JP6059405B2 - 癌の免疫学的治療に有用な生物学的マーカー - Google Patents
癌の免疫学的治療に有用な生物学的マーカー Download PDFInfo
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- JP6059405B2 JP6059405B2 JP2016518278A JP2016518278A JP6059405B2 JP 6059405 B2 JP6059405 B2 JP 6059405B2 JP 2016518278 A JP2016518278 A JP 2016518278A JP 2016518278 A JP2016518278 A JP 2016518278A JP 6059405 B2 JP6059405 B2 JP 6059405B2
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Description
エオタキシン−1(CCL11とも称する)、エオタキシン−2(CCL24とも称する)及びエオタキシン−3(CCL26とも称する)は、好酸球(eosinophils)及び他の白血球(leukocyte)を募集するケモカイン(chemokines)であると知られており、また細胞表面ケモカイン受容体(例:CCR3)に付着し、それらの効果を導き出す。
「GV1001」は、配列番号1:EARPALLTSRLRFIPKを有するテロメラーゼ由来ペプチドを示す。
臨床は、1,062人の患者をイギリス各地の52ヵ所センターで募集した。ワクチンを投与された群と、化学的治療法(GemCap therapy;以下を参照)を投与された対照群との間で、全生存率(overall survival)の確実な違いはなかったが、橋渡し研究(translational research)の鼓舞的なプログラムを含み、それについては、依然として研究が進行中である。しかし、本発明によるワクチンが、抗炎反応において、確実な差を有するという結果を示し、化学的療法と共に同時的なワクチン接種は、免疫反応及び抗炎効果をいずれも起こす効果的な方法を提供すると分かった。重要な点は、一部患者群において、ワクチンに対応して増加した生存を示す生物学的マーカーが明らかにされたということである。
TeloVac臨床は、局所的な進行性膵臓癌及び転移性膵臓癌において、2007年1月始まり、ゲムシタビンとカペシタビンとの組み合わせ治療法(GemCap)と、GV1001とを使用してなされる併用及び順次的な化学・免疫的治療方法との比較が行われた。
図25は、採択されたワクチン接種スケジュールをしめし、GV1001の皮内注射は、1週目(week 1)に3回(望ましくは、月曜日、水曜日及び金曜日)行われ、2週目、3週目、4週目及び6週目に、週1回ずつさらに行われた。その後、GV1001は、1ヵ月に1回投与された。顆粒球マクロファージコロニー刺激因子(GM−CSF:granulocyte-macrophage colony-stimulating factor)は、別途に注射され、GV1001注射の10ないし15分前に、ほぼ同じな部位に皮内注射された。
1週目(ベースライン)及び10週目(ゲムシタビン+カペシタビン+GV1001)で得た血清サンプル(第3患者群のみ)がルミネックスマルチプレックスサイトカイン分析法(Luminex multiplex cytokine analysis)で分析された。総26個サイトカインが分析され、CRPレベルはELISAde分析された。
分析されたサンプルの概要:
テストされたいくつかのサイトカインのグループ化:
免疫刺激機能と係わる因子:
INF−γ 免疫刺激
IL−12(p70) 免疫刺激
IL−1β 免疫刺激
IL−6 免疫刺激
TNF−α 免疫刺激
免疫低下機能と係わる因子:
IL−10 免疫抑制
IL−1Ra 免疫抑制
IL−4 免疫抑制
VEGF 免疫抑制
化学性機能と係わる因子:
Eotaxin 化学走性
IL−8 化学走性
IP−10 化学走性
MCP−1 化学走性
MIP−1α 化学走性
MIP−1β 化学走性
RANTES 化学走性
血管再生性と係わる因子:
FGF basic 血管リモデリング
PDGF−BB 血管リモデリング
VEGF 血管リモデリング
