Successful Treatment of Advanced Thymic Carcinoma with Carboplatin plus <b><i>nab</i></b>-Paclitaxel and Maintenance Monotherapy with <b><i>nab</i></b>-Paclitaxel: Two Case Reports

Abstract

A standard chemotherapy regimen for advanced thymic carcinoma has not yet been established. We treated 2 cases of thymic carcinoma with carboplatin plus nanoparticle albumin-bound (&lt;i&gt;nab&lt;/i&gt;)-paclitaxel, and &lt;i&gt;nab&lt;/i&gt;-paclitaxel maintenance therapy. The first case was a 68-year-old female, admitted for dyspnea and left shoulder pain. Chest computed tomography (CT) showed a huge mass in the anterior mediastinum, pleural and pericardial effusions, and multiple lung metastases. Specimens obtained from the anterior mediastinal mass by CT-guided needle biopsy revealed squamous cell carcinoma of the thymus, which was in stage IVB. The patient was administered carboplatin plus &lt;i&gt;nab&lt;/i&gt;-paclitaxel as first-line treatment. After 3 cycles of chemotherapy, a partial response was observed with marked shrinkage of the tumor. Following 6 cycles of chemotherapy, &lt;i&gt;nab&lt;/i&gt;-paclitaxel maintenance therapy was initiated. Disease progression was seen 9.1 months after initiation of treatment. The patient experienced no serious adverse events. The second case was a 70-year-old male who had productive cough, dyspnea, and right-sided chest pain. Chest CT revealed a huge mass in the anterior mediastinum, pericardial effusion, and multiple lymphadenopathies. Specimens obtained from station 11s by endobronchial ultrasound-guided transbronchial needle aspiration revealed undifferentiated thymic carcinoma, which was in stage IVB. Six cycles of carboplatin plus &lt;i&gt;nab&lt;/i&gt;-paclitaxel were administered, followed by 5 cycles of &lt;i&gt;nab&lt;/i&gt;-paclitaxel for maintenance. A partial response was seen, which was sustained for more than 13 months. The patient experienced no serious adverse events. These cases show that chemotherapy with carboplatin plus &lt;i&gt;nab&lt;/i&gt;-paclitaxel and &lt;i&gt;nab&lt;/i&gt;-paclitaxel as maintenance therapy can be a useful regimen for advanced thymic carcinoma.

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

“…Continuing research has led to the development of different forms of paclitaxel, including nabpaclitaxel. Nab-PC showed higher efficacy and less toxicity in patients with non-small cell lung cancer compared with PC 13 . However, no studies have yet compared the efficacy and safety of PC and nab-PC for advanced thymic carcinoma.…”

Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report

“…However, a low frequency of side effects, including neutropenia and peripheral neuropathy, has been reported in phase III clinical trials with a combination of carboplatin and nanoparticle albumin-bound paclitaxel for advanced nonsmall-cell lung cancer [15]. Efficacy of carboplatin plus nanoparticle albumin-bound paclitaxel was also previously reported for advanced thymic carcinoma [16]. However, even though this therapy may be effective, the drugs cannot be administered long term to control the disease progression because they are cytotoxic.…”