Successful treatment with lenvatinib in a patient with thymic carcinoma presenting with cardiac tamponade: a case report and review of literature

Abstract

Thymic carcinoma (TC) presenting with cardiac tamponade has a poor prognosis because of the difficulty in controlling malignant pericardial effusion using conventional chemotherapy. Lenvatinib, a multitargeted kinase inhibitor of vascular endothelial growth factor receptor and other kinases, has recently been proven effective against TC. As the inhibition of vascular endothelial growth factor signaling is effective in malignant pericardial effusion, lenvatinib may also be effective in TC presenting with cardiac tamponade. However, no reports have shown that lenvatinib is effective in such cases. Herein, we present a case of successful treatment with lenvatinib in a patient with TC presenting with cardiac tamponade. The present case suggests that lenvatinib should be considered an effective treatment option for such cases.

Sustained antitumor response to lenvatinib with weekend-off and alternate-day administration in chemotherapy-refractory thymic carcinoma: a case report

“…In that study, the response rate and overall survival of patients receiving the weekend-off protocol were superior to those not receiving this protocol, and 66.7% of patients continued weekend-off administration without developing severe or intolerable AEs. A recent case report of thymic carcinoma also described that switching from daily lenvatinib administration to the weekend-off regimen successfully relieved symptoms of fatigue and anorexia and enabled the continuation of treatment without disease progression [14]. From a biological perspective, lenvatinib administration with a weekend-off protocol caused the revascularization of the thyroid and adrenal glands in an orthotopic hepatoma mouse model with sustained inhibition of vascularization in the tumors [13], suggesting that the vascular structure of healthy organs can be recovered during a planned off-treatment period while sustaining its antiangiogenic effect.…”

Successful resection after first‐line lenvatinib therapy in an advanced thymic carcinoma

“…Based on this study, lenvatinib was approved for unresectable thymic carcinoma in JAPAN 2021. Subsequently, several reports demonstrated the useful therapeutic effect of lenvatinib in specific clinical situations for patients with thymic carcinoma 6–8 . However, there have been no reports demonstrating successful surgical resection after a good response to first‐line lenvatinib therapy in advanced thymic carcinoma.…”