Thymic Epithelial Tumors: Prognostic Determinants Among Clinical, Histopathologic, and Computed Tomography Findings

Moon, Jung Won; Lee, Kyung Soo; Shin, Myung-Hee; Kim, Seonwoo; Woo, Sook Young; Lee, Geewon; Han, Joungho; Shim, Young Mog; Choi, Yong Soo

doi:10.1016/j.athoracsur.2014.09.050

Cited by 43 publications

(44 citation statements)

References 14 publications

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“…As such, malignancies of the thymus can be classified into two main groups; thymomas that contain immature non-malignant lymphocytes and the epithelial component retains histologic features specific to the normal thymus, and thymic carcinomas that exhibit a set of histologic features that are similar to those found in carcinomas of other organs, rather than a normal thymus [136][137][138]. These malignancies are uncommon and have a variable prognosis, as indicated by a comprehensive study of 1320 Japanese patients in which the five year survival rate was 67% for patients treated with total resection, 30% for patients treated with subtotal resection, and 24% for patients whose disease was inoperable [136].…”

Section: Thymic Epithelial Tumorsmentioning

confidence: 99%

PU-H71: An improvement on nature's solutions to oncogenic Hsp90 addiction

Trendowski

2015

Pharmacological Research

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Despite recent advances in precision medicine, many molecular-based antineoplastic agents do not potentiate sustainable long term remissions, warranting the investigation of novel therapeutic strategies. Heat shock protein 90 (Hsp90) is a molecular chaperone that not only has oncogenic properties, but also has distinct expression profiles in malignant and normal cells, providing a rational strategy to attain preferential damage. Prior attempts to target Hsp90 with natural product-based compounds have been hampered by their associated off target toxicities, suggesting that novel, fully synthetic inhibitors may be required to achieve the specificity necessary for therapeutic efficacy. Therefore, this review highlights the antineoplastic potential of PU-H71 (8-[(6-iodo-1,3-benzodioxol-5-yl)sulfanyl]-9-[3-(propan-2-ylamino)propyl]purin-6-amine), a novel purine based analog that has shown efficacy in many preclinical models of malignancy, and is now under clinical examination. In addition, the review suggests potential concomitant therapeutic approaches that may be particularly beneficial to molecular-based, as well as traditional cytotoxic cancer chemotherapy.

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Section: Thymic Epithelial Tumorsmentioning

confidence: 99%

PU-H71: An improvement on nature's solutions to oncogenic Hsp90 addiction

Trendowski

2015

Pharmacological Research

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“…The most effective therapeutic modality for treating thymic carcinoma is surgical complete resection (1,2), which increases the 5-year overall survival (OS) from 33.3%-65.0% to 53.0%-65.7% (3)(4)(5)(6)(7)(8). Moreover, thymic carcinoma is widely recognized to respond poorly to many chemotherapeutic agents, with an objective response rate of 20%-36%, although concomitant administration of carboplatin and paclitaxel yields longer survival (9,10).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Yokoyama

Miyoshi

Nakashima

et al. 2016

Clinical Cancer Research

113

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Purpose: The immune checkpoint of the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway is believed to play an important role in evasion of host antitumor immune surveillance in various malignancies; however, little is known about its role in thymic carcinoma. This study investigated PD-1/PD-L1 expression and its association with clinicopathologic features, the expression of immune-related proteins in tumor-infiltrating lymphocytes (TIL), and patient prognosis. Experimental Design: PD-L1 and PD-1 expression was evaluated by IHC in 25 thymic carcinoma tissue specimens. Copy number alterations of the PD-L1 gene in 11 cases were assessed in formalin-fixed, paraffin-embedded material using qRT-PCR. Results: Compared with normal subjects, 3 thymic carcinoma patients showed an increase in PD-L1 copy number, whereas 8 did not. PD-L1 was significantly overexpressed in cases with copy number gain as compared with normal cases. High PD-L1 expression was associated with higher disease-free and overall survival rates as compared to cases with low expression. Prognostic analysis revealed low PD-L1 expression and high number of PD-1+ TILs as significant predictors of poor survival, together with Masaoka–Koga stage IVa/IVb disease and incomplete resection. In the quantitative analysis of TILs, PD-L1 expression correlated proportionally with the number of infiltrating CTLs. Conclusions: Here, for the first time, we report that PD-L1 and PD-1 expression might be useful prognostic predictors in thymic carcinoma. Further studies are expected to substantiate the prognostic value of PD-L1 and PD-1 expression, and the potential efficacy of targeting the PD-1/PD-L1 pathway in thymic carcinoma via immunotherapy. Clin Cancer Res; 22(18); 4727–34. ©2016 AACR.

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“…Only one study 21 has reported the comparison between low-risk (Types A and AB) and high-risk (Types B1, B2, B3 and TC) TETs using conventional enhancement CT. However, a large number of studies have compared LRT (Types A, AB, and B1), HRT (Type B2, B3), and TC [22][23][24] . Therefore, we aimed to regroup the six subtypes into three risk levels: LRT* (Types A and AB), HRT* (Types B1, B2 and B3), and TC.…”

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confidence: 99%

Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors

Zhang

et al. 2020

Sci Rep

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To evaluate the role of conventional contrast-enhanced CT (CECT) imaging and dual-energy spectral CT (DECT) perfusion imaging in differentiating the WHO histological subtypes of thymic epithelial tumours (TETs). Eighty-eight patients with TETs who underwent DECT perfusion scans (n = 51) and conventional CT enhancement scans (n = 37) using a GE Discovery CT750 HD scanner were enrolled in this study. The mean maximal contrast-enhanced range (mean CEmax) and the perfusion and spectral parameters of the lesions were analysed. Among the six WHO subtypes (Type A, AB, B1, B2, and B3 thymoma and thymic carcinoma), the mean CEmax values and most of the perfusion and spectral parameter values of Type A and Type AB were significantly higher than those of the other subtypes (all P < 0.05), and there was no difference among Type B1, B2 and B3 (all P > 0.05). The mean CEmax value was not different between Type B (including Type B1, B2, and B3) and thymic carcinoma (P = 1.000). The PS, IC, NIC and λ HU values in the optimal venous phase of thymic carcinoma were higher than those of Type B (all p < 0.05). The parameters of conventional CECT imaging and DECT perfusion imaging can help identify the subtype of TETs, especially those of DECT perfusion imaging in type B thymomas and thymic carcinomas.

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Thymic Epithelial Tumors: Prognostic Determinants Among Clinical, Histopathologic, and Computed Tomography Findings

Cited by 43 publications

References 14 publications

PU-H71: An improvement on nature's solutions to oncogenic Hsp90 addiction

PU-H71: An improvement on nature's solutions to oncogenic Hsp90 addiction

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors

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