Pembrolizumab in patients with thymic carcinoma: a cautionary tale

The development of novel treatment options for advanced-stage thymic neoplasms remains a challenge. The rarity of this disease has precluded the conduct of large randomized controlled trials and all current data stem from phase II clinical trials and retrospective cohort studies. Thymic carcinomas comprise a small subset of thymic epithelial neoplasms and despite the fact that they behave more aggressively and have a worse prognosis than thymomas, they are either analyzed in combination with thymomas or excluded from clinical trials altogether (1).