer. 2,3,4<\/sup><\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div><\/span><\/div><\/div>\n\n\nVissa tyrosinkinash\u00e4mmare h\u00e4mmar \u00e4ven AXL och MET, som b\u00e5da f\u00f6rmodas vara involverade i utvecklingen av resistens mot VEGFR.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\n\n\n\nSunitinib<\/a><\/li>\nPazopanib<\/a><\/li>\nAxitinib<\/a><\/li>\nKabozantinib<\/a><\/li>\nSorafenib<\/a><\/li>\nLenvatinib<\/a><\/li>\nTivozanib<\/a><\/li>\n<\/ul>\n<\/div>\n<\/section>\n<\/div>\n<\/div>Monoklonala antikroppars effekt mot VEGF-A<\/h4><\/div><\/span><\/div><\/div>Bevacizumab<\/a> \u00e4r en rekombinant monoklonal anti-VEGF-A-antikropp som binder och neutraliserar alla isoformer av cirkulerande VEGF-A. Verkningsmekanismen \u00e4r s\u00e5ledes h\u00e4mning av angiogenesen.<\/p>\nBevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
K\u00e4lla: 6<\/sup><\/small><\/p>\n<\/div><\/div>Tyrosinkinash\u00e4mmare<\/h4><\/div>Tyrosinkinasreceptorer (TKR) finns i cellmembranet och \u00e4r viktiga regulatorer f\u00f6r celltillv\u00e4xt och differentiering. De har en extracellul\u00e4r del till vilken liganden\/signalmolekylen binds och en cytoplasmatisk del som fungerar som ett enzym som kan aktivera andra enzymer i cellen. Kinaser \u00e4r enzymer som fosforylerar, dvs. \u00f6verf\u00f6r en fosfatgrupp. Exempel p\u00e5 TKR: VEGFR, EGFR, PDGFR, insulinreceptor osv.<\/p>\nGenom att binda en ligand (signalmolekyl) till tyrosinkinasreceptorn (TKR) p\u00e5 cellens utsida -> bildar tv\u00e5 TKR tillsammans en dimer –> de tv\u00e5 TKR-svansarna fosforylerar varandras tyrosin -> TKR aktiv -> aktivering av intracellul\u00e4ra signalv\u00e4gar –> cellsvar.<\/span><\/p>\n<\/div>Tyrosinkinash\u00e4mmares effekt vid mRCC1,4<\/sup><\/h4><\/div>Tyrosinkinash\u00e4mmare (TKI) \u00e4r sm\u00e5 molekyler som blockerar effekten av TKR genom att h\u00e4mma kinaset p\u00e5 insidan av receptorn. Tyrosinkinash\u00e4mmare som anv\u00e4nds vid behandling av mRCC h\u00e4mmar VEGF-receptorn (och eventuellt andra tyrosinkinasreceptorer) som finns p\u00e5 endotel- och tum\u00f6rceller och h\u00e4mmar:<\/p>\n\nBildning av nya blodk\u00e4rl (angiogenes)<\/li>\nTum\u00f6rproliferation<\/li>\n<\/ul>\n<\/div><\/span><\/div><\/div>\n\n\nTKI kan h\u00e4mma andra TKR, d\u00e4ribland trombocytderiverad tillv\u00e4xtfaktorreceptor (PDGFR), rearrangemang under transfektion (RET), FMS-liknande tyrosinkinas (FLT3), fibroblasttillv\u00e4xtfaktorreceptor (FGFR) och KIT, som alla \u00e4r viktiga regulatorer f\u00f6r normala cellul\u00e4ra processer, men \u00e4ven har en avg\u00f6rande roll i utvecklingen och progressionen av m\u00e5nga typer av cancer. 2,3,4<\/sup><\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div><\/span><\/div><\/div>\n\n\nVissa tyrosinkinash\u00e4mmare h\u00e4mmar \u00e4ven AXL och MET, som b\u00e5da f\u00f6rmodas vara involverade i utvecklingen av resistens mot VEGFR.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\n\n\n\nSunitinib<\/a><\/li>\nPazopanib<\/a><\/li>\nAxitinib<\/a><\/li>\nKabozantinib<\/a><\/li>\nSorafenib<\/a><\/li>\nLenvatinib<\/a><\/li>\nTivozanib<\/a><\/li>\n<\/ul>\n<\/div>\n<\/section>\n<\/div>\n<\/div>Monoklonala antikroppars effekt mot VEGF-A<\/h4><\/div><\/span><\/div><\/div>Bevacizumab<\/a> \u00e4r en rekombinant monoklonal anti-VEGF-A-antikropp som binder och neutraliserar alla isoformer av cirkulerande VEGF-A. Verkningsmekanismen \u00e4r s\u00e5ledes h\u00e4mning av angiogenesen.<\/p>\nBevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Tyrosinkinasreceptorer (TKR) finns i cellmembranet och \u00e4r viktiga regulatorer f\u00f6r celltillv\u00e4xt och differentiering. De har en extracellul\u00e4r del till vilken liganden\/signalmolekylen binds och en cytoplasmatisk del som fungerar som ett enzym som kan aktivera andra enzymer i cellen. Kinaser \u00e4r enzymer som fosforylerar, dvs. \u00f6verf\u00f6r en fosfatgrupp. Exempel p\u00e5 TKR: VEGFR, EGFR, PDGFR, insulinreceptor osv.<\/p>\n
