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

Kunitoh, Hideo; Tamura, Tomohide; Shibata, Taro; Nakagawa, Kazuhiko; Takeda, Koji; Nishiwaki, Yutaka; Osaki, Yoshinobu; Noda, Kazumasa; Yokoyama, Akira; Saijo, Nagahiro

doi:10.1038/sj.bjc.6605347

Cited by 32 publications

(21 citation statements)

References 29 publications

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“…Compliance to chemotherapy was poorer; only 57% of patients completed the planned 9-week schedule, as compared with the 87% rate in the JCOG 9605 study for stage IV disease (Kunitoh et al , 2009). Doctors' and patients' decisions were the main reasons for ceasing chemotherapy and early local therapy.…”

Section: Discussionmentioning

confidence: 93%

A phase II trial of dose-dense chemotherapy, followed by surgical resection and/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606)

Kunitoh

Tamura

Shibata³

et al. 2010

Br J Cancer

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Background:This study aimed to evaluate the safety and efficacy of dose-dense weekly chemotherapy, followed by resection and/or thoracic radiotherapy.Methods:Patients with histologically documented thymoma with unresectable stage III disease received 9 weeks of chemotherapy: cisplatin 25 mg m−2 on weeks 1–9; vincristine 1 mg m−2 on weeks 1, 2, 4, 6 and 8; and doxorubicin 40 mg m−2 and etoposide 80 mg m−2 on days 1–3 of weeks 1, 3, 5, 7 and 9. Patients went on to surgery and post-operative radiotherapy of 48 Gy; those with unresectable disease received 60 Gy radiotherapy.Results:total of 23 patients were entered. The main toxicities of the chemotherapy regimen were neutropenia and anaemia, and 57% of patients completed the planned 9 weeks of therapy. There were no toxic deaths. Of the 21 eligible patients, 13 (62%) achieved a partial response (95% confidence interval: 38–82%). Thirteen patients underwent a thoracotomy and nine (39%) underwent complete resection. Progression-free survival at 2 and 5 years was 80 and 43%, respectively. Overall survival at 5 and 8 years was 85 and 69%, respectively. Survival did not seem to be affected by resection.Conclusion:In thymoma patients, weekly dose-dense chemotherapy has activity similar to that of conventional regimens. Although some patients could achieve complete resection, the role of surgery remains unclear.

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Section: Discussionmentioning

confidence: 93%

A phase II trial of dose-dense chemotherapy, followed by surgical resection and/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606)

Kunitoh

Tamura

Shibata³

et al. 2010

Br J Cancer

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“…Agents with good activity against thymoma include cisplatin, vincristine, doxorubicin, etoposide, cyclophosphamide and ifosfamide 16. Therapy with corticosteroids is also effective for the treatment of metastatic thymoma 17.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy improves thymoma-associated graft-versus-host-disease-like erythroderma

Nagano¹,

Kotani²,

Kobayashi³

et al. 2011

Case Reports

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Graft-versus-host-disease (GVHD) with erythroderma can rarely occur in the context of thymoma and is associated with a poor prognosis due to an increased risk of infection-related death. The present study describes a case of a 50-year-old man with malignant thymoma who developed sepsis in addition to skin manifestations similar to that seen in GVHD. This patient experienced marked improvement in skin lesions in response to steroids and combination chemotherapy with carboplatin and paclitaxel, with subsequent resolution of infection. The present study describes the clinical course of this patient, followed by a review of pertinent reports of thymoma associated with GVHD with particular focus on the efficacy of treatment strategies.

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“…18 Several platinumcontaining regimens have been evaluated over a period of years, and these are associated with overall response rates ranging from 30% to 90% and survival rates ranging from 15 months to more than 70 months; the range of results probably highlights differences in the patient popula- A colon-biopsy specimen (Panel A, hematoxylin and eosin) shows colonic mucosa with reactive epithelial injury, prominent crypt-cell apoptosis, and loss of goblet cells. 21 No standard therapy exists for relapsed or refractory thymoma. A smear of bone marrow aspirate (Panel C, Wright-Giemsa) contains numerous maturing myeloid precursors but no erythroid precursors.…”

Section: Management Of Advanced Thymomamentioning

confidence: 99%

Case 31-2015

Fidias¹,

Long²,

Fintelmann³

et al. 2015

N Engl J Med

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1458T h e ne w e ngl a nd jou r na l o f m e dicine Pr esentation of C a seDr. Kimberly G. Blumenthal (Medicine): A 29-year-old man with metastatic thymoma was seen in the outpatient oncology clinic of this hospital because of intractable diarrhea of 1 month's duration.The patient had received a diagnosis of thymoma at another hospital 5 years earlier, after a chest radiograph had been obtained to evaluate acute pain in the left shoulder.Dr. Florian J. Fintelmann: The chest radiograph showed a large mediastinal mass and left pleural effusion (Fig. 1A). Subsequent computed tomographic (CT) scans showed an anterior mediastinal soft-tissue mass that measured 10.0 cm craniocaudally, 10.1 cm transversely, and 5.0 cm anteroposteriorly (Fig. 1B), as well as left pleural soft-tissue nodules, a pleural effusion, and associated atelectasis (Fig. 1C). 18 F-fluorodeoxyglucose positron-emission tomography revealed uptake in the mediastinal mass and left pleural nodules that was suggestive of pleural metastases. Magnetic resonance imaging (MRI) of the head was unremarkable.Dr. Lawrence R. Zukerberg: Flexible bronchoscopy with video-assisted thoracoscopic evaluation of the left lung and pleural space was performed. Pleural-biopsy specimens showed nests of epithelioid tumor cells, some with numerous admixed lymphocytes separated by thick, hyalinized fibrous bands (Fig. 2); these features are diagnostic of type B2 thymoma, with areas of type B3 thymoma. Flow cytometry revealed immature T cells that were consistent with thymocytes.Dr. Blumenthal: Levels of human chorionic gonadotropin and alpha-fetoprotein were normal. A chemotherapy regimen of doxorubicin, cisplatin, vincristine, and cyclophosphamide was administered for three cycles, and then a thymectomy was performed.Dr. Zukerberg: The resection specimen was a yellow, necrotic mass that measured 6.5 cm by 5.0 cm by 3.0 cm; no viable tumor was seen on microscopic examination. No measurable disease was present in the pleura.Dr. Blumenthal: Thirteen months after the patient's initial presentation, follow-up CT of the chest revealed new nodular left pleural thickening, a finding that was suggestive of metastatic disease. Thereafter, the patient was monitored with serial

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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)

Cited by 32 publications

References 29 publications

A phase II trial of dose-dense chemotherapy, followed by surgical resection and/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606)

A phase II trial of dose-dense chemotherapy, followed by surgical resection and/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606)

Chemotherapy improves thymoma-associated graft-versus-host-disease-like erythroderma

Case 31-2015

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