Author of

• 20166

  +

  P1.17 - Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies (ID 703)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22844

    +

    P1.17-014 - Platinum Rechallenge in Advanced Thymic Epithelial Tumors: Still an Option in the Age of Target Therapy? A Monocentric Experience (ID 10296)

    09:30 - 16:00  |  Presenting Author(s): Margaret Ottaviano
    • Abstract

    Background:
    Advanced unresectable thymic epithelial tumors (TETs) are usually treated with platinum-based chemotherapy, although no randomized trials have been conducted and no clear recommendation on the regimens choice are available. Actually, the modern scenario of TETs treatment has become more complex after the introduction of biological agents, but no clear evidences on the more effective sequence treatment between chemotherapy and target therapy have been stated. Here we investigate the effectiveness of platinum rechallenge in advanced TETs.
    
    Method:
    All the clinical data of patients with advanced/unresectable or metastatic TETs, treated with first line platinum-based chemotherapy at our institution during a 10-year period were retrospectively reviewed, and those who received platinum rechallenge from the third line and beyond, were included in this study. Patients characteristics, disease control rate (DCR), overall survival (OS), progression free survival (PFS) and post-rechallenge (P-Re) OS and PFS were analysed.
    
    Result:
    Platinum rechallenge was administered in 22 patients, of whom 17 had thymoma and 5 thymic carcinoma. A DCR of 95.4% (stable disease (SD) 63.6%, partial response (PR) 31.8%) was achieved after the first line platinum-based chemotherapy according to RECIST criteria, while a DCR of 81.8% (SD 63.6%, PR 18.1%) was registered after platinum rechallenge. All the responders to first line, were confirmed as responders also to rechallenge, only 3 patients with stable disease to first line, had a progressive disease after rechallenge. The median OS of 122 months was statistically correlated with histotype (p=0.015) and with the median treatment free interval (TFI) of 18 months (p=0.019). No statistical correlation has been found between the median P-Re OS of 27 months, the histotype and the TFI. To point out that a statistical correlation between the P-Re PFS of 7 months and the administration of target therapy before rechallenge, has been observed (p=0.04).
    
    Conclusion:
    Our retrospective analysis showed that platinum rechallenge may be considered a suitable treatment for advanced, heavily pretreated TETs, especially in case of previous response and longer TFI. Moreover, in the light of our results, we assume, as already stated for other solid tumors, that the chemo-resistant clones can be re-sensitized to platinum by target agents. Prospective trials are needed.
    
    

  • 22845

    +

    P1.17-015 - Long Acting Octreotide plus Prednisone in Advanced Thymic Epithelial Tumors: A Real Life Clinical Experience (ID 10354)

    09:30 - 16:00  |  Presenting Author(s): Margaret Ottaviano
    • Abstract

    Background:
    The effectiveness of long acting octreotide and prednisone has been already observed in some cases of advanced, heavily pretreated thymic epithelial tumors (TETs) and confirmed in small phase II study with an overall response rate of about 30-38%. Based on these reports, here we investigate the outcome of patients treated with LAR octreotide and prednisone in a real life clinical experience.
    
    Method:
    All the patients with advanced and heavily pretreated TETs, who received LAR octreotide and prednisone from January 2007 to January 2017, were included in this monocentric, retrospective analysis. As for local practice, all the patients performed OctreoScan and the treatment schedule consisted of administration of LAR octreotide (30 mg/every 28 days intramuscularly) plus prednisone 0.2 mg/kg/day until documented progressive disease. Patients characteristics, survival outcome, overall response rate and toxicity were evaluated.
    
    Result:
    26 patients (12 males and 14 females) were included in the study. The median overall survival was 88 months, which statistically correlates with histotype (thymoma vs thymic carcinoma) (p=0.0006), but no with stage disease (Masaoka-Koga IVA vs IVB) (p=0.21). The median progression free survival of 21 months, statistically correlates with stage disease (p=0.008); age at diagnosis (p=0.04) and previous surgery (p=0.04). No correlation has been found with histotype (p=0.12) and line of therapy (third vs beyond) (p=0.50). In the whole population, an overall response rate of 42% was achieved and only 2 patients, both with thymic carcinoma, showed a progressive disease. Treatment was safe and no severe side effects were registered.
    
    Conclusion:
    Our clinical real life data confirm that somatostatin analogs plus prednisone is an effective and safe treatment in advanced, heavily pretreated TETs and, despite the new available therapy options, it may be still considered in the therapeutic algorithm for obtaining a prolonged control disease.