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  P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

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    P1.14-06 - Treatment Outcomes of Patients with Thymic Carcinoma: A Monocentric Experience of Sequential Regimens Modality (ID 14222)

    16:45 - 18:00  |  Author(s): Margherita Muratore
    • Abstract
    • Slides

    Background
    

    Thymic carcinoma (TC) compared with thymoma has a lower incidence rate and is more likely to be diagnosed in advanced-stage disease, with a worst prognosis. Platinum combination regimen is widely recognized as the best treatment in the first line setting, followed by other systemic therapies, such as cytotoxic drugs and target agents, with the aim of achieving control disease and prolonging survival. Since there is limited information about the optimal treatment modality in TC, this study aims to identify the most promising therapeutic sequence in terms of efficacy and toxicity profile.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We conducted a monocentric retrospective analysis of patients (pts) with un-resectable-metastatic TC, referred to our Rare Tumors Reference Center over a 15-year period. All pts with confirmed histological diagnosis, treated with at least three lines of therapy were included in the analysis. For each identified sequence treatment, progression free survival (PFS) and overall survival (OS), according to RECIST 1.1 and toxicity profile according to CTCAE v 4.0, were determined.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Among 52 patients with advanced TC, 17 of them (32.6%) treated with at least three lines of chemotherapies and target agents (imatinib, sunitinib, everolimus) were included in the study. Three main therapeutic sequences were identified: 1) platinum-based therapy - platinum-based therapy – target agent (7 pts); 2) platinum-based therapy – capecitabine and gemcitabine combination-therapy – target agent (5 pts); 3) platinum- based therapy – target agent – no platinum-based chemo (5 pts). The median OS from the start of first-line chemotherapy was 67 months with no significant difference among sequences, with an OS respectively of 83, 67 and 106 months (p< 0.99). Also for PFS, with a median value of 33 months, there was registered no significant difference, with respectively 33, 38 and 32 months (p< 0.99). A different toxicity profile was instead revealed, with no adverse events more than grade 2 for the second and third sequence, and, conversely, toxicity of grade 3 registered in more than 50% of the pts in first sequence. Asthenia, emesis and pancytopenia which required hospitalization in 3 pts, were the most frequent.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    To our knowledge, this is the first data analysis of sequential regimens modality in patients with advanced TC. Since the efficacy of each treatment sequence did not vary significantly, we suggest to administer the therapy sequence with the better toxicity profile. Moreover, considering the median survival outcome reached, we support the need to refer these patients to reference center with high expertise.

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