Carboplatin and paclitaxel show promise for advanced thymic carcinoma

By Afsaneh Gray, medwireNews Reporter

A multicentre, phase II study of carboplatin and paclitaxel (CbP) in chemotherapy-naïve patients with advanced thymic carcinoma has shown that the treatment has promising efficacy compared with standard anthracycline-based chemotherapy.

Thymic carcinoma is very rare, and consequently it is hard to investigate it separately from thymoma. Previous studies evaluating chemotherapy regimens have included patients with both types of tumour, explain Takashi Seto (National Kyushu Cancer Center, Fukuoka, Japan) and colleagues.

Forty patients from 21 centres across Japan were enrolled in the current study from May 2008 until November 2010. One patient subsequently dropped out. The sample size was decided on the basis that it was large enough to reject the primary endpoint of an objective response rate (ORR) of 20%.

Secondary endpoints included overall survival, progression-free survival and safety.

An independent pathological review committee determined the histological type of the patient tumours, including nine squamous cell carcinomas, 11 poorly differentiated neuroendocrine carcinomas, one basaloid carcinoma and 14 that were classified as “not otherwise specified”.

The patients received paclitaxel (200 mg/m2) followed by carboplatin (dose equivalent to area under the curve of six) every 3 weeks for a maximum of six cycles.

The team reports that one patient experienced a complete response to treatment,while thirteen had partial responses, yielding an ORR of 36%. Twenty-three patients had stable disease and two had disease progression.

Median progression-free survival was 7.5 months and the overall survival rates at 1 and 2 years were 85% and 71%, respectively.

Eighty-seven percent of patients experienced grade 3 to 4 neutropenia. All-grade sensory neuropathy was also high at 87%, but only 5.1% of patients developed grade 3 to 4 neuropathy.

No severe cardiovascular problems were observed, in contrast to anthracycline-based regimens, which are known to be associated with congestive heart failure, and there were no treatment-related deaths.

The researchers write in the Annals of Oncology: “In this trial, CbP showed a higher efficacy with an ORR of 36% and 1-year survival rate of 85% for advanced [thymic carcinoma] as compared with those from previous studies.”

They conclude: “Our results established that CbP, one of the standard treatments for non-small cell lung cancer, might be an option as a chemotherapy regimen for [thymic carcinoma].”

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