サイトカイン結果:第2患者群及び第3患者群に対して、ベースラインにおいて、(すなわち、治療前)、第2患者群(GemCap)に対して治療7週目において、及び第3患者群(GemCap及びGV1001)に対して治療10週目において得た血清サンプル間のクラスカル・ワリス(Kruskal−Wallis)比較を下記表1に示す。クラスカル・ワリス試験において著しいレベル差を示す18個サイトカインが示され、続いてボンフェローニ・ホルム(Bonferroni-Holm)検定を経た後には、8個のサイトカインが著しいレベルの差を示した。
結果は、表1ないし表6、及び図1ないし図24に示した。
GemCapのみ使用した治療と比較するとき、GV1001/GemCap併用治療後には、7個のサイトカイン(IL−4、IL−5、IL−7、IL−17、PDGF、VEGF及びRANTES)が著しく高まったレベルを示した。未加工の非校正2テイルドマン・ホイットニー(crude uncorrected 2−tailed Mann-Whitney)では、PDGF(p<0.0001)及びRANTES(p=0.002)を使用したものが、最も著しく高いレベルを示した。次に、ボンフェローニ・ホルム校正を経た後にも、前記2つの結果は、著しく高レベルを示した(表2及び図1を参照)。
表1は、第2患者群及び第3患者群において、ベースライン、第2患者群において、7週目(GemCap)、及び第3患者群において、10週目(GemCap及びGV1001)で得た血清間のクラスカル・ワリス(Kruskal−Wallis)比較を示している。
マン・ホイットニー分析では、GemCapのみを投与された第2患者群において、7週目に得た血清サンプルと比較するとき、GemCapとGV1001とを受けた第3患者群において、10週目に得た血清サンプルにおいて、IL−17、IL−4、IL−5、IL−7、PDGF、RANTES及びVEGFのレベルが著しい上昇を示した。しかし、後続的なボンフェローニ・ホルム(Bonferroni−Holm)検定を経て、PDGFだけが著しい結果として残った。第2患者群及び第3患者群において、ベースライン及び治療後において、IL−17、IL−4、IL−5、IL−7、PDGF、RANTES及びVEGFのサイトカイン比較グラフは、図1に示した。
●第2患者群に対して、ベースライン及び後続的な7週目において、GemCap治療
●第3患者群に対して、ベースライン及び後続的な10週目において、GemCap及びGV1001治療。そのテストの全体p値結果は、表3に示した。
第2患者群及び第3患者群において得たp値において、明確に異なる点があった。対応ウィルコクソン(Wilcoxon)分析において、第2患者群に対して、ベースラインと7週間のGemCap治療後との間で、19個のサイトカインレベルの著しい差があるということが分かり、それに対する後続的なボンフェローニ・ホルム検定を経て、10個のサイトカインに低下した。しかし、第3患者群は、GM−CSFだけが、ベースラインと10週間のGV1001/GemCap治療後との間で、顕著である(p=0.052)に逹したが、後続的なボンフェローニ・ホルム検定を経れば、それ以上有意なものではなかった。
血清CRPレベルも分析された。図3は、第2患者群及び第3患者群において、ベースライン及び治療後における血清CRPレベルを示している。データは、ベースラインでは、CRPレベルの著しい差がないということを示しているが、治療後での分析は、著しい差があり、それは、GV1001/GemCapを受けた患者のレベルが、GemCapのみを受けた患者に比べ、著しく低いということを示している。表4は、CRPデータの要約統計を、患者群と、ベースライン及び治療後とに分けて示している。
サイトカイン結果:
第1患者群に対して、14週目(GemCap)、及び第3患者群に対して、14週目(GemCap及びGV1001)における血漿サンプル間の比較は、表4に示したが、そこには著しい差がない。第1患者群26週目(GemCap)及び第3患者群26週目(GemCap及びGV1001)における血漿サンプル間の比較は、表5に示してあるが、そこには著しい差がない。
血清サイトカイン:
ベースライン、治療後、及びサイトカインレベルの絶対値変化において、初期生存値分析は、IL−8(図5参照)、エオタキシン(図6参照)、MIP1α(図7参照)、MIP1β(図8参照)及びVEGF(図9参照)と共に、一方または双方の治療患者群において、生存値に対する影響を示した。