Genom att binda en ligand (signalmolekyl) till tyrosinkinasreceptorn (TKR) p\u00e5 cellens utsida -> bildar tv\u00e5 TKR tillsammans en dimer –> de tv\u00e5 TKR-svansarna fosforylerar varandras tyrosin -> TKR aktiv -> aktivering av intracellul\u00e4ra signalv\u00e4gar –> cellsvar.<\/span><\/p>\n<\/div>Tyrosinkinash\u00e4mmares effekt vid mRCC1,4<\/sup><\/h4><\/div>Tyrosinkinash\u00e4mmare (TKI) \u00e4r sm\u00e5 molekyler som blockerar effekten av TKR genom att h\u00e4mma kinaset p\u00e5 insidan av receptorn. Tyrosinkinash\u00e4mmare som anv\u00e4nds vid behandling av mRCC h\u00e4mmar VEGF-receptorn (och eventuellt andra tyrosinkinasreceptorer) som finns p\u00e5 endotel- och tum\u00f6rceller och h\u00e4mmar:<\/p>\n\nBildning av nya blodk\u00e4rl (angiogenes)<\/li>\nTum\u00f6rproliferation<\/li>\n<\/ul>\n<\/div><\/span><\/div><\/div>\n\n\nTKI kan h\u00e4mma andra TKR, d\u00e4ribland trombocytderiverad tillv\u00e4xtfaktorreceptor (PDGFR), rearrangemang under transfektion (RET), FMS-liknande tyrosinkinas (FLT3), fibroblasttillv\u00e4xtfaktorreceptor (FGFR) och KIT, som alla \u00e4r viktiga regulatorer f\u00f6r normala cellul\u00e4ra processer, men \u00e4ven har en avg\u00f6rande roll i utvecklingen och progressionen av m\u00e5nga typer av cancer. 2,3,4<\/sup><\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div><\/span><\/div><\/div>\n\n\nVissa tyrosinkinash\u00e4mmare h\u00e4mmar \u00e4ven AXL och MET, som b\u00e5da f\u00f6rmodas vara involverade i utvecklingen av resistens mot VEGFR.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\n\n\n\nSunitinib<\/a><\/li>\nPazopanib<\/a><\/li>\nAxitinib<\/a><\/li>\nKabozantinib<\/a><\/li>\nSorafenib<\/a><\/li>\nLenvatinib<\/a><\/li>\nTivozanib<\/a><\/li>\n<\/ul>\n<\/div>\n<\/section>\n<\/div>\n<\/div>Monoklonala antikroppars effekt mot VEGF-A<\/h4><\/div><\/span><\/div><\/div>Bevacizumab<\/a> \u00e4r en rekombinant monoklonal anti-VEGF-A-antikropp som binder och neutraliserar alla isoformer av cirkulerande VEGF-A. Verkningsmekanismen \u00e4r s\u00e5ledes h\u00e4mning av angiogenesen.<\/p>\nBevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Tyrosinkinash\u00e4mmare (TKI) \u00e4r sm\u00e5 molekyler som blockerar effekten av TKR genom att h\u00e4mma kinaset p\u00e5 insidan av receptorn. Tyrosinkinash\u00e4mmare som anv\u00e4nds vid behandling av mRCC h\u00e4mmar VEGF-receptorn (och eventuellt andra tyrosinkinasreceptorer) som finns p\u00e5 endotel- och tum\u00f6rceller och h\u00e4mmar:<\/p>\n
TKI kan h\u00e4mma andra TKR, d\u00e4ribland trombocytderiverad tillv\u00e4xtfaktorreceptor (PDGFR), rearrangemang under transfektion (RET), FMS-liknande tyrosinkinas (FLT3), fibroblasttillv\u00e4xtfaktorreceptor (FGFR) och KIT, som alla \u00e4r viktiga regulatorer f\u00f6r normala cellul\u00e4ra processer, men \u00e4ven har en avg\u00f6rande roll i utvecklingen och progressionen av m\u00e5nga typer av cancer. 2,3,4<\/sup><\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div><\/span><\/div><\/div>\n\n\nVissa tyrosinkinash\u00e4mmare h\u00e4mmar \u00e4ven AXL och MET, som b\u00e5da f\u00f6rmodas vara involverade i utvecklingen av resistens mot VEGFR.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\n\n\n\nSunitinib<\/a><\/li>\nPazopanib<\/a><\/li>\nAxitinib<\/a><\/li>\nKabozantinib<\/a><\/li>\nSorafenib<\/a><\/li>\nLenvatinib<\/a><\/li>\nTivozanib<\/a><\/li>\n<\/ul>\n<\/div>\n<\/section>\n<\/div>\n<\/div>Monoklonala antikroppars effekt mot VEGF-A<\/h4><\/div><\/span><\/div><\/div>Bevacizumab<\/a> \u00e4r en rekombinant monoklonal anti-VEGF-A-antikropp som binder och neutraliserar alla isoformer av cirkulerande VEGF-A. Verkningsmekanismen \u00e4r s\u00e5ledes h\u00e4mning av angiogenesen.<\/p>\nBevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Vissa tyrosinkinash\u00e4mmare h\u00e4mmar \u00e4ven AXL och MET, som b\u00e5da f\u00f6rmodas vara involverade i utvecklingen av resistens mot VEGFR.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/div>
