Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Thorac Cancer. 2020 Nov;11(11):3383-3387. doi: 10.1111/1759-7714.13658. Epub 2020 Sep 30.
Thymic carcinoma is a rare and highly aggressive mediastinal tumor. Most patients are diagnosed at surgically unresectable stages. Current prospective and retrospective studies have indicated that platinum and anthracycline-based chemotherapy are the first choice drugs of first-line therapy for advanced thymic carcinoma. However, there is no optimal treatment after progression for patients who have undergone first-line and subsequent chemotherapy. Anlotinib, a novel small molecule tyrosine kinase multitarget inhibitor, was approved by the China Food and Drug Administration as a third-line treatment for advanced non-small cell lung cancer (NSCLC) in May 2018. Herein we report a case of an advanced thymic squamous cell carcinoma patient harboring EGFR exon 20 insertion who had previously received multiline therapy, including chemotherapy, radiotherapy as well as antiangiogenic therapy. Also as an angiogenesis inhibitor, anotinib had controlled his mediastinal mass after failure of the apatinib treatment. To date, over 23 months of progression-free survival (PFS) and six years of overall survival (OS) have been achieved. Compared with apatinib, the adverse reactions have been mild and tolerable and the patient's quality of life has improved. To our knowledge, this is the first report where anlotinib has been effective in controlling the progression of thymic carcinoma. In the multiline treatment of advanced thymic carcinoma, anlotinib appears to show great potential when utilized as a salvage treatment.
胸腺癌是一种罕见且高度侵袭性的纵隔肿瘤。大多数患者在手术无法切除的阶段被诊断出来。目前的前瞻性和回顾性研究表明，铂类和蒽环类药物为基础的化疗是晚期胸腺癌一线治疗的首选药物。然而，对于接受一线和后续化疗后进展的患者，目前尚无最佳的治疗方法。安罗替尼是一种新型小分子酪氨酸激酶多靶点抑制剂，于 2018 年 5 月被中国食品药品监督管理局批准用于治疗晚期非小细胞肺癌（NSCLC）三线治疗。在此，我们报告一例先前接受过多种治疗，包括化疗、放疗和抗血管生成治疗的晚期胸腺癌鳞状细胞癌患者，该患者存在 EGFR 外显子 20 插入。作为一种血管生成抑制剂，安罗替尼在阿帕替尼治疗失败后控制了他的纵隔肿块。截至目前，该患者无进展生存期（PFS）已超过 23 个月，总生存期（OS）已超过 6 年。与阿帕替尼相比，不良反应较轻且可耐受，患者的生活质量得到了改善。据我们所知，这是首例报道安罗替尼有效控制胸腺癌进展的病例。在晚期胸腺癌的多线治疗中，安罗替尼作为挽救性治疗似乎具有很大的潜力。