初期生存値分析が、ベースラインCRPの生存値に対する影響を表示するとしても、それは、著しい値に至るものではない。しかし、第3患者群において、治療後CRPレベルは、生存値偏差と著しく関連して示され(高CRPにおいて、生存中央値は222日、低いCRPにおいて、生存中央値は486日、p=0.002、図11参照)、それは、第2患者群においては、示されていない(図10参照)。
配列番号1; GV1001 amino acid sequence:
EARPALLTSRLRFIPK
MKVSAALLWLLLIAAAFSPQGLAGPASVPTTCCFNLANRKIPLQRLESYRRITSGKCPQKAVIFKTKLAKDICADPKKKWVQDSMKYLDQKSPTPKP
MAGLMTIVTSLLFLGVCAHHIIPTGSVVIPSPCCMFFVSKRIPENRVVSYQLSSRSTCLKAGVIFTTKKGQQFCGDPKQEWVQRYMKNLDAKQKKASPRARAVAVKGPVQRYPGNQTTC
MMGLSLASAVLLASLLSLHLGTATRGSDISKTCCFQYSHKPLPWTWVRSYEFTSNSCSQRAVIFTTKRGKKVCTHPRKKWVQKYISLLKTPKQL
ATGGGCAAAGGCTTCCCTGGAATCTCCCACACTGTCTGCTCCCTATAAAAGGCAGGCAGATGGGCCAGAGGAGCAGAGAGGCTGAGACCAACCCAGAAACCACCACCTCTCACGCCAAAGCTCACACCTTCAGCCTCCAACATGAAGGTCTCCGCAGCACTTCTGTGGCTGCTGCTCATAGCAGCTGCCTTCAGCCCCCAGGGGCTCGCTGGGCCAGCTTCTGTCCCAACCACCTGCTGCTTTAACCTGGCCAATAGGAAGATACCCCTTCAGCGACTAGAGAGCTACAGGAGAATCACCAGTGGCAAATGTCCCCAGAAAGCTGTGATCTTCAAGACCAAACTGGCCAAGGATATCTGTGCCGACCCCAAGAAGAAGTGGGTGCAGGATTCCATGAAGTATCTGGACCAAAAATCTCCAACTCCAAAGCCATAAATAATCACCATTTTTGAAACCAAACCAGAGCCTGAGTGTTGCCTAATTTGTTTTCCCTTCTTACAATGCATTCTGAGGTAACCTCATTATCAGTCCAAAGGGCATGGGTTTTATTATATATATATATTTTTTTTTTTAAAAAAAAAACGTATTGCATTTAATTTATTGAGGCTTTAAAACTTATCCTCCATGAATATCAGTTATTTTTAAACTGTAAAGCTTTGTGCAGATTCTTTACCCCCTGGGAGCCCCAATTCGATCCCCTGTCACGTGTGGGCAATGTTCCCCCTCTCCTCTCTTCCTCCCTGGAATCTTGTAAAGGTCCTGGCAAAGATGATCAGTATGAAAATGTCATTGTTCTTGTGAACCCAAAGTGTGACTCATTAAATGGAAGTAAATGTTGTTTTAGGAATACATAAAGTATGTGCATATTTTATTATAGTCACTAGTTGTAATTTTTTTGTGGGAAATCCACACTGAGCTGAGGGGG
ATGGCAGGCCTGATGACCATAGTAACCAGCCTTCTGTTCCTTGGTGTCTGTGCCCACCACATCATCCCTACGGGCTCTGTGGTCATCCCCTCTCCCTGCTGCATGTTCTTTGTTTCCAAGAGAATTCCTGAGAACCGAGTGGTCAGCTACCAGCTGTCCAGCAGGAGCACATGCCTCAAGGCAGGAGTGATCTTCACCACCAAGAAGGGCCAGCAGTTCTGTGGCGACCCCAAGCAGGAGTGGGTCCAGAGGTACATGAAGAACCTGGACGCCAAGCAGAAGAAGGCTTCCCCTAGGGCCAGGGCAGTGGCTGTCAAGGGCCCTGTCCAGAGATATCCTGGCAACCAAACCACCTGCTAA
