Zucali Paolo Andrea, De Vincenzo Fabio, Perrino Matteo, Digiacomo Nunzio, Cordua Nadia, D'Antonio Federica, Borea Federica, Santoro Armando
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Department of Oncology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Mediastinum. 2021 Sep 25;5:24. doi: 10.21037/med-21-11. eCollection 2021.
Thymic epithelial tumours (TETs) are rare tumours originating from the thymus. Considering the rarity of this disease, the management of TETs is still challenging and difficult. In fact, all the worldwide clinical practice guidelines are based on data from retrospective analyses, prospective single arm trials or experts' opinions. The results of combined modality therapy (chemotherapy, surgery, radiotherapy) in thymic malignancies are reasonably good in less advanced cases whereas in case of advanced (unsuitable for surgery) or metastatic disease, a platinum-based chemotherapy is considered standard of care. Unfortunately, chemotherapy in the palliative setting has modest efficacy. Moreover, due to the lack of known oncogenic molecular alterations, no targeted therapy has been shown to be efficient for these tumours. In order to offer the best diagnostic and therapeutic tools, patients with TETs should be managed with a continuous and specific multidisciplinary expertise at any step of the disease, especially in the era of a novel coronavirus disease (COVID-19). Current evidences show that cancer patients might have more severe symptoms and poorer outcomes from COVID-19 infection than general population. With the exception of the patients carrying a Good's syndrome, there is no evidence that patients with TETs present a higher risk of infection compared with other cancer patients and their management should be the same. The aim of this review is to summarize the existing literature about systemic treatments for TETs in all clinical setting (local and locally advanced/metastatic disease) exploring how these therapeutic strategies have been managed in the COVID-19 era.
胸腺上皮肿瘤（TETs）是起源于胸腺的罕见肿瘤。鉴于这种疾病的罕见性，TETs的管理仍然具有挑战性且困难重重。事实上，所有全球临床实践指南均基于回顾性分析、前瞻性单臂试验或专家意见的数据。在病情不太严重的情况下，胸腺恶性肿瘤的综合治疗（化疗、手术、放疗）效果相当不错，而对于晚期（不适于手术）或转移性疾病，以铂类为基础的化疗被视为标准治疗方法。不幸的是，姑息治疗中的化疗疗效一般。此外，由于缺乏已知的致癌分子改变，尚无靶向治疗被证明对这些肿瘤有效。为了提供最佳的诊断和治疗工具，TETs患者在疾病的任何阶段都应通过持续且特定的多学科专业知识进行管理，尤其是在新型冠状病毒病（COVID-19）流行的时代。目前的证据表明，癌症患者感染COVID-19后可能会出现比普通人群更严重的症状和更差的预后。除了患有古德综合征的患者外，没有证据表明TETs患者与其他癌症患者相比存在更高的感染风险，他们的管理方式应该相同。本综述的目的是总结所有临床情况下（局部及局部晚期/转移性疾病）TETs全身治疗的现有文献，探讨在COVID-19时代这些治疗策略是如何实施的。
