Thymoma is usually treated with surgery. Where surgery is inappropriate, chemotherapy concurrent with, or sequential to, radiation therapy is recommended. Cisplatin-based combination chemotherapy is an appropriate option. Octreotide, alone or in combination with a corticosteroid, may be a reasonable option for recurrent cases. A recent Phase II study revealed that complete responses (CR) and partial responses were observed in three (20%) and three (20%) patients for a 40% RR, respectively. Grade 1–2 neutropenia, anemia and thrombocytopenia were the most common side-effects, noted in seven (46.7%), five (33.3%) and five (33.3%) patients, respectively. The most common grade 3 toxicity was neutropenia in three patients (20%). Median PFS was 11 months (95% confidence interval 4–17). The 1- and 2-year survival rates were 80% and 67%, respectively. There are other phase II trials that also suggest that cepacitabine in combination is effective.
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G. Palmieri , G. Merola , P. Federico , L. Petillo , M. Marino , M. Lalle , M. Milella , A. Ceribelli , L. Montella , C. Merola , S. Del Prete , M. Bergaglio , S. De Placido , and G. Di Lorenzo Preliminary results of phase II study of capecitabine and gemcitabine (CAP-GEM) in patients with metastatic pretreated thymic epithelial tumors (TETs) Annals of Oncology Advance Access published on October 30, 2009, DOI 10.1093/annonc/mdp483.
Palmieri, G., Merola, C., Petillo, L., Merola, G., Federico, P., Leopardo, D., Marino, M., Montella, L. Gemcitabine-capecitabine in platinum-refractory patients with thymic epithelial tumors J Clin Oncol (Meeting Abstracts) 2009 27: 7590