A Phase II Study of Pemetrexed in Patients with Recurrent Thymoma and Thymic Carcinoma

Abstract

Pemetrexed is an active agent in this heavily pretreated population of patients with recurrent thymic malignancies, especially thymoma.

Phase II study of S-1 in patients with previously-treated invasive thymoma and thymic carcinoma: North Japan lung cancer study group trial 1203

“…Clinical features and histology are different in IT and TC and recent improved genetic, epigenetic and transcriptomic analyses revealed distinct molecular bases for these disease [12,13]. Correspondingly, previous studies and the present study showing different outcomes for IT and TC are probably due to their histological and biological differences [6,14].…”

“…However, no standard treatment has been established for previously-treated IT and TC because there have been very few prospective studies in such patients. In recent phase II trials, sunitinib, everolimus, pemetrexed and pembrolizumab have shown beneficial effects [4][5][6][7][8].…”

Clinical Outcomes of Second-Line Chemotherapy in Patients with Previously Treated Advanced Thymic Carcinoma: A Retrospective Analysis of 191 Patients from the NEJ023 Study

“…Patients with advanced thymic carcinoma are usually treated with palliative chemotherapy or supportive care; however, there is little evidence in support of chemotherapy because of the rarity of this tumor. Furthermore, there are very few reports about second-line chemotherapy for patients with previously treated advanced thymic carcinoma, and these are all from retrospective studies with small sample sizes (Table 1) [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Owing to the limited number of studies performed, it is difficult to select a chemotherapy regimen for these patients in clinical practice.…”

Can Pemetrexed Also Have a Potential Role Preoperatively in the Management of Advanced Thymic Epithelial Tumors?

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We read with interest the article by Gbolahan et al 1 about a phase II study testing pemetrexed in a patient with recurrences of thymoma and thymic carcinoma. In particular, they showed encouraging results in terms of response rate with use of this antifolate agent after different lines of previous chemotherapy, with a response rate of about 25%.In their conclusion, Gbolahan et al 1 underline the fact that the potential role of this agent as first-line therapy or in association with other agents may be tested, as is indicated also for other malignancies such as lung cancer or mesothelioma.

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We read with interest the article by Gbolahan et al 1 about a phase II study testing pemetrexed in a patient with recurrences of thymoma and thymic carcinoma. In particular, they showed encouraging results in terms of response rate with use of this antifolate agent after different lines of previous chemotherapy, with a response rate of about 25%.In their conclusion, Gbolahan et al 1 underline the fact that the potential role of this agent as first-line therapy or in association with other agents may be tested, as is indicated also for other malignancies such as lung cancer or mesothelioma. 2 With regard to this consideration, we would ask Gbolahan et al 1 whether they intend to utilize the possibility of maintenance therapy after complete or partial response after first-line chemotherapy or as an independent initial treatment.Moreover, with regard to thymomas, we would ask Gbolahan et al 1 whether they think that pemetrexed may also have a role in induction protocols.

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