4.6 Review

Current Treatment Approaches for Thymic Epithelial Tumors

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Review Oncology

Balancing the Risk of Adverse Events against the Efficacy of Immunotherapy in Advanced Thymic Epithelial Tumors

Birte Ohm et al.

Summary: Treatment options for advanced thymic malignancies are limited. Immune checkpoint inhibitors are effective against thymic epithelial tumors, but carry a high risk of adverse events. This article aims to provide new insights on predictive markers for treatment efficacy and risk of adverse events, allowing for safe and precise clinical indications for immunotherapy in thymic malignancies.

CANCERS (2023)

Article Oncology

A Phase 2 Study of Palbociclib for Recurrent or Refractory Advanced Thymic Epithelial Tumors (KCSG LU17-21)

Hyun Ae Jung et al.

Summary: The study evaluated the efficacy and safety of Palbociclib monotherapy in patients with recurrent or refractory advanced thymic epithelial tumors (TETs). The results showed that Palbociclib monotherapy had good tolerability and encouraging efficacy in patients with TETs. However, there is currently no standard chemotherapy option for patients who fail platinum-based combination chemotherapy.

JOURNAL OF THORACIC ONCOLOGY (2023)

Article Oncology

Long term outcome of complex surgical resection and reconstruction for rare thoracic cancers

Ugo Pastorino et al.

Summary: This study aimed to report the long-term survival rates of patients with rare thoracic cancers (RTCs) based on the complexity of surgical procedures and cancer type. The results showed that surgical complexity and cancer type were associated with 90-day mortality and 10-year survival rates, which can help with clinical decision making.

TUMORI JOURNAL (2023)

Article Multidisciplinary Sciences

Prognostic CT features in patients with untreated thymic epithelial tumors

Haiyang Dai et al.

Summary: This study aimed to determine the prognostic CT features in patients with untreated thymic epithelial tumors (TETs). It was found that vessel invasion and pericardial mass were independent predictors for poor outcomes in patients with thymic carcinoma, while pericardial mass was an independent predictor in high-risk thymoma. Features including lung invasion, great vessel invasion, lung metastasis, and distant organ metastasis indicated worse survival in thymic carcinoma, whereas lung invasion and pericardial mass indicated worse survival in high-risk thymoma. In conclusion, CT can serve as an important tool for predicting the prognosis and survival of patients with TETs.

SCIENTIFIC REPORTS (2023)

Article Oncology

Resound Trial: A phase 2 study of regorafenib in patients with thymoma (type B2-B3) and thymic carcinoma previously treated with chemotherapy

Matteo Perrino et al.

Summary: The study showed that regorafenib has anti-tumor activity in TETs patients, with 13 patients achieving partial response. The data demonstrated a median progression-free survival of 9.6 months and a median overall survival of 33.8 months, indicating potential efficacy of regorafenib in the treatment of TETs.

CANCER (2022)

Article Cardiac & Cardiovascular Systems

CT Radiomic Features for Predicting Resectability and TNM Staging in Thymic Epithelial Tumors

Jose Arimateia Batista Araujo-Filho et al.

Summary: The computed tomography radiomics model showed good performance in predicting resectability status and staging in thymic epithelial tumors. The model was able to accurately predict incomplete resections and advanced stage tumors preoperatively.

ANNALS OF THORACIC SURGERY (2022)

Review Oncology

Imaging Evaluation of Thymoma and Thymic Carcinoma

Chad D. Strange et al.

Summary: Imaging is crucial in the management of patients with thymoma and thymic carcinoma, providing information for diagnosis, staging, assessing treatment response, and detecting recurrent disease.

FRONTIERS IN ONCOLOGY (2022)

Article Medicine, General & Internal

Apatinib in patients with recurrent or metastatic thymic epithelial tumor: a single-arm, multicenter, open-label, phase II trial

Zhengbo Song et al.

Summary: This study evaluated the efficacy and safety of apatinib in the treatment of advanced TETs. The results showed promising antitumor activity and manageable toxicity of apatinib in this patient population.

BMC MEDICINE (2022)

Article Oncology

SARS-CoV-2 vaccine in patients with thymic epithelial tumours with and without active or pre-existing autoimmune disorders: Brief report of a TYME network safety analysis

Federica Giugliano et al.

Summary: The study found that SARS-CoV-2 mRNA vaccines are safe in patients with TET, with no cases of worsening or reactivation of autoimmune diseases observed. Some patients experienced mild adverse events post-vaccination, but none required hospitalization.

EUROPEAN JOURNAL OF CANCER (2022)

Article Oncology

Joint-Predominant Rheumatic Complications of Immune Checkpoint Inhibitor Therapy in Patients with Thymic Epithelial Tumors

Cristina Mullenix et al.

Summary: ICIs have revolutionized cancer treatment, but immune-mediated toxicity is a concern for TETs patients. The cases presented in this report highlight the spectrum of immune-mediated musculoskeletal adverse events in TETs patients.

ONCOLOGIST (2022)

Article Respiratory System

CT-based radiomics analysis for differentiation between thymoma and thymic carcinoma

Ryosuke Ohira et al.

Summary: This study successfully differentiated between thymoma and thymic carcinoma using a radiomics analysis of CT image features. GLCM-energy and solidity were identified as significant predictors of thymic carcinoma, providing valuable diagnostic information.

JOURNAL OF THORACIC DISEASE (2022)

Review Oncology

Diagnostic Challenges in the Cytology of Thymic Epithelial Neoplasms

Jonathan Willner et al.

