AB049. Sequential induction chemoradiotherapy for locally advanced thymic tumors: a phase II clinical trial
Abstract

AB049. Sequential induction chemoradiotherapy for locally advanced thymic tumors: a phase II clinical trial

Xuefei Zhang1, Changlu Wang2, Xiuxiu Hao1, Ning Xu1, Fenghao Yu1, Zhitao Gu1, Teng Mao1, Yan Shen3, Lei Zhu4, Qin Zhang2, Wentao Fang1

1Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; 2Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; 3Department of Radiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; 4Department of Pathology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Correspondence to: Wentao Fang, MD. Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, West Huaihai Road No. 241, Shanghai 200030, China. Email: vwtfang@hotmail.com.

Background: The optimal management of locally advanced thymic tumors remains controversial. We conducted a clinical trial (ChiCTR-OIC-16009130) to investigate the safety and efficacy of neoadjuvant sequential chemoradiotherapy in patients with locally advanced thymic tumors.

Methods: The trial was conducted in Shanghai Chest Hospital for patients with potentially unresectable (T3–4N0M0) thymic tumors. Induction consisted of chemotherapy (paclitaxel and carboplatin) and sequential radiation (40 Gy). Re-evaluation would be managed after chemotherapy. If the tumor became resectable, surgical resection would be performed, otherwise subsequent radiation would be performed. The primary endpoint was objective response rate (ORR).

Results: A total of 33 patients were accrued, which included 14 with thymomas and 19 with thymic carcinomas. ORR was 57.6%, with 19 patients having partial response (PR), 13 had stable disease (SD) and 1 had progression disease (PD). Thymomas had higher ORR (71.4%) than thymic carcinomas (47.4%). Both histologies presented poor ORR to chemotherapy, which was 14.3% in thymoma and 21.1% in thymic carcinoma. Meanwhile, higher ORR to radiation was also seen in thymoma (50%) compared to thymic carcinoma (25%). Nine (27.3%) patients experienced grade 3–4 toxicity. Surgical resection was feasible after induction in 27 patients (81.8%), among which 20 (74.1%) had complete resection. Pathological complete response was found in 1 (3.7%) patient. After a median follow up of 46 months, 5-year overall survival and progression free survival for the whole group were 75.6% and 48.8%, respectively.

Conclusions: Sequential induction chemoradiotherapy is tolerable and effective for patients with locally advanced thymic tumors, especially for patients with thymomas.

Keywords: Sequential; induction; chemoradiotherapy; locally advanced; thymic tumor

Acknowledgments

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-ab049/coif). W.F. serves as the Editor-in-Chief of Mediastinum from March 2017 to March 2027. 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 committee of Shanghai Chest Hospital (No. KS1970) and informed consent was obtained from all individual participants.

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-ab049
Cite this abstract as: Zhang X, Wang C, Hao X, Xu N, Yu F, Gu Z, Mao T, Shen Y, Zhu L, Zhang Q, Fang W. AB049. Sequential induction chemoradiotherapy for locally advanced thymic tumors: a phase II clinical trial. Mediastinum 2024;8:AB049.

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