Departments of Radiation Oncology.
Respiratory.
Anticancer Drugs. 2023 Aug 1;34(7):852-856. doi: 10.1097/CAD.0000000000001473. Epub 2022 Dec 5.
The optimal pharmaceutical regimen for advanced thymic epithelial tumors (TETs) remains controversial when first-line chemotherapy fails. This retrospective study aims to evaluate the efficacy and safety of anlotinib treatment for patients with relapsed and refractory TETs. Patients with progressive disease after failure of platinum-based chemotherapy were enrolled in this study. Anlotinib was orally taken once a day at an initial dose of 12 mg (10 mg when body weight <60 kg). The cycle was repeated every 3 weeks (2 weeks of treatment followed by 1-week rest). Objective response rate (ORR) and progression-free survival (PFS) were recorded as primary endpoints. There were 50 patients enrolled in this study from October 2018 to June 2021 at a median age of 50 (range 23-79) years old. Patients with thymoma and thymic carcinoma were 33 (66%) and 17 (34%), respectively. The ORR in thymoma and thymic carcinoma patients were 33% (11/33) and 41% (7/17), respectively. The median PFS (mPFS) was 7 (95% CI, 5.9-10.2) months in thymoma patients and 6 (95% CI, 4.6-9.3) months in the thymic carcinoma group. Eleven patients experienced dose reduction due to toxicities, among whom, eight patients discontinued treatment even after dose reduction. Six patients with thymoma showed myasthenia gravis deterioration during treatment, and two of them died of myasthenia gravis crisis. Anlotinib is active in patients with advanced TETs refractory to routine chemotherapy. Prescription of anlotinib to patients with myasthenia gravis should be made cautiously.
对于一线化疗失败的晚期胸腺癌（TET）患者，最佳药物治疗方案仍存在争议。本回顾性研究旨在评估安罗替尼治疗复发和难治性 TET 患者的疗效和安全性。本研究纳入了铂类化疗失败后疾病进展的患者。安罗替尼初始剂量为 12mg（体重<60kg 时为 10mg），每日口服 1 次。每 3 周（2 周治疗，1 周休息）重复一个周期。客观缓解率（ORR）和无进展生存期（PFS）被记录为主要终点。2018 年 10 月至 2021 年 6 月，本研究共纳入 50 例患者，中位年龄为 50 岁（范围 23-79 岁）。患者中胸腺瘤和胸腺癌分别为 33 例（66%）和 17 例（34%）。胸腺瘤和胸腺癌患者的 ORR 分别为 33%（11/33）和 41%（7/17）。胸腺瘤患者的 mPFS 为 7 个月（95%CI，5.9-10.2），胸腺癌组为 6 个月（95%CI，4.6-9.3）。11 例患者因毒性反应而减少剂量，其中 8 例即使减少剂量后也停止了治疗。6 例胸腺瘤患者在治疗过程中出现肌无力恶化，其中 2 例死于肌无力危象。安罗替尼对常规化疗耐药的晚期 TET 患者有效。对于患有重症肌无力的患者，应谨慎开具安罗替尼处方。
