Claire Merveilleux du Vignaux1, Eric Dansin2, Laurent Mhanna3, Laurent Greillier4, Eric Pichon5, Mallorie Kerjouan6, Christelle Clément-Duchêne7, Bertrand Mennecier8, Virginie Westeel9, Marie Robert10, Xavier Quantin11, Gérard Zalcman12, Luc Thiberville13, Hervé Lena6, Thierry Molina14, Fabien Calcagno9, Pierre Fournel15, Julien Mazières3, Benjamin Besse16, Nicolas Girard17. 1. Respiratory Medicine Department, Hospices Civils de Lyon, Lyon, France; University of Lyon, University Claude Bernard Lyon 1, Lyon, France. 2. Medical Oncology Department, Centre Oscar Lambret, Lille, France. 3. Respiratory Medicine Department, University Hospital, Toulouse, France. 4. Respiratory Medicine Department, Assistance Publique Hôpitaux de Marseille, Marseille, France. 5. Respiratory Medicine Department, University Hospital, Tours, France. 6. Respiratory Medicine Department, University Hospital, Rennes, France. 7. Medical Oncology Department, Cancer Institute, Nancy, France. 8. Respiratory Medicine Department, University Hospital, Strasbourg, France. 9. Respiratory Medicine Department, University Hospital, Besançon, France. 10. Medical Oncology Department, Institut de Cancérologie de l'Ouest, Nantes, France. 11. Respiratory Medicine Department, University Hospital, Montpellier, France. 12. Respiratory Medicine Department, Bichat Hospital, Assistance Publique Hôpitaux de Paris, Paris, France. 13. Respiratory Medicine Department, University Hospital, Rouen, France. 14. Pathology Department, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France. 15. Medical Oncology Department, Institut de Cancérologie de la Loire, Saint-Etienne, France. 16. Medical Oncology Department, Gustave Roussy, Villejuif, France. 17. University of Lyon, University Claude Bernard Lyon 1, Lyon, France; Thorax Institute Curie-Montsouris, Curie Institute, Paris, France. Electronic address: nicolas.girard2@curie.fr.
Abstract
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.
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.
Authors: Gabrielle Drevet; Stéphane Collaud; François Tronc; Nicolas Girard; Jean-Michel Maury Journal: Cancer Manag Res Date: 2019-07-22 Impact factor: 3.989
Authors: Sanjay Popat; Neal Navani; Keith M Kerr; Egbert F Smit; Timothy J P Batchelor; Paul Van Schil; Suresh Senan; Fiona McDonald Journal: Oncologist Date: 2020-11-21 Impact factor: 5.837