Comparison of efficacy and safety of carboplatin combined with nab-paclitaxel or paclitaxel as first-line therapy for advanced thymic epithelial tumors

Abstract

Background: Paclitaxel/carboplatin (PC) is the standard first-line chemotherapy for advanced thymoma and thymic carcinoma. However, although nanoparticle albumin-bound (nab)-PC and PC have exhibited efficacy in various solid tumors, data for thymic epithelial tumors are lacking, including a comparison of the efficacies of nab-PC and PC. Methods: We conducted a retrospective study to compare the efficacy and safety of nab-PC with PC in previously untreated patients with advanced thymoma and thymic carcinoma. We analyzed the objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs). Cox proportional hazards regression analyses were carried out to determine the factors independently associated with survival. Results: Ninety-one patients were enrolled from October 2006 to September 2021. The ORRs in patients treated with nab-PC and PC were 48.8% vs 36%, respectively (P=0.219). Among patients with thymic carcinoma, PFS differed between the nab-PC and PC groups (10.5 vs 6.3 months, P=0.0049); however, no such difference occurred in the thymoma group (13.8 vs 12.3 months, P=0.6948). The median OS was 27.4 months in 54 patients in thymic carcinoma, but was not reached for thymoma patients (P=0.0024). Conclusions: Nab-PC may be more effective than PC as first-line therapy in patients with advanced thymic epithelial tumors. Nab-PC could thus become an alternative regimen in patients with thymic epithelial tumors, especially thymic carcinoma.