Thymomas and Thymic Carcinomas

Ettinger, David S.; Riely, Gregory J.; Akerley, Wallace; Borghaei, Hossein; Chang, Andrew C.; Cheney, Richard; Chirieac, Lucian R.; D’Amico, Thomas A.; Demmy, Todd L.; Govindan, Ramaswamy; Grannis, Frederic W.; Grant, Stefan C.; Horn, Leora; Jahan, Thierry; Komaki, Ritsuko; Kong, Feng-Ming; Kris, Mark G.; Krug, Lee M.; Lackner, Rudy P.; Lennes, Inga T.; Loo, Billy W.; Martins, Renato; Otterson, Gregory A.; Patel, Jyoti D.; Pinder-Schenck, Mary; Pisters, Katherine M.W.; Reckamp, Karen L.; Rohren, Eric M.; Shapiro, Theresa A.; Swanson, Scott J.; Tauer, Kurt W.; Wood, Douglas E.; Yang, Stephen C.; Gregory, Kristina M.; Hughes, Miranda

doi:10.6004/jnccn.2013.0072

Cited by 85 publications

(52 citation statements)

References 113 publications

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“…National Comprehensive Cancer Network (NCCN) guidelines recommend induction cyclophosphamide-adriamycin-cisplatin chemotherapy (CAP) every three weeks for thymoma and carboplatin/ paclitaxel every three weeks for thymic carcinoma. 2 Little conclusive evidence exists regarding the response rates of chemotherapy compared to the combination of radiation and chemotherapy, either concurrent or consecutive (herein referred to as chemoRT) in the cytoreduction of TETs. Clinical observations in TETs support chemoRT as an effective induction therapy to cytoreduce tumors leading to successful resection.…”

Section: Introductionmentioning

confidence: 99%

Radiologic response of chemotherapy alone versus radiation and chemotherapy in the treatment of locally‐advanced or advanced thymic epithelial tumors

Chu

Hussien

et al. 2020

Thoracic Cancer

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Background: Here, we investigated radiological responses following chemotherapy alone as compared to both radiation/chemotherapy (chemoRT) in patients with thymic epithelial tumors (TETs) who did not receive upfront surgery. Methods: TETs treated at a tertiary academic cancer center between January 2007 and July 2018 were identified. Patients received chemotherapy or chemoRT as initial therapy and pre-and post-treatment scans were available. Student's t-test, Wilcoxon rank-sum tests, and Cox proportional hazards method were used to compare clinical details and survival between groups. The primary outcome was change in tumor size, which was compared between groups using linear mixedeffects regression models, adjusting for baseline tumor size, age, and histology. Results: A total of 24 of 114 patients with TETs identified met the inclusion criteria. The majority of patients had 67% thymoma (67%, n = 16) and AJCC8 III-IVA disease (58%, n = 14). Median age was 58.5 years (range: 33-76), median initial tumor volume was 187.1 cc (range: 28.7-653.6) and diameter was 8.5 cm (range: 4.5-14.3). Half of the patients received upfront chemotherapy (n = 12: 83% cisplatin/adriamycin/cyclophosphamide) or che-moRT (n = 12: 58% carboplatin/paclitaxel; median RT dose: 63 Gy [range: 60-70 Gy]). At a median imaging follow-up of 15 months (range: 0-86): ChemoRT was associated with increased average radiological response compared to chemotherapy alone (volume: −47.0 cc more, P < 0.001; diameter: −0.8 cm more, P = 0.03). In eight patients who received chemotherapy, 33% saw further tumor shrinkage (median volume: −42.3%, P = 0.03; diameter: −3.0%, P = 0.049) with additional radiation/chemoradiation. Median survival increased for patients ultimately receiving surgery versus those who did not (46 month, range: 16-127 vs. 14 month, range: 6-82; P < 0.01). Conclusions: ChemoRT produced a greater radiologic response compared to chemotherapy alone in patients with TETs not suitable for upfront resection.

