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1 PAT21SS1046 PAT21SS1046 PAT21SS1046 2018 2019 1 93858148392 65840240043 40777220564 39103148885 20800182326 1708925977 1667058398 1384612439 13049473310 12148851411 1168885412 109782921 PAT21SS1046 PAT21SS1046 35-45 50-60 55-65 PAT21SS1046 PAT21SS1046 18 218-20 2 2 6 3 sexual intermitted infection International Collaboration of EpidemiololgicalStudies of Cervical Cancer, Int J Cancer.

2 2007;120(4):885,Castellsague, N EnglJ Med. 2002;346(15):1105, Anttila, JAMA Network. 2001;285(1):47,Castle, J Natl Cancer Inst. 2002;94(18):1406, International Collaboration of EpidemiololgicalStudies of Cervical Cancer , Lancet. 2007;370(9599):1609 PAT21SS1046 100 (HPV) 10 15% HPV HPV 100 HPV HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 82 HPV16/18 76 Munoz, N EnglJ Med. 2003 Feb 6;348(6):518-27, Inoue, Int J GynecolCancer, May-Jun 2006;16(3):1007-13 PAT21SS1046 HPV CIN1 CIN: cervical interepitherialneoplasia( CIN3 HPV CIN CIN212-16%90%22-25%High risk HPV: PAT21SS1046 HPV 10 Mark Schiffman, N Engl J Med 2013;369:2324-2331 PAT21SS10462 4 R (GlaxoSmith Kline R(Merck 16 /18 16 /18 /6/11 10 9 HPV16/18 HPV16,18, 6, 11 0, 1, 6 3 0, 2, 6 3 PATRICIAFUTURE I and II 15 25 16 26 HPV HPV16, HPV18 virus-like particle:VLP)Munoz, J Natl Cancer Inst 2010;102:325 339, Paavonen, Lancet 2009.))

3 374: 301 14 PAT21SS10469 9 R (MSD 16 /18 /6/11+31/33/45/52/58 10 HPV6/11/16/18/31/33/45/52/58 9 0, 2, 6 3 V503-003 16-26 HPV 2020 7 21 Huh, . Lancet 2017; 390: 2143-2159 PAT21SS1046 HPV 10 1 10 1 25 6 96 1 430 1 ADEM 430 1 crps 860 1 2013 3 PAT21SS1046 80 90 Cohortstudy 30-80% PAT21SS1046 PAT21SS1046 30-40 100% HPV)

4 16, 18 HPV 76% 2 4 9 90-100% 80% 90% PAT21SS1046I II 1/3 III 1/3 IV A: B: (FIGO2018) PAT21SS1046 74% 20% 3 3% 75% 20% 3% 3% 2016 PAT21SS1046 2017 IA PAT21SS1046 * 2017 PAT21SS1046 (GOG092) (GOG109) 79% vs.

5 88%HR: (p= )Sedlis, GynecolOncol. 1999 May;73(2):177-83 4 71% vs. 81%HR: (p= )Peters 3rd, J Clin Oncol. 2000 Apr;18(8):1606-13 PAT21SS1046 2017 Green, Lancet 2001; 358:781 vs. PAT21SS1046 ( 50Gy) 40mg/m2, weekly 5-6 ( 50Gy) 50mg/m2+5-Fu 4g/m2(96hours) , q28days 2 5-Fu5-FuPAT21SS1046 +- 18 R : 5 Ruhlmann, Lancet Oncol. 2016 Apr;17(4):509-518 CDDP 40mg/m2, weekly : 150mg : 161684 PAT21SS1046 Subhazardratio: (95% CI ), p= : 5 Ruhlmann, Lancet Oncol. 2016 Apr.

6 17(4):509-518 PAT21SS1046 community standard community standard 2017 PAT21SS1046 2017 PAT21SS1046 (1985) CDDP100 or 20 (2004) CDDP/PTX(TP) (2012)CBDCA/PTX (TC) 240 (2013) + * CDDP(50) TP TC +B-mab CDDP:cisplatin,PTX:paclitaxel,Topo:topot ecan,VRB:vinorerubine,GEM:gemcitabine,CB DCA:carboplatin,B-mab:bevacizumabPAT21SS 1046 HR= (95% CI, < ) (p= )Kitagawa, J Clin Oncol.

