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Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report

Thymic carcinoma is a rare malignant tumor with a poor prognosis. No standard treatment is currently available. The present case was a 64-year-old male smoker with no symptoms referred to our hospital because of abnormal chest radiological findings. The CT study showed a tumor between the anterior m...

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Autores principales: Nishii, Yoichi, Furuhashi, Kazuki, Ito, Kentaro, Sakaguchi, Tadashi, Suzuki, Yuta, Fujiwara, Kentaro, Yasuma, Taro, Kobayashi, Tetsu, D’Alessandro-Gabazza, Corina N., Gabazza, Esteban C., Taguchi, Osamu, Hataji, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319623/
https://www.ncbi.nlm.nih.gov/pubmed/35890187
http://dx.doi.org/10.3390/ph15070889
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author Nishii, Yoichi
Furuhashi, Kazuki
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Fujiwara, Kentaro
Yasuma, Taro
Kobayashi, Tetsu
D’Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Taguchi, Osamu
Hataji, Osamu
author_facet Nishii, Yoichi
Furuhashi, Kazuki
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Fujiwara, Kentaro
Yasuma, Taro
Kobayashi, Tetsu
D’Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Taguchi, Osamu
Hataji, Osamu
author_sort Nishii, Yoichi
collection PubMed
description Thymic carcinoma is a rare malignant tumor with a poor prognosis. No standard treatment is currently available. The present case was a 64-year-old male smoker with no symptoms referred to our hospital because of abnormal chest radiological findings. The CT study showed a tumor between the anterior mediastinum and the right lung upper lobe, multiple nodular shadows along the right pleura, and pleural effusion. A CT-guided needle biopsy revealed squamous cell carcinoma. However, the differential diagnosis between thymic carcinoma and primary lung cancer was difficult. Treatment with carboplatin, nanoparticle albumin-bound paclitaxel, and pembrolizumab was initiated. The CT scan showed tumor shrinkage and good clinical response after four treatment cycles. Therapy was switched to maintenance therapy with pembrolizumab alone. Imaging studies showed further tumor shrinkage after twelve cycles of maintenance therapy with pembrolizumab. Sixteen cycles of maintenance therapy were continued without performance status deterioration. An abnormal radiological finding was detected after a twelve-month exacerbation-free period. The diagnosis was thymic carcinoma. Treatment with lenvatinib was initiated, and tumor-size reduction was observed. This is the first report of a case showing a successful maintenance therapy with pembrolizumab after effective first-line therapy with a combination of carboplatin-based chemotherapy plus pembrolizumab in advanced thymic carcinoma.
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spelling pubmed-93196232022-07-27 Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report Nishii, Yoichi Furuhashi, Kazuki Ito, Kentaro Sakaguchi, Tadashi Suzuki, Yuta Fujiwara, Kentaro Yasuma, Taro Kobayashi, Tetsu D’Alessandro-Gabazza, Corina N. Gabazza, Esteban C. Taguchi, Osamu Hataji, Osamu Pharmaceuticals (Basel) Case Report Thymic carcinoma is a rare malignant tumor with a poor prognosis. No standard treatment is currently available. The present case was a 64-year-old male smoker with no symptoms referred to our hospital because of abnormal chest radiological findings. The CT study showed a tumor between the anterior mediastinum and the right lung upper lobe, multiple nodular shadows along the right pleura, and pleural effusion. A CT-guided needle biopsy revealed squamous cell carcinoma. However, the differential diagnosis between thymic carcinoma and primary lung cancer was difficult. Treatment with carboplatin, nanoparticle albumin-bound paclitaxel, and pembrolizumab was initiated. The CT scan showed tumor shrinkage and good clinical response after four treatment cycles. Therapy was switched to maintenance therapy with pembrolizumab alone. Imaging studies showed further tumor shrinkage after twelve cycles of maintenance therapy with pembrolizumab. Sixteen cycles of maintenance therapy were continued without performance status deterioration. An abnormal radiological finding was detected after a twelve-month exacerbation-free period. The diagnosis was thymic carcinoma. Treatment with lenvatinib was initiated, and tumor-size reduction was observed. This is the first report of a case showing a successful maintenance therapy with pembrolizumab after effective first-line therapy with a combination of carboplatin-based chemotherapy plus pembrolizumab in advanced thymic carcinoma. MDPI 2022-07-19 /pmc/articles/PMC9319623/ /pubmed/35890187 http://dx.doi.org/10.3390/ph15070889 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Nishii, Yoichi
Furuhashi, Kazuki
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Fujiwara, Kentaro
Yasuma, Taro
Kobayashi, Tetsu
D’Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Taguchi, Osamu
Hataji, Osamu
Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title_full Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title_fullStr Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title_full_unstemmed Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title_short Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report
title_sort good response of advanced thymic carcinoma with low pd-l1 expression to chemotherapy plus pembrolizumab as first-line therapy and to pembrolizumab as maintenance therapy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319623/
https://www.ncbi.nlm.nih.gov/pubmed/35890187
http://dx.doi.org/10.3390/ph15070889
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