Tateishi Akiko, Okuma Yusuke, Goto Yasushi, Arakaki Motoko, Igawa Yukiko Shimoda, Torasawa Masahiro, Shinno Yuki, Yoshida Tatsuya, Horinouchi Hidehito, Yamamoto Noboru, Ohe Yuichiro
Thoracic Oncology Department, National Cancer Center Hospital, Tokyo, Japan.
Thoracic Oncology Department, National Cancer Center Hospital, Tokyo, Japan;
Anticancer Res. 2024 Dec;44(12):5501-5513. doi: 10.21873/anticanres.17376.
BACKGROUND/AIM: Thymic carcinoma is a rare cancer with poor prognosis in unresectable cases. Treatment efficacy of carboplatin+paclitaxel (CP), lenvatinib, S-1, and sunitinib remains uncertain, with some patients experiencing increased post-treatment liver metastasis.
We performed a retrospective analysis of patients with metastatic thymic carcinoma who received chemotherapy between 2006 and 2023 at the National Cancer Center Hospital. We evaluated the clinical outcomes [progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), liver metastasis response rate (LMRR), and liver metastasis control rate (LMCR)] of CP, lenvatinib, S-1, and sunitinib.
A total of 178 patients were evaluated, with 78.1% having stage IV disease. Most patients had squamous cell carcinoma (85.4%), and 39 patients had liver metastases (21.9%). The most frequently administered treatments as 1-, 2-, and 3 line were CP (85.5%), S-1 (58.3%), and sunitinib (28.4%). The median PFS was 6.8, 9.4, 4.5, and 3.4 months in CP, lenvatinib, S-1, and sunitinib. CP showed an ORR of 41.6% and LMRR of 40.9%. The reverse response, in which only liver metastasis increased despite shrinkage of other lesions, was observed in lenvatinib (20%), S-1 (3.4%), and sunitinib (8.3%).
CP and lenvatinib provided effective outcomes in metastatic thymic carcinoma, aligning with previous findings. S-1 and sunitinib also show clinical activity but with variable responses in liver metastases. These results highlight the importance of tailored treatment strategies, particularly for patients with liver involvement.
背景/目的：胸腺癌是一种罕见的癌症，不可切除病例的预后较差。卡铂+紫杉醇（CP）、乐伐替尼、S-1和舒尼替尼的治疗效果仍不确定，部分患者治疗后肝转移增加。
我们对2006年至2023年在国立癌症中心医院接受化疗的转移性胸腺癌患者进行了回顾性分析。我们评估了CP、乐伐替尼、S-1和舒尼替尼的临床结局[无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）、肝转移缓解率（LMRR）和肝转移控制率（LMCR）]。
共评估了178例患者，其中78.1%为IV期疾病。大多数患者为鳞状细胞癌（85.4%），39例患者有肝转移（21.9%）。作为一线、二线和三线最常用的治疗方法分别是CP（85.5%）、S-1（58.3%）和舒尼替尼（28.4%）。CP、乐伐替尼、S-1和舒尼替尼的中位PFS分别为6.8、9..4、4.5和3.4个月。CP的ORR为41.6%，LMRR为40.9%。在乐伐替尼（20%）、S-1（3.4%）和舒尼替尼（8.3%）中观察到反向反应，即尽管其他病灶缩小，但仅肝转移增加。
CP和乐伐替尼在转移性胸腺癌中提供了有效的治疗效果，与之前的研究结果一致。S-1和舒尼替尼也显示出临床活性，但对肝转移的反应各不相同。这些结果突出了量身定制治疗策略的重要性，特别是对于有肝脏受累的患者。
