Fukuda Akito, Okuma Yusuke, Hakozaki Taiki, Mirokuji Kie, Yomota Makiko, Hishima Tsunekazu, Hosomi Yukio
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Front Oncol. 2022 Jan 14;11:779700. doi: 10.3389/fonc.2021.779700. eCollection 2021.
Platinum-based chemotherapy is the standard treatment for metastatic or unresectable thymic carcinoma. The optimal chemotherapy regimen has not yet been determined, including whether this should be combined with a second- or third-generation anti-cancer agent. We retrospectively evaluated the data of patients with metastatic or unresectable thymic carcinoma who were treated with a combination of cisplatin and irinotecan as first-line chemotherapy between 2002 and 2021 (trial registration UMIN000012175). The primary endpoint was response rate according to the RECIST criteria version 1.1. Secondary endpoints were disease control rate, progression-free survival (PFS), overall survival (OS), and toxicity (adverse events). Some patients analyzed in this study were also included in the previous trial, which was terminated early. For this analysis, we included 18 patients with a median age of 56 years and an Eastern Cooperative Oncology Group performance status of 0 or 1. All patients had clinical stage IVa or IVb thymic carcinoma according to the Masaoka-Koga staging system. The response rate was 44% and the disease control rate was 89%. The median PFS was 8.4 months (95% confidence interval (CI): 2.7-11.6 months) and the median OS was 45.6 months (95% CI: 15.7-69.1 months). Grade 3 or worse hematological toxicity was observed in 5 patients and grade 3 or worse non-hematological toxicity was observed in 3 patients. None of the patients developed febrile neutropenia, and no treatment-related deaths occurred. Thus, the combination of cisplatin and irinotecan as first-line chemotherapy for metastatic thymic carcinoma showed efficacy and acceptable toxicity.
铂类化疗是转移性或不可切除胸腺癌的标准治疗方法。尚未确定最佳化疗方案，包括是否应与第二代或第三代抗癌药物联合使用。我们回顾性评估了2002年至2021年间接受顺铂和伊立替康联合治疗作为一线化疗的转移性或不可切除胸腺癌患者的数据（试验注册号UMIN000012175）。主要终点是根据RECIST 1.1标准的缓解率。次要终点是疾病控制率、无进展生存期（PFS）、总生存期（OS）和毒性（不良事件）。本研究中分析的一些患者也包括在先前提前终止的试验中。对于本次分析，我们纳入了18例患者，中位年龄为56岁，东部肿瘤协作组体能状态为0或1。根据Masaoka-Koga分期系统，所有患者均患有临床IVa期或IVb期胸腺癌。缓解率为44%，疾病控制率为89%。中位PFS为8.4个月（95%置信区间（CI）：2.7 - 11.6个月），中位OS为45.6个月（95%CI：15.7 - 69.1个月）。5例患者观察到3级或更严重的血液学毒性，3例患者观察到3级或更严重的非血液学毒性。没有患者发生发热性中性粒细胞减少，也没有治疗相关死亡。因此，顺铂和伊立替康联合作为转移性胸腺癌的一线化疗显示出疗效和可接受的毒性。
