Highlights
- •Immunotherapy is effective in advanced thymic carcinoma.
- •Immunochemotherapy was associated with better efficacy compared to immune checkpoint inhibitors monotherapy.
- •Immunochemotherapy as first line treatments may be a good treatment choice.
- •Liver or brain metastasis was a poor prognostic factor of mPFS in immune checkpoint inhibitors monotherapy.
Abstract
Background
Immunotherapy has demonstrated good efficacy and survival outcomes in solid tumours.
However, efficacy data for immune checkpoint inhibitors (ICIs) in advanced thymic
carcinoma are lacking. The present study aimed to assess the activity of ICIs in advanced
thymic carcinoma.
Methods
A multicentre retrospective study was conducted to explore the efficacy and safety
of ICIs for advanced thymic carcinoma. Objective response rate (ORR), progression-free
survival (PFS), overall survival, and immune-related adverse events (irAEs) were analysed.
In addition, factors independently associated with treatment efficacy and survival
outcomes were evaluated.
Results
A total of 77 patients with advanced thymic carcinoma were enrolled between March
2016 and September 2021. The ORR was existing the difference between ICIs monotherapy
(n = 23) and ICIs combined with chemotherapy (n = 54) (17.4% versus 44.4%, P = 0.024).
The ICIs combination treatments were associated with better median PFS (mPFS) compared
to ICIs monotherapy (12.7 months versus 2.1 months, P < 0.001). Notably, liver or
brain metastasis was a poor prognostic factor of mPFS (1.8 months versus 3.5 months,
P = 0.012) in the ICIs monotherapy group. In addition, mPFS for the first-line treatment
(n = 27) was longer than that for ICIs as the second- or posterior-line treatment
(n = 50) (P < 0.001). The incidence of irAEs was 54.5% (42/77) in the 77 enrolled
patients. The incidence of grade 3–4 irAE was 15.6% (12/77).
Conclusions
Immunotherapy is effective in advanced thymic carcinoma, especially for combination
with chemotherapy showed promising antitumour activity, which indicates worthy of
combination treatment strategy for further study. IrAEs also require close monitoring
and management.
Keywords
Abbreviations:
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Article info
Publication history
Published online: August 13, 2022
Accepted:
June 30,
2022
Received:
June 17,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
