Long‐term effect of everolimus in recurrent thymic neuroendocrine neoplasia

Lang, Matthias; Hackert, Thilo; Anamaterou, Chrysanthi

doi:10.1111/cen.14572

Cited by 6 publications

(4 citation statements)

References 33 publications

(35 reference statements)

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“…In thymic carcinoids, only a few cases have been reported that were treated with everolimus, octreotide, pasireotide, sunitinib, or chemotherapy 10–14 . To our knowledge, this is the first thymic atypical carcinoid case treated with the combination of everolimus and SSAs.…”

Section: Discussionmentioning

confidence: 91%

Everolimus in combination with octreotide LAR in thymic atypical carcinoid

et al. 2023

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Thymic atypical carcinoids are extremely rare tumors and have a poor prognosis owing to their aggressive clinical course. The efficacy of treatments other than complete surgical resection is unclear. We herein report a postoperative recurrent case of thymic atypical carcinoid treated with everolimus and octreotide long‐acting repeatable (LAR). A 75‐year‐old woman was admitted to our department because a nodule was detected in the right lobe of thymus by annual computed tomography. The patient underwent thymothymectomy, and a diagnosis of thymic atypical carcinoid was made. One year and seven months after surgery, she developed multiple metastases in the lung, hilar and mediastinal lymph nodes, liver, and bone. Everolimus 10 mg/day was administered; however, the dose had to be reduced to 5 mg/day due to grade 3 hyperglycemia and grade 3 interstitial lung disease. Metastatic lesions other than liver metastasis markedly responded to everolimus, although the liver metastases gradually progressed. Three years and six months after surgery, she was administered octreotide LAR 30 mg per month in combination with everolimus. She has maintained stable disease for 8 months after the application of this combination therapy.

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Section: Discussionmentioning

confidence: 91%

Everolimus in combination with octreotide LAR in thymic atypical carcinoid

et al. 2023

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“…Everolimus may be a therapeutic approach for recurrent Th-NENs. Anamaterou reported 4 cases of Th-NENs (including 3 cases treated with surgery and 1 case treated with octreotide) treated with everolimus after disease progression, with progress-free survival of 7–42 months ( 36 ). Case 1 in this study, who developed bilateral axillary lymph node metastases 116 months after extended thymectomy, was treated with sandostatin LAR for 1 year and everolimus for maintenance therapy, and has survived for more than 134 months.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of intermediate to high grade thymic neuroendocrine neoplasms: case series of five patients and literature review

Huang¹,

Sun²,

Wu³

et al. 2022

Transl Cancer Res TCR

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Background: Thymic neuroendocrine neoplasms (Th-NENs) are extremely rare. Th-NENs are divided into four pathological subtypes: typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC), and small cell carcinoma (SCC). The latter three subtypes are highly aggressive with poor prognosis. There are limited reports on the optimal surgical strategies for Th-NENs. This study aims to report a case series of Th-NENs after surgical treatment and review the literatures.Methods: We report a case series of five patients diagnosed with Th-NENs and summarize their clinical characteristics. Literatures related to surgical treatment of Th-NENs were reviewed.Results: There were three males and two females, and mean age was 53.6 years. No myasthenia gravis or neuroendocrine symptoms were found. Three patients were diagnosed with AC and the other two were diagnosed with LCNEC. Two patients were stage II-b, one patient was stage III-a, and two patients were stage IV-b. One patient received preoperative chemotherapy, one patient received preoperative chemoradiotherapy, and three patients underwent surgery directly. Two patients underwent extended thymectomy via VATS, two patients underwent extended thymectomy via median sternotomy, and one patient underwent resection of anterior mediastinal tumor, sternal metastases, superior vena cava and partial right atrium via median sternotomy and cardiopulmonary bypass. R0 resection was achieved in 80% (4/5) of patients. There was no postoperative 90-day complication and death. One patient had no recurrence. One patient had lymph node metastases and was still alive after somatostatin analogue therapy. One patient had no recurrence of Th-NENs but died of other tumors. Two patients had distant metastases. Median overall survival (mOS) was 49 (range, 4-134) months. A total of 22 original studies related to surgical treatment of Th-NENs were retrieved.Conclusions: Th-NENs is a very rare and extremely aggressive malignancy. Early diagnosis and surgical resection are the most important methods to improve prognosis. Radical resection and lymph node dissection are recommended for accurate staging and better prognosis. Currently, there are few clinical data on Th-NENs and several important surgical issues remain unresolved. In the future, multi-center, largesample database and clinical studies are urgently needed to explore better treatment modality.

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“…Some more publications are related to medical therapies of t-NEN, which we summarized recently ( 7 ). Everolimus, temozolomide and in high proliferative disease platinum based chemotherapies are the recommended options.…”

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confidence: 99%