Metastatic Thymic Carcinoma with Long Survival After Treatment with Sunitinib

Abstract

Thymic carcinomas are the most aggressive histological subtype of thymic tumors with limited data to guide correct management. No standard treatments are available for patients with advanced thymic carcinoma after progressing while on platinum-based chemotherapy. We present a case of a patient with metastatic thymic carcinoma with an unusual response and favorable evolution after receiving treatment with sunitinib, obtaining a progression-free survival of 23 months, much higher than reported to date. We review the literature on the efficacy of sunitinib in metastatic thymic carcinoma after progression to first-line treatment with platinum combinations.

The Use of Sunitinib as Maintenance Therapy in a Pediatric Patient With a Poorly Differentiated Thymic Carcinoma

“…15 A case report of metastatic carcinoma in an adult treated with sunitinib after developing progressive disease with multiple other treatments, documented a PFS of 23 months on sunitinib, after which disease progression was again noted. 19 Further studies are needed to determine the ideal treatment regimens for patients with thymic carcinoma, especially in the pediatric population. We describe a pediatric patient with stage IV thymic carcinoma who was initially treated with cisplatin/docetaxel with good response, who then went on to maintenance with daily sunitinib for over 5 years.…”

“…An additional report of 20 patients in France with thymic carcinoma and 8 with thymoma treated with sunitinib included patients 17 to 75 years of age, and showed a disease control rate of 55% for thymic carcinoma, with median PFS and OS of 3.3 and 12.3 months, respectively, for thymic carcinoma patients 15. A case report of metastatic carcinoma in an adult treated with sunitinib after developing progressive disease with multiple other treatments, documented a PFS of 23 months on sunitinib, after which disease progression was again noted 19…”

Dissolution of metastatic thymic carcinoma–associated right atrial thrombus with rivaroxaban

“…4,5 The International Thymic Malignancies Interest Group (ITMIG) was established to increase collaborative efforts in the treatment of these tumors. 6,7 Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality in patients with cancer. 8 The cumulative relative risk ranges from 7-fold to as high as 28-fold in advanced neoplasia.…”

“…4,5 The International Thymic Malignancies Interest Group (ITMIG) was established to increase collaborative efforts in the treatment of these tumors. 6,7…”

Überwindung der Chemoresistenz bei malignen Thymomen und Thymuskarzinomen

“…Ungefähr 50 % der Patienten mit malignen Thymomen und Thymuskarzinomen sprechen allerdings nicht auf die platinbasierte Therapie an oder leiden im Verlauf unter Rezidiven und benötigen dann eine Zweitlinientherapie (Ströbel et al 2010b). In einigen Quellen wird der RTK-Inhibitor Sunitinib als mögliche Zweitlinientherapie genannt (Ströbel et al 2010a;Cabezón-Gutiérrez et al 2018). Ein besseres Verständnis der molekularbiologischen Resistenzmechanismen kann dabei helfen, das Ansprechen einer Therapie vorauszusagen und langfristig zu wirkungsvolleren Therapieansätzen führen.…”