Summary: Thymic epithelial neoplasms, including thymoma, thymic carcinoma, and thymic neuroendocrine neoplasms, are rare tumors that make up the majority of anterior mediastinal masses. Fine needle aspirations (FNA) of these masses are challenging to interpret due to the histologic diversity of thymic neoplasms and overlapping features with tumors from other sites. However, with the use of ancillary studies and radiology, FNAs can provide clinically actionable results. This review discusses the utility and limitations of thymic FNAs and highlights the diagnostic features and pitfalls of these specimens.

CANCERS (2022)

Article Oncology

CD117, BAP1, MTAP, and TdT Is a Useful Immunohistochemical Panel to Distinguish Thymoma from Thymic Carcinoma

Mounika Angirekula et al.

Summary: This study aimed to identify immunohistochemical markers that can aid in distinguishing between thymomas and thymic carcinomas. The results showed that a combination panel of CD117, BAP1, mTAP, and TdT can predict thymic carcinomas and thymomas with a certain level of accuracy.

CANCERS (2022)

Article Oncology

Continuous sunitinib schedule in advanced platinum refractory thymic epithelial neoplasms: A retrospective analysis from the ThYmic MalignanciEs (TYME) Italian collaborative group

Gabriele Antonarelli et al.

Summary: Continuous daily dosing (CDD) sunitinib showed significant antitumor activity and a manageable toxicity profile in platinum-resistant thymic epithelial tumors (TETs) patients. This study provides evidence for considering CDD sunitinib as a potential treatment option for TETs.

EUROPEAN JOURNAL OF CANCER (2022)

Article Oncology

Treatment outcomes and prognosis of immune checkpoint inhibitors therapy in patients with advanced thymic carcinoma: A multicentre retrospective study

Wenxian Wang et al.

Summary: This study evaluated the efficacy and safety of immune checkpoint inhibitors (ICIs) in advanced thymic carcinoma. The results showed that combination treatment of ICIs with chemotherapy had better objective response rate and progression-free survival compared to ICIs monotherapy. Liver or brain metastasis was a poor prognostic factor for ICIs monotherapy. The incidence of immune-related adverse events was high.

EUROPEAN JOURNAL OF CANCER (2022)

Article Immunology

Fatal toxicity induced by anti-PD-1 immune checkpoint inhibitor in thymic epithelial tumor

Xuquan Jing et al.

Summary: Standard treatment options for advanced thymic epithelial tumors (TETs) are still lacking. However, targeted immune checkpoint inhibitors (ICIs) of the PD-1 pathway may be a practical choice, although close monitoring is needed due to the higher risk of severe immuno-related adverse events, especially for thymomas.

IMMUNOTHERAPY (2022)

Article Oncology

Avelumab plus axitinib in unresectable or metastatic type B3 thymomas and thymic carcinomas (CAVEATT): a single-arm, multicentre, phase 2 trial

Fabio Conforti et al.

Summary: This study reported the efficacy and safety of the combination of avelumab and axitinib in patients with advanced type B3 thymoma and thymic carcinoma. The results showed promising anti-tumor activity and acceptable toxicity, suggesting that this combination therapy could be a new standard treatment option for patients who have progressed after chemotherapy.

LANCET ONCOLOGY (2022)

Article Oncology

Comparison of Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy between B3 Thymoma and Thymic Carcinoma

Yue Hao et al.

Summary: There is no significant difference in the efficacy and safety of platinum-based chemotherapy as first-line therapy between B3 thymoma and thymic carcinoma. Squamous carcinoma and non-squamous carcinoma subgroup showed similar survival outcomes.

CURRENT ONCOLOGY (2022)

Article Medicine, General & Internal

Severe cardiotoxicity in 2 patients with thymoma receiving immune checkpoint inhibitor therapy: A case report

Shiwei Liu et al.

Summary: This article highlights the serious complications that immunotherapy may cause in cancer treatment through two cases of immune myocarditis in patients. It reminds doctors to pay close attention to the cardiac condition of patients when using immunotherapy.

MEDICINE (2022)

Review Oncology

Impact of expert pathologic review of thymic epithelial tumours on diagnosis and management in a real-life setting: A RYTHMIC study

Thierry J. Molina et al.

Summary: A retrospective analysis of patients discussed at the RYTHMIC tumor board revealed a high level of discordances in TET diagnosis, with 6% of patients having major discordances that could lead to completely different clinical management. Further follow-up and expert reviews are essential for optimal patient care.

EUROPEAN JOURNAL OF CANCER (2021)

Article Cell Biology

Molecular predictors of response to pembrolizumab in thymic carcinoma

Yongfeng He et al.

Summary: This study analyzed potential predictive markers for response to immunotherapy in patients with advanced thymic carcinoma, identifying that PDL1 expression and alterations in genes or pathways correlated with PD-L1 expression (CYLD and BAP1) could be key factors influencing treatment response.

CELL REPORTS MEDICINE (2021)

Article Oncology

Diffuse High Intensity PD-L1 Staining in Thymic Epithelial Tumors

Sukhmani K. Padda et al.

JOURNAL OF THORACIC ONCOLOGY (2015)

Article Oncology

When a thymic carcinoma becomes a GIST

Valentina Rossi et al.

LUNG CANCER (2013)

Article Oncology

Rare thoracic cancers, including peritoneum mesothelioma

Sabine Siesling et al.

EUROPEAN JOURNAL OF CANCER (2012)

Article Oncology

The Masaoka-Koga Stage Classification for Thymic Malignancies Clarification and Definition of Terms

Frank C. Detterbeck et al.

JOURNAL OF THORACIC ONCOLOGY (2011)