CTGGAATTGAGGCTGAGCCAAAGACCCCAGGGCCGTCTCAGTCTCATAAAAGGGGATCAGGCAGGAGGAGTTTGGGAGAAACCTGAGAAGGGCCTGATTTGCAGCATCATGATGGGCCTCTCCTTGGCCTCTGCTGTGCTCCTGGCCTCCCTCCTGAGTCTCCACCTTGGAACTGCCACACGTGGGAGTGACATATCCAAGACCTGCTGCTTCCAATACAGCCACAAGCCCCTTCCCTGGACCTGGGTGCGAAGCTATGAATTCACCAGTAACAGCTGCTCCCAGCGGGCTGTGATATTCACTACCAAAAGAGGCAAGAAAGTCTGTACCCATCCAAGGAAAAAATGGGTGCAAAAATACATTTCTTTACTGAAAACTCCGAAACAATTGTGACTCAGCTGAATTTTCATCCGAGGACGCTTGGACCCCGCTCTTGGCTCTGCAGCCCTCTGGGGAGCCTGCGGAATCTTTTCTGAAGGCTACATGGACCCGCTGGGGAGGAGAGGGTGTTTCCTCCCAGAGTTACTTTAATAAAGGTTGTTCATAGAGTTGACTTGTTCAT
MEKLLCFLVLTSLSHAFGQTDMSRKAFVFPKESDTSYVSLKAPLTKPLKAFTVCLHFYTELSSTHEINTIYLGGPFSPNVLNWRALKYEVQGEVFTKPQLWP
AAGGCAAGAGATCTAGGACTTCTAGCCCCTGAACTTTCAGCCGAATACATCTTTTCCAAAGGAGTGAATTCAGGCCCTTGTATCACTGGCAGCAGGACGTGACCATGGAGAAGCTGTTGTGTTTCTTGGTCTTGACCAGCCTCTCTCATGCTTTTGGCCAGACAGACATGTCGAGGAAGGCTTTTGTGTTTCCCAAAGAGTCGGATACTTCCTATGTATCCCTCAAAGCACCGTTAACGAAGCCTCTCAAAGCCTTCACTGTGTGCCTCCACTTCTACACGGAACTGTCCTCGACCCGTGGGTACAGTATTTTCTCGTATGCCACCAAGAGACAAGACAATGAGATTCTCATATTTTGGTCTAAGGATATAGGATACAGTTTTACAGTGGGTGGGTCTGAAATATTATTCGAGGTTCCTGAAGTCACAGTAGCTCCAGTACACATTTGTACAAGCTGGGAGTCCGCCTCAGGGATCGTGGAGTTCTGGGTAGATGGGAAGCCCAGGGTGAGGAAGAGTCTGAAGAAGGGATACACTGTGGGGGCAGAAGCAAGCATCATCTTGGGGCAGGAGCAGGATTCCTTCGGTGGGAACTTTGAAGGAAGCCAGTCCCTGGTGGGAGACATTGGAAATGTGAACATGTGGGACTTTGTGCTGTCACCAGATGAGATTAACACCATCTATCTTGGCGGGCCCTTCAGTCCTAATGTCCTGAACTGGCGGGCACTGAAGTATGAAGTGCAAGGCGAAGTGTTCACCAAACCCCAGCTGTGGCCCTGAGGCCCAGCTGTGGGTCCTGAAGGTACCTCCCGGTTTTTTACACCGCATGGGCCCCACGTCTCTGTCTCTGGTACCTCCCGCTTTTTTACACTGCATGGTTCCCACGTCTCTGTCTCTGGGCCTTTGTTCCCCTATATGCATTGCAGGCCTGCTCCACCCTCCTCAGCGCCTGAGAATGGAGGTAAAGTGTCTGGTCTGGGAGCTCGTTAACTATGCTGGGAAACGGTCCAAAAGAATCAGAATTTGAGGTGTTTTGTTTTCATTTTTATTTCAAGTTGGACAGATCTTGGAGATAATTTCTTACCTCACATAGATGAGAAAACTAACACCCAGAAAGGAGAAATGATGTTATAAAAAACTCATAAGGCAAGAGCTGAGAAGGAAGCGCTGATCTTCTATTTAATTCCCCACCCATGACCCCCAGAAAGCAGGAGGGCATTGCCCACATTCACAGGGCTCTTCAGTCTCAGAATCAGGACACTGGCCAGGTGTCTGGTTTGGGTCCAGAGTGCTCATCATCATGTCATAGAACTGCTGGGCCCAGGTCTCCTGAAATGGGAAGCCCAGCAATACCACGCAGTCCCTCCACTTTCTCAAAGCACACTGGAAAGGCCATTAGAATTGCCCCAGCAGAGCAGATCTGCTTTTTTTCCAGAGCAAAATGAAGCACTAGGTATAAATATGTTGTTACTGCCAAGAACTTAAATGACTGGTTTTTGTTTGCTTGCAGTGCTTTCTTAATTTTATGGCTCTTCTGGGAAACTCCTCCCCTTTTCCACACGAACCTTGTGGGGCTGTGAATTCTTTCTTCATCCCCGCATTCCCAATATACCCAGGCCACAAGAGTGGACGTGAACCACAGGGTGTCCTGTCAGAGGAGCCCATCTCCCATCTCCCCAGCTCCCTATCTGGAGGATAGTTGGATAGTTACGTGTTCCTAGCAGGACCAACTACAGTCTTCCCAAGGATTGAGTTATGGACTTTGGGAGTGAGACATCTTCTTGCTGCTGGATTTCCAAGCTGAGAGGACGTGAACCTGGGACCACCAGTAGCCATCTTGTTTGCCACATGGAGAGAGACTGTGAGGACAGAAGCCAAACTGGAAGTGGAGGAGCCAAGGGATTGACAAACAACAGAGCCTTGACCACGTGGAGTCTCTGAATCAGCCTTGTCTGGAACCAGATCTACACCTGGACTGCCCAGGTCTATAAGCCAATAAAGCCCCTGTTTACTTGAAAAAAAAAA
MQVSTAALAVLLCTMALCNQFSASLAADTPTACCFSYTSRQIPQNFIADYFETSSQCSKPGVIFLTKRSRQVCADPSEEWVQKYVSDLELSA
AGCTGGTTTCAGACTTCAGAAGGACACGGGCAGCAGACAGTGGTCAGTCCTTTCTTGGCTCTGCTGACACTCGAGCCCACATTCCGTCACCTGCTCAGAATCATGCAGGTCTCCACTGCTGCCCTTGCTGTCCTCCTCTGCACCATGGCTCTCTGCAACCAGTTCTCTGCATCACTTGCTGCTGACACGCCGACCGCCTGCTGCTTCAGCTACACCTCCCGGCAGATTCCACAGAATTTCATAGCTGACTACTTTGAGACGAGCAGCCAGTGCTCCAAGCCCGGTGTCATCTTCCTAACCAAGCGAAGCCGGCAGGTCTGTGCTGACCCCAGTGAGGAGTGGGTCCAGAAATATGTCAGCGACCTGGAGCTGAGTGCCTGAGGGGTCCAGAAGCTTCGAGGCCCAGCGACCTCGGTGGGCCCAGTGGGGAGGAGCAGGAGCCTGAGCCTTGGGAACATGCGTGTGACCTCCACAGCTACCTCTTCTATGGACTGGTTGTTGCCAAACAGCCACACTGTGGGACTCTTCTTAACTTAAATTTTAATTTATTTATACTATTTAGTTTTTGTAATTTATTTTCGATTTCACAGTGTGTTTGTGATTGTTTGCTCTGAGAGTTCCCCTGTCCCCTCCCCCTTCCCTCACACCGCGTCTGGTGACAACCGAGTGGCTGTCATCAGCCTGTGTAGGCAGTCATGGCACCAAAGCCACCAGACTGACAAATGTGTATCGGATGCTTTTGTTCAGGGCTGTGATCGGCCTGGGGAAATAATAAAGATGCTCTTTTAAAAGGTAAAAAAAAAAAAAAAAAAA
Claims (20)
- 個体への抗癌又は抗炎症処置のための組成物であって、活性成分として配列番号1からなるポリペプチドを含み、
ここで、各個体の血清中のエオタキシンレベル(w/v)が測定され、同一の癌又は炎症症状を患う個体群平均と比較して、前記エオタキシンレベルの値が少なくとも10%の増大を示す場合に前記組成物が投与される、前記組成物。 - 膵臓癌患者の処置のための抗癌組成物であることによって特徴づけられる、請求項1に記載の組成物。
- CRPレベル(w/v)が各個人の血清中でさらに測定され、ここで、同一の癌又は炎症症状を患う個体群平均と比較して、前記CRPレベルの値が少なくとも10%の減少を示す場合に前記組成物が投与される、請求項1又は2に記載の組成物。
- 化学的療法剤の投与と同時に投与される、請求項1又は2に記載の組成物。
