Phase II Study of Carboplatin and Paclitaxel in Advanced Thymoma and Thymic Carcinoma

Abstract

A B S T R A C T PurposeThe purpose of this study was to evaluate the impact of carboplatin and paclitaxel in patients with advanced previously untreated thymoma and thymic carcinoma. Patients and MethodsWe conducted a prospective multicenter study in patients with unresectable thymoma (n ϭ 21) or thymic carcinoma (n ϭ 23). Patients were treated with carboplatin (area under the curve, 6) plus paclitaxel (225 mg/m 2 ) every 3 weeks for a maximum of six cycles. The primary end point of this trial was to evaluate the objective response rate. ResultsFrom February 2001 through January 2008, 46 patients were enrolled. Thirteen patients had grade 4 or greater toxicity, mostly neutropenia. Using RECIST (Response Evaluation Criteria in Solid Tumors) 1.0 criteria, three complete responses (CRs) and six partial responses (PRs; objective response rate [ORR], 42.9%; 90% CI, 24.5% to 62.8%) were observed in the thymoma cohort; 10 patients had stable disease. For patients with thymic carcinoma, no CRs and five PRs (ORR, 21.7%; 90% CI, 9.0% to 40.4%) were observed; 12 patients had stable disease. Progression-free survival (PFS) was 16.7 (95% CI, 7.2 to 19.8) and 5.0 (95% CI, 3.0 to 8.3) months for thymoma and thymic carcinoma cohorts, respectively. To date, only seven patients (33.3%) with thymoma have died, compared with 16 patients (69.6%) with thymic carcinoma. Median survival time was 20.0 months (95% CI, 5.0 to 43.6 months) for patients with thymic carcinoma, but it has not been reached for patients with thymoma. ConclusionCarboplatin plus paclitaxel has moderate clinical activity for patients with thymic malignancies, but this seems less than expected with anthracycline-based therapy. Patients with thymic carcinoma have poorer PFS and overall survival than patients with thymoma.

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

“…The most effective therapeutic modality for treating thymic carcinoma is surgical complete resection (1,2), which increases the 5-year overall survival (OS) from 33.3%-65.0% to 53.0%-65.7% (3)(4)(5)(6)(7)(8). Moreover, thymic carcinoma is widely recognized to respond poorly to many chemotherapeutic agents, with an objective response rate of 20%-36%, although concomitant administration of carboplatin and paclitaxel yields longer survival (9,10). Second-line treatments have also met with varying degrees of success, whereas therapeutic efficacy of sunitinib, an oral tyrosine kinase inhibitor, was recently reported in refractory patients previously treated with platinum-based chemotherapy (11).…”

Expression of excision repair cross-complementation group 1 and class III β-tubulin in thymic carcinoma

“…CP chemotherapy is another regimen for thymic malignant tumors, thymic carcinomas and thymomas. To a certain degree, case reports and small-size clinical trials reported the effectiveness of CP regimens for thymic malignant tumors (26)(27)(28)(29). However, one of the remarkable problems in those previous studies was that they examined thymic epithelial malignant tumors without separating them from thymic carcinoma and thymoma.…”

Successful chemotherapy with carboplatin and nab-paclitaxel for thymic large cell neuroendocrine carcinoma: A case report

“…Therefore, carboplatin-based, cisplatin, doxorubicin, vincristine and cyclophosphamide, and cisplatin, vincristine, doxorubicin and etoposide regimens may be suitable treatment options for patients with thymic LCNECs (12)(13)(14)(15)(16)(17). However, the optimal regimen for second or subsequent lines of chemotherapy for the treatment of thymic carcinoma remains unclear.…”