*Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Jpn J Clin Oncol. 2013 Oct;43(10):1018-22. doi: 10.1093/jjco/hyt106. Epub 2013 Aug 4.
Thymic carcinoma is a rare mediastinal neoplasm, and the prognosis of patients with advanced thymic carcinoma is poor. No standard chemotherapeutic regimen has yet been established for the disease. This is the first report to evaluate the role of amrubicin, a novel anthracycline anticancer drug, in second-line and beyond treatment for patients with platinum-refractory advanced thymic carcinoma.
This study was a review of thymic carcinoma patients who had received amrubicin monotherapy between June 2003 and December 2011 for the progression of disease previously treated with platinum-based chemotherapy. Amrubicin was administered at 35 or 40 mg/m(2) for three consecutive days every 3 weeks, until progression.
Nine patients with recurrent thymic carcinoma were registered. Their median age was 61 years (range 45-72), and the patients included five males and four females. All nine patients had Masaoka's Stage IVb disease. There were three squamous cell carcinomas, one adenocarcinoma, one small-cell carcinoma and two other histological types. The mean number of chemotherapy cycles was five (range 2-13). Grade 3 or higher toxicities included mainly neutropenia (55.5%), anemia (25.0%) and febrile neutropenia (11.1%). No treatment-related deaths were observed. The response rate was 44.4% (95% confidence interval: 19-73). The median progression-free survival after the amrubicin monotherapy was 4.9 months, while the median overall survival was 6.4 months.
Single-agent amrubicin was found to be potentially useful as second-line and beyond chemotherapy for patients with advanced thymic carcinoma. Further multi-institutional prospective studies are warranted.
胸腺癌是一种罕见的纵隔肿瘤，晚期胸腺癌患者的预后较差。目前尚未为该疾病确立标准的化疗方案。这是首份报告，评估新型蒽环类抗癌药物氨柔比星在铂类耐药的晚期胸腺癌二线及以上治疗中的作用。
本研究回顾性分析了 2003 年 6 月至 2011 年 12 月期间接受氨柔比星单药治疗的胸腺癌患者，这些患者在铂类化疗进展后接受了治疗。氨柔比星的剂量为 35 或 40mg/m2，连续 3 天，每 3 周 1 次，直至疾病进展。
登记了 9 例复发性胸腺癌患者。患者的中位年龄为 61 岁（范围 45-72 岁），包括 5 例男性和 4 例女性。所有 9 例患者均为 Masaoka 分期 IVb 期。组织学类型包括 3 例鳞状细胞癌、1 例腺癌、1 例小细胞癌和 2 例其他类型。化疗周期的平均数量为 5 个（范围 2-13 个）。3 级或以上毒性主要包括中性粒细胞减少（55.5%）、贫血（25.0%）和发热性中性粒细胞减少（11.1%）。未观察到与治疗相关的死亡。客观缓解率为 44.4%（95%置信区间：19-73）。氨柔比星单药治疗后的中位无进展生存期为 4.9 个月，中位总生存期为 6.4 个月。
单药氨柔比星可能对晚期胸腺癌患者的二线及以上化疗有效。需要进一步开展多机构前瞻性研究。
