AB046. Clinical landscape and immunological features of patients with thymic carcinoma
Abstract

AB046. Clinical landscape and immunological features of patients with thymic carcinoma

Erica Pietroluongo1, Pietro De Placido1,2, Angelo Luciano1, Margaret Ottaviano3, Rocco Morra4, Marianna Tortora5, Annarita Peddio1, Carmine De Angelis1, Grazia Arpino1, Sabino De Placido1, Alberto Servetto1, Giovannella Palmieri1, Roberto Bianco1, Mario Giuliano1,2

1Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 2Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy; 3Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy; 4Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy; 5Regional Coordinating Center for Rare Tumors (CRCTR) of Campania Region at University Federico II, Naples, Italy

Correspondence to: Erica Pietroluongo, MD. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy. Email: erica.pietroluongo@unina.it.

Background: Thymomas are frequently associated with autoimmune disorders (ADs), including myasthenia gravis (MG), pure red cell aplasia (PRCA), and Good’s syndrome (GS). On the other hand, the association of immune disorders (IDs), comprising ADs and paraneoplastic syndromes (PNSs), with thymic carcinoma (TC) has not been clearly established. This analysis aimed to explore prevalence, clinical presentation, and prognostic implications of IDs in a cohort of TC patients.

Methods: This was a retrospective study including consecutive patients who were diagnosed with TC between January 2014 and January 2024 at the University of Naples Federico II, Italy. Clinical data were extracted from electronic medical records. Immunological screening was performed as per national guidelines. PNSs were investigated only upon clinical suspicion. Patients’ characteristics were summarized using media, medians, and percentages as appropriate. For categorical data, Fisher’s exact tests were used. Kaplan-Meier methods and log-rank tests were used for survival analyses (GraphPad Prism 9.0 software).

Results: Twenty-seven TC patients were included in the study. The median age at diagnosis was 58 years (range, 29–77 years). Among the study cohort, 24 (88.8%) patients were diagnosed with advanced, inoperable TC. Eighteen IDs were identified (66.6%), including 1 rheumatoid arthritis, 1 Guillain-Barré syndrome, 4 MG (1 being subclinical), and 12 GS. All patients received a median of 3 systemic lines of anticancer treatment (range, 1–11); 25 out of the 27 patients received platinum-based chemotherapy as a first-line treatment. No statistically significant correlation was found between objective response (OR) to platinum-based chemotherapy and IDs (P=0.65). Nevertheless, a statistically significant correlation was found between the clinical benefit rate (CBR) and the presence of any IDs (P=0.047). Within the study cohort, patients with IDs showed significantly longer OS than those without IDs (137.7 vs. 15.9 months; P=0.01).

Conclusions: To our knowledge, this is the first report providing a comprehensive description of IDs and long-term outcome in a cohort of TC patients. These data support the need to perform systematic screening of TC patients for IDs at the diagnosis and throughout the natural disease course. Further studies, possibly using larger international databases.

Keywords: Thymic epithelial tumors (TETs); thymic carcinoma (TC); immune disorders (IDs)

Acknowledgments

The authors thank the European Reference Network (ERN-EURACAN), which is a powerful resource for transnational collaboration in rare cancers. Clinical research was performed by E.P. and P.D.P. within the PhD Program in Advanced Biomedical and Surgical Therapies at the Department of Clinical Medicine and Surgery, University “Federico II”, Naples, Italy. P.D.P. performed this research as part of the research activities as a PNRR “Fit4MedRob” - RTD-A at the Department of Advanced Biomedical Sciences.

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab046/coif). M.O. reports speakers’ fees and travel accommodations from MSD, Novartis, BMS, Sanofi Regeneron, Amgen. C.D.A. reports an advisory role for Roche, Lilly, Novartis, Astrazeneca, Pfizer, Seagen, Daiichi-Sankyo, Gilead, GSK, speaker fees from Roche, Lilly, Novartis, Pfizer, Seagen, GSK, Gilead, Daiichi-Sankyo, travel grants from Gilead, and research support (to the institution) from Novartis, Gilead, and Daiichi-Sankyo. Roberto Bianco reports fees for lectures and participation on advisory boards from Roche, AstraZeneca, Novartis, Lilly, BMS, MSD, Pfizer. A.S. reports payment or honoraria for lectures, presentations, speakers’ bureaus, or educational events from Lilly, Gilead, MSD, Roche, Novartis, MSD, Janssen, AstraZeneca. He also reports support for attending meetings and/or travel from Bristol-Myers Squibb, AstraZeneca, Janssen, and Daiichi Sankyo. He reports participation on Data Safety Monitoring Boards for MSD and Novartis. MSD. G.A. reports consulting fees, honoraria for lectures, presentations, speakers’ bureaus, and travel support from AstraZeneca, Daiichi Sankyo, Novartis, Roche, Pfizer, Lilly, Gilead, and Seagen. She also reports participation on a Data Safety Monitoring Board for Roche and Novartis. M.G. reports consulting fees from Lilly, Celgene, Novartis, Pfizer; fees for lectures and travel support from Lilly, Celgene, Novartis, Pfizer, Istituto Gentili, Eisai Europe Ltd., Roche. S.D.P. reports consulting fees and lecture fees from Astrazeneca, Novartis, Pfizer, Roche, Daiichi Sankyo, Lilly, Clovis, Seagen, GSK, MSD. Pietro De Placido is supported by an American-Italian Cancer Foundation Post-Doctoral Research Fellowship, years 2023–2024. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the ethics board of the University of Naples Federico II (approval No. 186/2023), and individual consent for this retrospective analysis was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-24-ab046
Cite this abstract as: Pietroluongo E, De Placido P, Luciano A, Ottaviano M, Morra R, Tortora M, Peddio A, De Angelis C, Arpino G, De Placido S, Servetto A, Palmieri G, Bianco R, Giuliano M. AB046. Clinical landscape and immunological features of patients with thymic carcinoma. Mediastinum 2024;8:AB046.

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