Primary chemotherapy with adriamycin, cisplatin, vincristine and cyclophosphamide in locally advanced thymomas: a single institution experience

Berruti, Alfredo; Borasio, P.; Gerbino, Aldo; Gorzegno, G.; Moschini, T. O.; Tampellini, Marco; Ardissone, Francesco; Brizzi, Maria Pia; Dolcetti, A; Dogliotti, Luigi

doi:10.1038/sj.bjc.6690773

Cited by 80 publications

(48 citation statements)

References 26 publications

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“…Conversely, thymomas are generally reported to be chemotherapy-sensitive tumours, with response rates of 50 -70% to combination chemotherapy (Fornasiero et al, 1990;Loehrer et al, 1994Loehrer et al, , 1997Loehrer et al, , 2001Giaccone et al, 1996;Berruti et al, 1999;Kim et al, 2004;Lucchi et al, 2006;Yokoi et al, 2007). Active agents include cisplatin (CDDP), vincristine (VCR), doxorubicin (ADM), etoposide (ETP), cyclophosphamide (CPM) and ifosfamide (IFX).…”

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confidence: 99%

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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BACKGROUND: To evaluate the safety and efficacy of dose-dense weekly chemotherapy in the treatment of advanced thymoma. METHODS: Subjects comprised patients with histologically documented chemotherapy-naïve thymoma with stage-IVa or IVb disease. Thymic carcinoma, carcinoid or lymphoma cases were excluded. Patients received 9 weeks of chemotherapy: cisplatin (25 mg m À2 ) on weeks 1 -9; vincristine (1 mg m À2 ) on weeks 1, 2, 4, 6 and 8; and doxorubicin (40 mg m À2 ) and etoposide (80 mg m À2 ) on days 1 -3 of weeks 1, 3, 5, 7 and 9. Chemotherapy courses were supported by granulocyte colony-stimulating factor. Post-protocol local therapy was allowed. RESULTS: From July 1997 to March 2004, 30 patients were entered. Three were ineligible due to different histology. Chemotherapyassociated toxicity was mainly haematological and was well tolerated, with no deaths due to toxicity, and 87% of patients completed the planned 9-week regimen. Overall response rate was 59%, with 16 of the 27 eligible patients achieving partial response. Median progression-fee survival (PFS) was 0.79 years (95% confidence interval: 0.52 -1.40 years), and PFS at 1 and 2 years was 37 and 15%, respectively. Overall survival rates at 2 and 5 years were 89 and 65%, respectively. CONCLUSION: In stage-IV thymoma patients, weekly dose-dense chemotherapy offers similar activity to conventional regimens.

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A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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“…Limited data on the outcomes with neoadjuvant chemoradiotherapy are available [21]. The three available prospective studies included a total of 61 patients and ranged in sample size from 16 to 23 patients [31][32][33]. PAC (cyclophosphamide, doxorubicin, cisplatin) was the most commonly used chemotherapy regimen, although one trial investigated ADOC (cisplatin + doxorubicin, vincristine, and cyclophosphamide).…”

Section: Radiotherapymentioning

confidence: 99%

Unexpected Dramatic Response of Pretreated Invasive Thymic Malignancies on Pemetrexed-Case Report and Review of Current Treatment Modalities

Raman¹,

Surmont²

2012

OJRD

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Thymomas are rare and usually slowly growing tumors, originating from the epithelial layer of the thymus. Prognosis depends on the extent of invasion of adjacent tissues whereby multimodality treatment including surgery with or without adjuvant chemoradiotherapy is the preferred approach for locally advanced thymomas. For metastatic thymomas, only few chemotherapeutic options are available. We report 2 cases of patients with metastatic thymic malignancies with a dramatic response on pemetrexed treatment. The choice for this antifolate therapy is based upon a small series. Because metastatic thymic neoplasm is a rare disease, large randomised trials are not feasible. Case reports on the treatment of these malignancies are very important and can provide readers with the opportunity to deal with rare diseases.

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“…Several chemotherapy regimens have been used in this setting, mostly consisting of adriamycin-and/or platin-based multi-agent combinations (table 4, fig. 2) [78][79][80][81][82][83][84][85][86][87][88]. Usually two to four cycles of chemotherapy are administered before imaging reassessment.…”

Section: Chemotherapy Principlesmentioning

confidence: 99%

Thymic epithelial tumours: from basic principles to individualised treatment strategies

Girard¹

2013

Eur Respir Rev

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Thymic epithelial tumours represent a wide range of anatomical, clinical, histological and molecular malignant entities that may be aggressive and difficult to treat. The histopathological classification distinguishes thymomas from thymic carcinomas. Thymomas may be associated with autoimmune disorders.The management of thymic epithelial tumours is a paradigm of co-operation between clinicians, surgeons and pathologists, from establishing the diagnosis to organising the multimodal therapeutic strategy. Surgery is the mainstay of the curative-intent treatment, as complete resection represents the most significantly favourable prognostic factor on overall survival. In case of invasion of intra-thoracic structures and/or dissemination to the pleura and the pericardium, precluding complete resection to be achieved, primary chemotherapy has been used to reduce the tumour burden, possibly allowing subsequent surgery and/or radiotherapy.Novel strategies are needed, especially for refractory, recurrent tumours and thymic carcinomas, which carry a poor prognosis. Personalised approaches are currently being developed, as potentially ''druggable'' molecular targets are emerging from recent integrated genomic analyses. Along with the large variety of questions relative to the treatment strategy, thymic epithelial tumours represent a model of therapeutic implementation and achievement in orphan thoracic oncology, showing how the advent of new results induces new questions, as well as diversifies further clinical research directions and international collaborative initiatives.

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Primary chemotherapy with adriamycin, cisplatin, vincristine and cyclophosphamide in locally advanced thymomas: a single institution experience

Cited by 80 publications

References 26 publications

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

Unexpected Dramatic Response of Pretreated Invasive Thymic Malignancies on Pemetrexed-Case Report and Review of Current Treatment Modalities

Thymic epithelial tumours: from basic principles to individualised treatment strategies

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