Transformation from Small Cell to Squamous Cell Carcinoma in a Thymic Carcinoma Patient with a Durable Response to Anlotinib: A Case Report

Abstract

The most common pathologic type of thymic carcinoma (TC) is squamous cell carcinoma (SCC). Small cell carcinoma is relatively rare, accounting for approximately 2% to 5% of all thymic tumors. Histologic transformation of TC has not yet been reported. Available treatments for TC patients who progress after first-line therapy are limited, which contributes to their poor prognosis. We reported an extraordinary case of a 66-year-old man who was diagnosed with thymic small cell carcinoma that transformed into SCC after third-line treatment. Surprisingly, the patient had a progression-free survival (PFS) of 25 months and an overall survival (OS) of 10 years on anlotinib as fourth-line therapy. The tolerance was well. Thus, anlotinib may be a safe and promising treatment for TC patients, especially those who undergo histologic transformation.

Genomic and transcriptomic profiling of combined small-cell lung cancer through microdissection: unveiling the transformational pathway of mixed subtype

“…Abnormalities or dysfunctions in these pathways might be potential mechanisms for SCLC-to-SCC transformation. Additionally, a case report [ 28 ] has found a transformation from small cell to SCC in a thymic carcinoma patient, suggesting that although SCLC-to-SCC transformation is rare, it is possible to transform SCLC into SCC. Others could not infer the transformation mode (Additional file 1 : Figure S7G).…”

The Efficacy and Safety of Anlotinib Alone and in Combination with Other Drugs in Previously Treated Advanced Thymic Epithelia Tumors: A Retrospective Analysis

“…Zuo et al reported that an advanced TC patient who had previously received multi-line therapy, including chemotherapy, radiotherapy, and antiangiogenic therapy, achieved over 23 months of PFS and six years of OS with anlotinib treatment, and the adverse reactions were mild and tolerable [ 20 ]. Qin et al reported that a thymic small cell carcinoma patients who transformed into squamous cell carcinoma after failure of multi-line therapy received anlotinib as fourth-line [4 th -line] therapy and achieved a PFS of 25 months and an OS of 10 years, the tolerance was well [ 21 - 27 ]. These two case reports suggest that anlotinib may be a promising treatment strategy for patients with T and TC after failure of multi-line therapy.…”