대한위장관기질종양연구회
01 GIST 06 02 11 03 Imatinib 14
04 05 06 07 Sunitinib 32 40 44 48
GIST 6
01 7 GIST Guide book
GIST 8
01 9 GIST Guide book
GIST (CT) MRI FDG-PET 10
02 11 GIST Guide book
12
02 (Imatinib) (Sunitinib) 13 GIST Guide book
(Imatinib) (KIT/PDGFRA) (KIT/PDGFRA) 14
03 100 80 60 40 20 0 1 2 3 4 5 15 GIST Guide book
(Imatinib) 1.0 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 0 6 12 18 24 30 36 42 48 54 60 16
03 100 90 80 70 60 50 40 30 20 10 0 177 181 HR0.46(95%(0.31-0.68);p<0.0001 0 1 2 3 4 5 6 7 Years 167 163 88.1% 62.1% 157 126 121 81 67.4% 50.3% 71 81 35 25 7 10 0 0 100 90 80 70 60 50 40 30 20 10 0 198 199 HR0.45(95%(0.22-0.89);p<0.019 0 1 2 3 4 5 6 7 Years 192 188 96.3% 92.0% 94.0% 184 176 152 140 81.7% 100 87 56 46 13 20 0 0 17 GIST Guide book
(Imatinib) 100 90 80 70 60 50 40 30 20 10 0 imatinib HR0.50(95%(10.25-0.98);p<0.041 0 6 12 18 24 30 36 42 48 Time(months) 119 58 32 13 4 imatinib123 74 43 19 4 100 90 80 70 60 50 40 30 20 10 0 imatinib HR0.29(95%(10.16-0.55);p<0.0001 0 6 12 18 24 30 36 42 48 Time(months) 86 35 10 1 0 imatinib 93 51 21 2 0 18
Q 1. A1. Q 2. 03 A2. Q 3. A3. 19 GIST Guide book
(Imatinib) 01 02 03 04 05 20
01 06 07 03 08 09 10 11 21 GIST Guide book
(Imatinib) 22
03 23 GIST Guide book
(Imatinib) 24
03 25 GIST Guide book
(Imatinib) 26
03 27 GIST Guide book
(Imatinib) 28
03 29 GIST Guide book
(Imatinib) 30
03 31 GIST Guide book
(Sunitinib) 32
04 33 GIST Guide book
(Sunitinib) Estimated TTP probability(%) 100 50 (n=105) Median: 6.4 week(1.5 months) (95% CI: 4.4,10.0) (n=207) 67% reduced risk of progression Median: 27.3 week(6.3 months) (95% CI: 16.0, 32.1) 0 0 10 20 30 40 50 Time(weeks) HR0.33(95%(0.23-0.47);p<0.0001 34
01 04 35 GIST Guide book
(Sunitinib) 36
01 04 37 GIST Guide book
(Sunitinib) 38
01 04 39 GIST Guide book
Q Q Q 40
Q Q Q 05 41 GIST Guide book
Q Q Q 42
01 Q Q Q 03 05 43 GIST Guide book
44
06 45 GIST Guide book
46
06 47 GIST Guide book
1. 2. 3. 4. 5. 48
1. 2. 2006 3. http://www.cancer.go.kr 4. GIST GIST 2009 0523 5. GIST Glivec GIST 2009 0523 6. ( ) http://kr.blog.yahoo.com/ralrlghd0825/1049 7. Jean-Yves Baly,Peter Rechardt,Advanced gastrointestinal stromal tumor in Europe:a review of updataed treatment recommendations.expert Rev.Anticancer Ther.9(6),831-838(2009) 8. Jean-Yves Baly,Antoine Aadenis,Isabelle Ray-Coquard,Philippe A.Cassier and Axel Le Cesne. Is there a role for discontinuing imatinib in patients with advanced gastrointestinal stromal tumor?,current Opinion in Oncology 2009,21:360-366 9. A Phase II Study of Imatinib Mesylate as Adjuvant Treatment for Curatively Resected High-Risk Localized Gastrointestinal Stromal Tumors With C-Kit Exon11 Mutation 10. NCCN Clinical Practice Guidelines in Oncology, version 2, 2011 11. Joensuu H, et al. J Clin Oncol. 2011;29(suppl):Abstract LBA1 12. Schoffisk P, Huang X, Casali PG, et al. Phanse III trial of sunitinib in imatinib-resistant/intolerant GIST with novel statistical analysis of long-term survival to account for crossover (oral presentation). Presented at the 33rd Annual Meeting of the European Society for Medical Oncology (ESMO); Sep 12-16, 2008: Stockholm, Sweden. 13. Demetri GD, Huang X, Garrett CR, et al. Novel statistical analysis of long-term survival to account for crossover in a phase trial of sunitinib versus placebo in advanced GIST after imatinib failure. Paper presented at: 44th Annual Meeting of the American society of Clinical Oncology; May 30-June 3, 2008; Chicago, IL. Abstract 10524. 14. Demetri GD, van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomized controlled trial. Lancet. 2006;368(9544): 1329-1338. 15. SUTENE 49 GIST Guide book 07
2012~2013 1 JAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 5 MAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 9 SEP 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 30 24 25 26 27 28 29 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 1 2 3 4 5 6 7 7 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 2 FEB 2012 6 JUN 10 OCT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 3 MAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 7 JUL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 11 NOV 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 4 APR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 8 AUG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 12 DEC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 30 31 25 26 27 28 29 2013 1 JAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2 FEB 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 MAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 31 25 26 27 28 29 30 4 APR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 5 MAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 6 JUN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 30 24 25 26 27 28 29 7 JUL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 8 AUG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 9 SEP 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 10 OCT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 11 NOV 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 12 DEC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
2014~2015 2014 1 JAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2 FEB 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 MAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 30 31 25 26 27 28 29 4 APR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 5 MAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 6 JUN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 7 JUL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 8 AUG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 31 25 26 27 28 29 30 9 SEP 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 10 OCT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 11 NOV 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 30 24 25 26 27 28 29 12 DEC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2015 1 JAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2 FEB 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 MAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 4 APR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 5 MAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 31 25 26 27 28 29 30 6 JUN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 7 JUL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 8 AUG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 30 31 25 26 27 28 29 9 SEP 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 10 OCT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 11 NOV 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 12 DEC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31