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Section: Introductionmentioning

confidence: 99%

Radiologic response of chemotherapy alone versus radiation and chemotherapy in the treatment of locally‐advanced or advanced thymic epithelial tumors

Chu

Hussien

et al. 2020

Thoracic Cancer

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“…For a number of mediastinal masses, the definitive and most efficacious treatment is chemotherapy or radiation therapy or both [8]. However, the role of obtaining tissue diagnosis in the evaluation of mediastinal masses remains to be controversial because it may cause tumor cell seeding in the biopsy tract [9][10][11].For these reasons, diagnosis and treatment of anterior mediastinal masses are one of the most challenging issues of thoracic surgery. Regardless of the type of the tumor it must be kept in mind that early surgery and chemotherapy should be considered to improve the cure rate of these diseases [12].…”

Section: Discussionmentioning

confidence: 99%

Anterior Mediastinal Kitlelere Cerrahi Yaklaşım

Özkaya

Çavuşoğlu

2019

Acta Medica Alanya

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“…Due to the rarity of the disease, no standard and definitive systemic chemotherapy has been established for metastatic thymic carcinoma. According to an empirical investigation, the conventional chemotherapeutic regimens for thymoma, which are cisplatin- and anthracycline-based triplet or quartet regimens, are considered to be ADOC (cisplatin, doxorubicin, vincristine and cyclophosphamide) or PAC (cisplatin, cyclophosphamide and adriamycin) ( 16 ). The response rate to ADOC for thymic carcinoma was found to be 50% in a previous retrospective study, however, the National Comprehensive Cancer Network clinical guideline ( 27 ) recommends the CBDCA/PTX regimen, which was appraised by a phase II study and achieved a response rate of 21.7%.…”

Section: Discussionmentioning

confidence: 99%

“…Thymic lymphoepithelioma-like carcinoma (LELC) is a histological subtype of aggressive thymic carcinoma, which is frequently associated with the Epstein-Barr virus (EBV) and, although it is a relatively common subtype of thymic carcinoma in adults, only 13 cases have been reported in children ( 5 – 15 ). Optimal chemotherapeutic regimens have not yet been determined for the treatment of thymic carcinoma ( 16 ), thus, previous case studies were conducted based on the original regimens for advanced thymoma. Previously reported cases of chemotherapeutic regimens have consisted of cisplatin- and adriamycin-based chemotherapy with response rates of 70–90% for thymomas in the prospective studies ( 17 ), compared with response rates of 20–50% for thymic carcinomas in the retrospective studies ( 18 ), which included almost all histological subtypes of squamous cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of thymic lymphoepithelioma-like carcinoma: Case report of a 14-year-old male

et al. 2014

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Thymic carcinoma is a rare type of cancer, which arises from the thymic epithelium and accounts for ~1–4% of anterior mediastinal tumors in the USA. It rarely occurs in children, and is rarer among adults. Thymic lymphoepithelioma-like carcinoma (LELC) is an uncommon subtype of thymic carcinoma in children, however, it is one of the common histological subtypes of thymic carcinoma in adults. In the present study, a 14-year-old male patient presented to the Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital (Tokoyo, Japan) with chest pain due to a large anterior mediastinal mass. The patient was histologically diagnosed with thymic LELC via a needle biopsy specimen, which was obtained from the primary site and indicated the Epstein-Barr virus infection, whose markers are also associated with oncogenesis. Immunohistochemical analysis demonstrated positive staining for keratin (AE1/AE3), epithelial membrane antigen, and latent membrane protein-1 and negative staining for cluster of differentiation 5. Thus, the patient was diagnosed with metastatic thymic LELC. First-line chemotherapy comprising of a cisplatin- and adriamycin-based chemotherapy regimen achieved a partial response, however, the patient succumbed within 10 months of the initial diagnosis due to rapid disease progression and refractory to subsequent cycles of chemotherapy. Thus, the current study, as well as previously reported cases, demonstrates that pediatric patients with thymic LELC continue to have a poor prognosis.

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Thymomas and Thymic Carcinomas

Cited by 85 publications

References 113 publications

Radiologic response of chemotherapy alone versus radiation and chemotherapy in the treatment of locally‐advanced or advanced thymic epithelial tumors

Radiologic response of chemotherapy alone versus radiation and chemotherapy in the treatment of locally‐advanced or advanced thymic epithelial tumors

Anterior Mediastinal Kitlelere Cerrahi Yaklaşım

Clinical outcome of thymic lymphoepithelioma-like carcinoma: Case report of a 14-year-old male

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