7 2015 Jul 1;33(19):2129-35 JCOG0505 TP CDDP:50mg/m2+PTX 135mg/m2, q 21 days 6TC CBDCA:AUC=5+PTX 175mg/m2, q 21 days 6*TP TC PAT21SS1046 HR= (95% CI, ) (p= ) B-mab GOG240 TP TT TP +B-mabTT +B-mab1)B-mab 2) (Top/PTX) Tewari, N EnglJ Med 2014;370 Chemo+B-mabTP: , TT: , B-mab: PAT21SS1046 % % p 07 3 1 <1 6 3 1 <1 13 6 G3 NA: not applicable 70% Tewari, N EnglJ Med 2014;370 Bestsupportivecare TC PTX/CBDCA + TP PTX/CDDP + * TC PTX/CBDCA TP PTX/CDDP CDDP:cisplatin,PTX:paclitaxel,CBDCA:carb oplatin PAT21SS1046 73 6 p659 2014 I 93%II 78%III 58%IV 30%PAT21SS1046 PAT21SS1046 2-10 (55 )2 2 3 2-4 2 2/1000 Smith RA, American Cancer Society Guidelines, CA Cancer J Clin.

8 2001 Jan-Feb;51(1):38-75 PAT21SS1046 40-55 (liquid 60-65%) * * PAT21SS1046 Yamagami, ;28(6):e76 G1 G2 G3 80 Grade 1: 50% Grade 2: 20%Grade 3: 10% 5 2 Type I low riskER, PgR Type II high riskER, PgR ER: PgR: PAT21SS1046I A 1/2 B 1/2 II III A B / C IIIC1: IIIC2: IV A B FIGO2008) PAT21SS1046 2018 G1/2 G1/2 <1/2 G1/2 1/2 G1/2 G3 <1/2 G3 / G3 1/2 / / / PAT21SS1046I II III IV 2cm 30%* 60% ** 90% **GOG99 ** , GOG122 10%* ( ) PAT21SS1046 FIGOIII-IV 2cm + 30Gy (20Fr)+15Gy (8Fr) AP* 8 * 60mg/m2, day1+ 50mg/m2, day1, q21days vs.

9 HR= (95% CI, ) (p= )* Randall, J Clin Oncol. 2006 Jan 1;24(1):36-44 GOG122 PAT21SS1046 Miller et al. J Clin Oncol, Nov20;38(33):3841-3850 GOG209 TC 7 TAP 7 TAP: 45mg/m2, day1+ 50mg/m2+ 160mg/m2, day1, q21daysTC: 175mg/m2, day1+ AUC=6, day1, q21days FIGO III-IV TAP TC TC 37 TAP 41 HR (90% CI ) PAT21SS1046 FIGOI-II (G2/3, 1/2)FIGO IIIFIGO IV ( ) AP 6AP: 60mg/m2, day1+ 50mg/m2, day1, q21daysDP: 70mg/m2, day1+ 60mg/m2, day1, q21daysTC: 180mg/m2, day1+ AUC=6, day1, q21daysNomura, JAMA ;5(6):833-840 JGOG2043 1 DP 6 2 TC 6*AP DP TC Patients surviving progression-freeYears since *60% TC 5% AP Japan Gynecologic Oncology GroupGOG209 TC ?

10 ! JGOG2043 AP community standard TC TC AP GOG209 JGOG2043 AP TC JGOG2043 *Watanabe, Gynecol Oncol. 2009 Dec;115(3):456-9 PAT21SS1046 GOG177 TAP 7 G-CSFAP 7 TAP: 45mg/m2, day1+ 50mg/m2+ 160mg/m2, day1, q21daysAP: 60mg/m2, day1+ 50mg/m2, day1, q21days *AP TAP Fleming, J Clin Oncol 2004, 22:2159HR= (95% CI, ) (p= ) AP vs. TAP G4 50% vs. 36% (G-CSF+) 0% vs. 2% 0% vs. 4%PAT21SS1046 GOG209 TC 7 TAP 7 TAP: 45mg/m2, day1+ 50mg/m2+ 160mg/m2, day1, q21daysTC: 175mg/m2, day1+ AUC=6, day1, q21days FIGO III-IV TAP TC TC 37 TAP 41 HR (90% CI ) Miller et al.