Cisplatin and Irinotecan as First-Line Chemotherapy for Previously Untreated Metastatic Thymic Carcinoma: Updated Analysis

Abstract

Platinum-based chemotherapy is the de facto standard treatment for metastatic or unresectable thymic carcinoma. The optimal chemotherapy regimen has not yet been determined, including whether this should be combined with a second- or third-generation anti-cancer agent. We retrospectively evaluated the data of patients with metastatic or unresectable thymic carcinoma who were treated with a combination of cisplatin and irinotecan as first-line chemotherapy between 2002 and 2021 (trial registration UMIN000012175). The primary endpoint was response rate according to the RECIST criteria version 1.1. Secondary endpoints were disease control rate, progression-free survival (PFS), overall survival (OS), and toxicity (adverse events). Some patients analyzed in this study were also included in the previous trial, which was terminated early. For this analysis, we included 18 patients with a median age of 56 years and an Eastern Cooperative Oncology Group performance status of 0 or 1. All patients had clinical stage IVa or IVb thymic carcinoma according to the Masaoka-Koga staging system. The response rate was 44% and the disease control rate was 89%. The median PFS was 8.4 months (95% confidence interval (CI): 2.7–11.6 months) and the median OS was 45.6 months (95% CI: 15.7–69.1 months). Grade 3 or worse hematological toxicity was observed in 5 patients and grade 3 or worse non-hematological toxicity was observed in 3 patients. None of the patients developed febrile neutropenia, and no treatment-related deaths occurred. Thus, the combination of cisplatin and irinotecan as first-line chemotherapy for metastatic thymic carcinoma showed efficacy and acceptable toxicity.

Transformation from Small Cell to Squamous Cell Carcinoma in a Thymic Carcinoma Patient with a Durable Response to Anlotinib: A Case Report

“…A recent study reported that the median PFS of patients with metastatic or unresectable TC who were treated with first-line chemotherapy was 8.4 months. 18 Significantly, in our case, the patient still achieved a PFS of 2 years after fourth-line anlotinib treatment despite the tumor’s pathologic transformation. Anlotinib not only effectively inhibited the migration and proliferation of capillary-like tubes adjusted by VEGFR in endothelial cells, but also inhibited tumor cell proliferation.…”

An anti-glioblastoma gold(i)–NHC complex distorts mitochondrial morphology and bioenergetics to induce tumor growth inhibition

“…A more quiescent cell population known as cancer stem cells with high dependence on mitochondrial oxidative phosphorylation may be culpable in GBM resistance, evasion, metastasis, and lethality. [3][4][5] Additionally, aggressive tumor types have elevated mitochondrial fusion and fission activity referred to as mitochondrial dynamics that support high proliferation and invasiveness. [6][7][8] The number of mitochondria ranging from several to thousands characterizes the metabolic activity of different cell types.…”