Abstract 471P
Background
Despite being a rare disease entity, Thymoma and Thymic carcinomas represent the most common cause of anterior mediastinal mass. Clinical course is widely varied from an indolent course to florid metastatic disease with paraneoplastic manifestation. Treatment guidelines are based on small phase 2 studies. Data of chemotherapy in advanced thymoma is limited.
Methods
It is a retrospective study of advanced thymic epithelial tumors treated with chemotherapy over a period of 7 years (2011 -2017). All patients with unresectable /metastatic thymic tumours and who have received chemotherapy as were included in the study. Independent review of radiology images and histopathology slides were performed.
Results
There were 55 cases registered with thymic malignancy and 32 cases were analyzed for present study. Among them 27 cases were thymoma, 3 were thymic carcinoma and 2 were thymic NET. The median age was 39 years (22 65 years). Male: female ratio was 3: 1. The median duration of symptoms was 5.9 months (0-36 months). Twelve cases (38%) had features of superior vena cava obstruction at presentation. The mean size of mediastinal mass was 8.9 + 3.26 (range 2-15 cm). More than half of the cases (56%) showed calcification. Mediastinal lymph nodes were seen in 14 patients (46%). There was pleural involvement in 14 patients (73%) and pericardial involvement in 13 cases (43%). Pleural effusion was seen in 17(53%). Only 5 cases had stage III, 18 had stage Iva and 9 had stage IVb disease. The most common histological subtype as per WHO classification was B1 in 11 patients (34%) followed by B3 in 9 patients (28%) in our cohort. Out of 32 cases 3 have had upfront R2 resection. Post chemotherapy, one case attained CR, 10 had PR, 13 had SD and 3 had PD. 6 cases underwent surgery post induction therapy. 3 had R1 resection and 3 had R2 resection. Cisplatin, doxorubicin and cyclophosphamide (CAP) remains first choice for chemotherapy in 81% patients followed by paclitaxel-carboplatin in 12.5%. Radiation therapy was given to 13 patients. After a median follow up of 24.86 months, median PFS is 16.1 months and median OS was not reached.
Conclusions
Thymic malignancies are a heterogeneous group of disorders. Multi-modality treatment including chemotherapy is an effective and feasible treatment for advanced thymoma.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
All authors are equally responsible. Institute ethics committee has given the clearance.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
490P - Outcomes of sequential epidermal growth factor receptor tyrosine (EGFR) tyrosine kinase inhibitor (TKI) therapy in patients with advanced non-small cell lung carcinoma (NSCLC)- a real-world institutional experience
Presenter: Yvonne Ang
Session: Poster display session
Resources:
Abstract
498P - An observational retrospective study to evaluate the incidence of acquired EGFR T790M resistance in NSCLC patients with EGFR mutation following progression after at least one prior EGFR TKI treatment in Taiwan: ARISE study
Presenter: Shang-gin Wu
Session: Poster display session
Resources:
Abstract
501P - Clinical characteristics and efficacy in non-small cell lung cancer patients with EGFR exon 20 insertion and EGFR amplification
Presenter: Xin Gao
Session: Poster display session
Resources:
Abstract
502P - Epidermal growth factor receptor tyrosine kinase inhibitor treatment response in advanced non-small cell lung cancer with uncommon mutations: A multicenter observational study
Presenter: Masaki Kanazu
Session: Poster display session
Resources:
Abstract
482P - Interim analysis from a phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo De Marinis
Session: Poster display session
Resources:
Abstract
483P - A phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients with EGFR mutation-positive NSCLC: A biomarker analysis
Presenter: Rafael Rosell
Session: Poster display session
Resources:
Abstract
484P - Activity of afatinib in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC and baseline brain metastases: Pooled analysis of three large phase IIIb trials
Presenter: Maya Gottfried
Session: Poster display session
Resources:
Abstract
491P - Clinical outcomes of leptomeningeal metastases in EGFR-mutant lung adenocarcinoma
Presenter: Chia-I Shen
Session: Poster display session
Resources:
Abstract
510P - Paclitaxel as continuation maintenance therapy in patients with advanced non-small cell lung cancer
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract
496P - Higher osimertinib introduction rate achieved by multiple repeated re-biopsy after acquired resistance to first/second generation EGFR-TKIs
Presenter: Taira Ninomaru
Session: Poster display session
Resources:
Abstract