Immunotherapy for thymoma

Abstract

Thymic epithelial tumors (TETs) are rare thymic neoplasms. There are approximately 1.5 cases per million TETs per year. They are the most common anterior mediastinal tumors in adults. Due to limited activity of available treatment options novel strategies and treatment options are needed and treatment with immune checkpoint inhibitors is an attractive option. Thymic epithelial tumors have one of the lowest tumor mutational burden among all cancer in adults, but high expression of PD-L1 on tumor cells and abundant CD8+ lymphocytes provide a strong rational for implementing immune checkpoint inhibitors (ICIs) which target PD-1/PD-L1 pathway in the treatment of TETs. Few small early stage clinical trials were published so far evaluating efficacy of pembrolizumab and avelumab in thymoma and thymic carcinoma patients. Al trials showed reasonable response rates and progression-free survival. Higher PD-L1 expression was predictor of response in all trials. However, increased incidence of immune-related adverse events was seen in TET patients treated with immune checkpoint inhibitors compared to patients with other cancers. At the moment, ICIs are not standard of care for patients with TET and larger trials are needed to establish the right role of ICIs regarding efficacy and safety of these agents.

ImReLnc: Identifying Immune-Related LncRNA Characteristics in Human Cancers Based on Heuristic Correlation Optimization

“…Cholangiocarcinoma (CHOL), Kidney Chromophobe (KICH), Testicular Germ Cell Tumors (TGCT), Thyroid carcinoma (THCA), and Thymoma (THYM) were found to have more obvious immune enrichment, thus they are the so-called immune-preferred cancers. Studies have shown that immunotherapy plays an important role in the treatment of these five types of cancer ( Schott et al, 2001 ; Drake and Stein, 2018 ; Høgdall et al, 2018 ; Jakopovic et al, 2020 ; Kalavska et al, 2020 ). For these cancers, immunotherapy can achieve better prognostic effects, and our findings can provide a reference for their immunotherapy.…”

Case Report: The Neuromusclar Triad of Immune Checkpoint Inhibitors: A Case Report of Myositis, Myocarditis, and Myasthenia Gravis Overlap Following Toripalimab Treatment

“…It should be noted that thymic epithelial tumors (TETs) are associated with higher incidence of ICI-related irAEs compared with other types of cancers (25,26). This may be explained by the critical role of thymus in T lymphocyte education and the compromised immune tolerance of TETs.…”

Hadrontherapy for Thymic Epithelial Tumors: Implementation in Clinical Practice

“…The pro-inflammatory signals induced by particle beam (especially in case of CIRT) may lead to an immunological activation of auto-reactive T-lymphocyte clones. Jakopovic et al (52) demonstrated that TETs were associated with increased activation of auto-reactive T-lymphocyte clones under immunotherapy treatment compared with other cancer types. Lymphocytes are particularly sensitive to ionizing radiations and die off at a low dose level.…”

“…Jakopovic et al. ( 52 ) demonstrated that TETs were associated with increased activation of auto-reactive T-lymphocyte clones under immunotherapy treatment compared with other cancer types. Lymphocytes are particularly sensitive to ionizing radiations and die off at a low dose level.…”