Therapeutic Potential of Docetaxel plus Cisplatin Chemotherapy for Myasthenia Gravis Patients with Metastatic Thymoma

Abstract

The prognosis of myasthenia gravis (MG) in association with invasive or metastatic thymoma is usually worse, and therapeutic options are quite limited. Here, we retrospectively reported the therapeutic effect of docetaxel plus cisplatin (docetaxel/cisplatin) chemotherapy in 7 MG patients with metastatic thymoma. Previously, all patients underwent thymectomy at the first onset of thymoma. After the metastasis of thymoma, none of the patients received thymectomy due to unresectable conditions after surgeon's evaluation for great risk of myasthenic crisis (n = 5) or patients' refusal (n = 2). All patients received docetaxel (75 mg/m 2 ) and cisplatin (70 mg/m 2 ) on day 1 (d1) every 21 days, with the cycle ranging from 1 to 4. After docetaxel/cisplatin chemotherapy, one patient achieved partial response, and 6 with stable disease of the tumors. The clinical symptoms of MG were alleviated in all patients, 2 with complete remission and the other 5 with marked improvement. Myelosuppression was the major adverse event, occurring in 2 patients (grade II and IV). MG relapse occurred in one patient during the follow-up. Our study presented a series of MG patients with metastatic thymoma who underwent docetaxel/cisplatin chemotherapy. Besides the improved/stabilized thymoma, markedly improvement of MG with the tolerable adverse events was achieved. Docetaxel/cisplatin chemotherapy appears to be an effective treatment for selected patients with MG in association with unresectable metastatic thymoma. Further follow-up of these patients and additional subjects will be needed to determine whether the therapeutic benefits are durable.

Protective and Therapeutic Efficacy of Hesperidin versus Cisplatin against Ehrlich Ascites Carcinoma-Induced Renal Damage in Mice

“…Herein, Cis induced bone marrow hypocellularity, resulting in remarkable pancytopenia as reported by Hashem et al [ 17 ] and Kuter [ 37 ]. The recorded anemia may be attributed to the inhibition of the erythropoietin hormone [ 38 ], which correlates with Cis-induced kidney damage as the kidney is the major source of the erythropoietin hormone [ 39 ] or may be due to the suppression of bone marrow precursors [ 40 ].…”

Docetaxel/cisplatin therapy in myasthenia gravis with hypertension/diabetes

“…Interestingly, we have found that the responses of thymic carcinoma were minor to moderate, but the symptoms of MG were markedly improved by this regimen. Even in MG patients with unresectable metastatic thymoma, the symptom of MG could be markedly improved after docetaxel/cisplatin therapy [ 7 ]. Thus far, docetaxel/cisplatin therapy has proved to be generally safe and well tolerated in MG patients with thymoma, based on the observations at our center since 2005.…”

“…All patients were treated with 75 mg/m 2 of docetaxel and 70 mg/m 2 of cisplatin on day 1, and the treatment could be repeated at 3-week intervals [ 7 , 12 , 13 , 14 ]. The treatment ranged from 1 to 4 cycles, according to the status of the patients.…”

“…Based on the clinical experiences at our center since 2005, we have observed favorable responses of MG after docetaxel/cisplatin therapy for thymoma-associated MG patients. Even in MG patients with unresectable metastatic thymoma, the MG symptoms could be significantly improved after docetaxel plus cisplatin therapy [ 7 ]. In the present study, we report the therapeutic effects and adverse events of docetaxel plus cisplatin therapy in a serial of thymoma-associated MG patients complicated with hypertension and/or diabetes who did not respond to thymectomy or suffered from MG recurrence post thymectomy.…”

Identification of Potential Serum Protein Biomarkers in Thymoma with Myasthenia Gravis After Docetaxel Treatment

“…However, most chemotherapy drugs for patients with TMG do not relieve MG symptoms and even may make them worse. Previous studies reported the efficacy of docetaxel in thymic epithelial tumors [14], and our preliminary study showed that docetaxel could significantly alleviate MG symptoms in patients with TMG [15,16]. The serum is used to measure AChR antibody concentrations and is also used for other studies in patients with MG, such as serum metabolomic profiling [17] and expression levels of several interleukins [18,19].…”