Merveilleux du Vignaux Claire, Maury Jean-Michel, Girard Nicolas
Univ Lyon, Université Claude Bernard Lyon1, Lyon, France.
National Expert Centre for Thymic Malignancies, Hospices Civils de Lyon, Lyon, France.
Curr Treat Options Oncol. 2017 Aug 10;18(9):52. doi: 10.1007/s11864-017-0495-8.
The management of thymic tumours is a paradigm of multidisciplinary collaboration. Chemotherapy may be administered part of curative-intent sequential strategy integrating subsequent surgery or radiotherapy, or as an exclusive treatment if local treatment is not achievable. Recurrences of thymic epithelial tumors should be managed according to the same strategy as newly diagnosed tumors. Given the limited activity of cytotoxic agents in the advanced, refractory setting, novel and innovative agents are needed. The better understanding of thymic carcinogenesis may provide a rationale in this setting.Targeted agents approved for other solid tumors that have shown activity in thymic tumors include mTOR, KIT inhibitors, as well as somatostatin analogues. Anti-angiogenic agent sunitinib may be considered a standard in advanced lines of treatment. Ongoing studies are assessing the opportunity of targeting emerging targets, including PI3K, CDK, and immune checkpoint PD-1/PD-L1.
胸腺瘤的管理是多学科协作的典范。化疗可作为整合后续手术或放疗的根治性序贯策略的一部分，或者在无法进行局部治疗时作为唯一的治疗方法。胸腺上皮肿瘤的复发应按照与新诊断肿瘤相同的策略进行处理。鉴于细胞毒性药物在晚期难治性情况下的活性有限，需要新型和创新性药物。对胸腺肿瘤发生机制的更好理解可能在此背景下提供理论依据。已批准用于其他实体瘤且在胸腺肿瘤中显示出活性的靶向药物包括mTOR、KIT抑制剂以及生长抑素类似物。抗血管生成药物舒尼替尼可被视为晚期治疗线中的标准药物。正在进行的研究正在评估针对新兴靶点（包括PI3K、CDK和免疫检查点PD-1/PD-L1）的机会。