Bevacizumab<\/a> \u00e4r en rekombinant monoklonal anti-VEGF-A-antikropp som binder och neutraliserar alla isoformer av cirkulerande VEGF-A. Verkningsmekanismen \u00e4r s\u00e5ledes h\u00e4mning av angiogenesen.<\/p>\nBevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Bevacizumab \u00e4r godk\u00e4nt i kombination med interferon-\u03b1 som f\u00f6rsta linjens behandling f\u00f6r patienter med mRCC med klarcellig histologi.<\/span><\/p>\nBevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>Virkningen af mTOR-h\u00e6mmere<\/h4><\/div><\/span><\/div><\/div>mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>L\u00e4kemedel:<\/h4><\/div>\nTemsirolimus<\/a><\/li>\nEverolimus<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>Referenser<\/h4><\/div>\nDelacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, et al., eds. Brenner & Rector\u2019s The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:1508\u20131535.<\/em><\/li>\nLjungberg B, Bensalah K, Bex A, et al. EAU guidelines on renal cell carcinoma: 2016 update. European Association of Urology. https:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/. Accessed June 25, 2016.<\/em><\/li>\nEscudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practise Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 suppl 3:iii49-iii56,<\/em><\/li>\nPili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:1416-1444.e5. Chapter 82.<\/em><\/li>\nRini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373: 1119-1132.<\/em><\/li>\nBanumathy G, Cairns P. Cancer Biol Ther 2010;10:658\u201364<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div>Testa dina kunskaper<\/h4><\/div><\/div><\/div><\/div><\/div>Tyrosinkinash\u00e4mmare:<\/h5><\/div><\/div><\/div><\/div><\/div><\/div><\/div>H\u00e4mmar immunsystemet<\/label><\/div>H\u00e4mmar angiogenes och tum\u00f6rproliferation<\/label><\/div>H\u00e4mmar njurfunktionen<\/label><\/div><\/fieldset><\/div>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Bevacizumab har studerats i andra kombinationer, d\u00e4ribland IL-2\/interferon och i kombination med checkpointh\u00e4mmare.<\/p>\n<\/div>
mTOR inhibitorer blokerer et enzym, der kaldes mammalian target of rapamycin (mTOR). I kroppen binder mTOR inhibitorer sig f\u00f8rst til et protein kaldet FKBP-12, der findes i cellerne, hvorved det danner et \u201ckompleks\u201d. Dette kompleks h\u00e6mmer derefter mTOR. Da mTOR medvirker til at kontrollere cellernes deling og blodkarrenes v\u00e6kst, forhindrer mTOR inhibitorer tumorcellerne i at dele sig og reducerer blodforsyningen til dem. Dette forsinker kr\u00e6ftens v\u00e6kst og spredning.<\/p>\n<\/div>
(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><\/i><\/div>\n<\/div>Det \u00e4r r\u00e4tt!<\/p>\n<\/div><\/i><\/div><\/p>\n<\/div>Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div>Forts\u00e4tt till n\u00e4sta avsnitt: 4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/span>Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Det \u00e4r r\u00e4tt!<\/p>\n<\/div>
Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div>
Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div>4.1 Behandlingsalternativ f\u00f6r metastaserad njurcancer (mRCC)<\/span><\/i><\/a><\/div>4.2 Onkologisk behandling: M\u00e5lriktade l\u00e4kemedel<\/span><\/i><\/a><\/div>4.3 Onkologisk behandling: Immunterapi<\/span><\/i><\/a><\/div>4.4 Str\u00e5lbehandling<\/span><\/i><\/a><\/div>4.5 Underst\u00f6djande v\u00e5rd<\/span><\/i><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7554","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7554"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions"}],"predecessor-version":[{"id":11200,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7554\/revisions\/11200"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7546"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}