甲狀腺髓樣癌的分子分型及治療

1、會計學1甲狀腺髓樣癌的分子分型及治療甲狀腺髓樣癌的分子分型及治療第1頁/共42頁第2頁/共42頁第3頁/共42頁第4頁/共42頁第5頁/共42頁p.C611YMEN2A第6頁/共42頁Somatic RET mutations第7頁/共42頁第8頁/共42頁第9頁/共42頁 Predictors of MTC progress, including recurrence and survival 第10頁/共42頁 Predictors of MTC progress, including recurrence and survival 第11頁/共42頁第12頁/共42頁第13頁/共42頁第

2、14頁/共42頁MEN2B-de novo RET p.M918T第15頁/共42頁MEN2B-de novo RET p.M918T第16頁/共42頁MEN2A-CLA, RET p.C634R/F第17頁/共42頁第18頁/共42頁第19頁/共42頁第20頁/共42頁第21頁/共42頁ATA-2015 Guidelines recommended第22頁/共42頁第23頁/共42頁第24頁/共42頁Female, 5.5yr; p.C634Y; bilateral MTC; DFS 6yr第25頁/共42頁第26頁/共42頁第27頁/共42頁第28頁/共42頁第29頁/共42頁第30頁/共

3、42頁 Two small-molecule TKIs, vandetanib (Apr 2011) and cabozantinib(Nov 2012), are currently available as approved agents for the treatment of advanced or progressive MTC and provide significant increases in progression-free survival (PFS). 第31頁/共42頁QT prolongation (14%),diarrhea (56%), rash (45%),

4、hypertension (32%), headache (26%).第32頁/共42頁Choice: The patients comorbid conditions and the toxicity profile that the patient is willing to bear 第33頁/共42頁第34頁/共42頁Preimplantation genetic diagnosis of multiple endocrine neoplasia type 2A using informative markers identified by targeted sequencingJ, Thyroid, 2017. (UR) 第35頁/共42頁第36頁/共42頁第37頁/共42頁 Predictors of MTC progress, including re