TY - JOUR
T1 - Systemic Therapy in Advanced Thymic Epithelial Tumors
T2 - Insights from the RYTHMIC Prospective Cohort
AU - Merveilleux du Vignaux, Claire
AU - Dansin, Eric
AU - Mhanna, Laurent
AU - Greillier, Laurent
AU - Pichon, Eric
AU - Kerjouan, Mallorie
AU - Clément-Duchêne, Christelle
AU - Mennecier, Bertrand
AU - Westeel, Virginie
AU - Robert, Marie
AU - Quantin, Xavier
AU - Zalcman, Gérard
AU - Thiberville, Luc
AU - Lena, Hervé
AU - Molina, Thierry
AU - Calcagno, Fabien
AU - Fournel, Pierre
AU - Mazières, Julien
AU - Besse, Benjamin
AU - Girard, Nicolas
N1 - Publisher Copyright:
© 2018 International Association for the Study of Lung Cancer
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Introduction: Thymic epithelial tumors (TETs) are rare malignancies that may be aggressive and difficult to treat. In the advanced setting, systemic treatments may be delivered as primary therapy before surgery or definitive radiotherapy, as exclusive treatment when no focal treatment is feasible, or in the setting of recurrences. Réseau tumeurs THYMIques et Cancer (RYTHMIC) is the nationwide network for TETs in France. The objective of the study was to describe the modalities and analyze the efficacy of systemic treatments for patients with advanced TETs included in the RYTHMIC prospective database hosted by the French Thoracic Cancer Intergroup. Methods: All consecutive patients for whom systemic treatment was discussed at the RYTHMIC multidisciplinary tumor board from 2012 to 2015 and who received at least one cycle of treatment were included. The main end points were objective response and progression-free survival (PFS). Results: A total of 236 patients were included in this analysis. Of those 236 patients, 91 received primary chemotherapy, leading to response rates of 83% for thymomas and 75% for thymic carcinomas and a median PFS of 23.2 months. A strong predictor of longer PFS was histologic type of thymoma (p < 0.001). Exclusive chemotherapy was delivered to 54 patients. The response rates were 31% for thymomas and 37% for thymic carcinomas. The median PFS was 6.2 months, and it was correlated to response rate (p = 0.001). Systemic therapy for a first, second, third, and fourth recurrence was delivered to 114, 81, 51, and 27 patients, respectively. The response rates ranged between 15% and 39% for thymomas and 4% to 21% for thymic carcinomas. The median PFS times were 7.7, 6.2, 5.9, and 6.5 months, respectively. Conclusion: Patients with advanced thymic malignancies may receive multiple lines of systemic therapy, with an opportunity for clinically relevant PFS rates for which objective response may be a surrogate. Our real-life study provides landmark efficacy data that are needed when designing clinical trials to assess innovative agents.
AB - Introduction: Thymic epithelial tumors (TETs) are rare malignancies that may be aggressive and difficult to treat. In the advanced setting, systemic treatments may be delivered as primary therapy before surgery or definitive radiotherapy, as exclusive treatment when no focal treatment is feasible, or in the setting of recurrences. Réseau tumeurs THYMIques et Cancer (RYTHMIC) is the nationwide network for TETs in France. The objective of the study was to describe the modalities and analyze the efficacy of systemic treatments for patients with advanced TETs included in the RYTHMIC prospective database hosted by the French Thoracic Cancer Intergroup. Methods: All consecutive patients for whom systemic treatment was discussed at the RYTHMIC multidisciplinary tumor board from 2012 to 2015 and who received at least one cycle of treatment were included. The main end points were objective response and progression-free survival (PFS). Results: A total of 236 patients were included in this analysis. Of those 236 patients, 91 received primary chemotherapy, leading to response rates of 83% for thymomas and 75% for thymic carcinomas and a median PFS of 23.2 months. A strong predictor of longer PFS was histologic type of thymoma (p < 0.001). Exclusive chemotherapy was delivered to 54 patients. The response rates were 31% for thymomas and 37% for thymic carcinomas. The median PFS was 6.2 months, and it was correlated to response rate (p = 0.001). Systemic therapy for a first, second, third, and fourth recurrence was delivered to 114, 81, 51, and 27 patients, respectively. The response rates ranged between 15% and 39% for thymomas and 4% to 21% for thymic carcinomas. The median PFS times were 7.7, 6.2, 5.9, and 6.5 months, respectively. Conclusion: Patients with advanced thymic malignancies may receive multiple lines of systemic therapy, with an opportunity for clinically relevant PFS rates for which objective response may be a surrogate. Our real-life study provides landmark efficacy data that are needed when designing clinical trials to assess innovative agents.
KW - Chemotherapy
KW - Network
KW - Recurrence
KW - Thymic Carcinoma
KW - Thymoma
UR - http://www.scopus.com/inward/record.url?scp=85055259552&partnerID=8YFLogxK
U2 - 10.1016/j.jtho.2018.08.005
DO - 10.1016/j.jtho.2018.08.005
M3 - Article
C2 - 30138763
AN - SCOPUS:85055259552
SN - 1556-0864
VL - 13
SP - 1762
EP - 1770
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 11
ER -