Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241, West Huaihai Road, Shanghai, 200030, China.
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Med Oncol. 2022 Jan 4;39(2):25. doi: 10.1007/s12032-021-01620-9.
There are no optimal regimens for advanced thymic epithelial tumors (TETs) when frontline chemotherapy fails. In this study, we aimed to assess the activity of Bevacizumab in combination with a routine chemotherapeutic regimen. Patients with advanced TETs who had failed after previous chemotherapy were enrolled in this study. Paclitaxel (160 mg/m) and cisplatin (70 mg/m) or carboplatin (area under the curve, 6) plus Bevacizumab (7.5 mg/kg) were intravenously injected on day 1.The treatment was repeated every 3 weeks until the disease progressed or intolerable toxicities occurred. Between March 2018 and August 2020, a total of 49 patients (21 thymoma and 28 thymic carcinoma) received the new treatment. There were 28 men and 21 women with a median age of 50 years (range: 21-73 years). The median number of cycles was 3 (range: 1-6) per patient. The objective response rate (ORR) for all patients was 43% (21/49). The ORRs for thymoma and thymic carcinoma were 24% and 57%, respectively. The median progression-free survival for thymoma and thymic carcinoma was 6 and 8 months, respectively. Hematological toxicities were the main side effects. Paclitaxel and platinum plus Bevacizumab showed promising effects in refractory or relapsed advanced TETs without severe toxicity. Even when applied as salvage therapy, this regimen resulted in a better ORR than frontline chemotherapy.
当一线化疗失败时，晚期胸腺癌（TETs）没有最佳的治疗方案。本研究旨在评估贝伐珠单抗联合常规化疗方案的疗效。本研究纳入了先前化疗失败的晚期 TETs 患者。紫杉醇（160mg/m2）和顺铂（70mg/m2）或卡铂（曲线下面积 6）联合贝伐珠单抗（7.5mg/kg）于第 1 天静脉注射。每 3 周重复治疗，直到疾病进展或出现不可耐受的毒性。2018 年 3 月至 2020 年 8 月，共 49 例（21 例胸腺瘤和 28 例胸腺癌）患者接受了新的治疗。28 例为男性，21 例为女性，中位年龄为 50 岁（范围：21-73 岁）。中位治疗周期数为 3 个（范围：1-6 个）/患者。所有患者的客观缓解率（ORR）为 43%（21/49）。胸腺瘤和胸腺癌的 ORR 分别为 24%和 57%。胸腺瘤和胸腺癌的中位无进展生存期分别为 6 个月和 8 个月。血液学毒性是主要的副作用。紫杉醇联合铂类药物加贝伐珠单抗在难治性或复发性晚期 TETs 中显示出良好的疗效，且无严重毒性。即使作为挽救性治疗，该方案的 ORR 也优于一线化疗。
