Use of immune checkpoint inhibitors in thymic epithelial tumors

Thymic malignancies represent a heterogeneous group of rare thoracic cancers, which may be aggressive and difficult to treat. Thymic carcinomas are more aggressive tumours with frequent metastatic spread to lymph nodes and distant sites. In this setting, the use of immune checkpoint inhibitors has been considered a potential strategy for the treatment of those tumors. Overall, while immune checkpoint inhibitors targeting PD-1 or PD-L1 show promising efficacy, with response rates and duration of response in line with reported studies in other solid tumours, toxicity remains a major concern, despite systematic baseline workup for autoimmunity, with frequent occurrence of severe auto-immune adverse events. Therefore, immunotherapy is currently not a standard-of-care in thymic epithelial tumors, and should be further studied in clinical trials.