- 前記化学的療法剤が、ゲムシタビン又はフルオロピリミジンから選択される1つ又はそれ以上である、請求項4に記載の組成物。
- 前記フルオロピリミジンが5−フルオロウラシル又はカペシタビンである、請求項5に記載の組成物。
- アジュバントと組み合わせて投与される、請求項1又は2に記載の組成物。
- 前記アジュバントがサイトカインアジュバントである、請求項7に記載の組成物。
- 前記サイトカインアジュバントが、顆粒球マクロファージコロニー刺激因子(GM−CSF)である、請求項8に記載の組成物。
- 局所的な進行性膵臓癌及び転移性膵臓癌の処置用である、請求項1又は2に記載の組成物。
- 経口投与又は非経口投与される、請求項1又は2に記載の組成物。
- 前記処置の開始より前に測定された血清中のCRPレベルと比較して、前記処置の初期段階以後、前記個体が10%超の血清中のCRPレベルの減少を示す場合、前記初期段階以後に投与が継続される、請求項1又は2に記載の組成物。
- 血清レベルの測定がインビトロで行われる、請求項1又は2に記載の組成物。
- a)請求項1又は2に記載の抗癌又は抗炎症処置のための組成物、及び
b)少なくとも1つの細胞増殖抑制剤又は細胞毒性剤
を含む、抗癌又は抗炎症処置のためのキット。 - ゲムシタビン及びカペシタビン(GemCap)を含む、請求項14に記載のキット。
- サイトカインアジュバントとしての顆粒球マクロファージコロニー刺激因子(GM−CSF)を含む、請求項14に記載のキット。
- a)請求項1又は2に記載の組成物、及び
b)エオタキシンの血清濃度測定手段を含む、抗癌又は抗炎症処置のためのキット。 - ゲムシタビン及びカペシタビン(GemCap)、並びにサイトカインアジュバントとしての顆粒球マクロファージコロニー刺激因子(GM−CSF)を含む、請求項17に記載のキット。
- 膵臓癌を処置するための抗癌ワクチンであって、局所的な進行性膵臓癌及び転移性膵臓癌の処置用のワクチンであり、活性成分として配列番号1からなるポリペプチドを含み、
ここで、各個体の血清中のエオタキシンレベル(w/v)が測定され、同一の癌又は炎症症状を患う個体群平均と比較して、前記エオタキシンレベルの値が少なくとも10%の増大を示す場合に前記抗癌ワクチンは投与され、
前記抗癌ワクチンは、サイトカインアジュバントとしての顆粒球マクロファージコロニー刺激因子(GM−CSF)と組み合わせて投与され、そして
前記抗癌ワクチンは、抗癌化学的療法剤であるゲムシタビン及びカペシタビンと同時に投与される、前記抗癌ワクチン。 - アジュバントであるGM−CSFは、下腹部に皮内投与され、そして10〜15分後に、活性成分であるポリペプチドが、GM−CSFと同一の部位に皮内投与され、ここでGM−CSF及び前記ポリペプチドは、1週目に3回投与され、その後2週目、3週目、4週目及び6週目に、週1回ずつ投与され、その後4週ごとに投与される、請求項19に記載の抗癌ワクチン。
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ES2962532T3 (es) | 2014-04-30 | 2024-03-19 | Gemvax & Kael Co Ltd | Composición para el trasplante de órganos, tejidos o células, kit y procedimiento de trasplante |
KR102413243B1 (ko) | 2014-12-23 | 2022-06-27 | 주식회사 젬백스앤카엘 | 안질환 치료 펩티드 및 이를 포함하는 안질환 치료용 조성물 |
WO2016137162A1 (ko) | 2015-02-27 | 2016-09-01 | 주식회사 젬백스앤카엘 | 청력 손상 방어용 펩타이드 및 이를 포함하는 조성물 |
CN108431021B (zh) | 2015-11-03 | 2021-09-07 | 珍白斯凯尔有限公司 | 具有神经元损失预防和再生效果的肽以及包含该肽的组合物 |
KR20170054310A (ko) | 2015-11-09 | 2017-05-17 | 주식회사 젬백스앤카엘 | 텔로머라제 유래 펩티드를 포함하는 수지상세포 치료제 및 면역 치료제, 및 이를 사용하는 치료방법 |
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