Efficacy and safety of uracil-tegafur in patients with recurrent or metastatic thymic carcinoma

Abstract

Background: Thymic carcinoma (TC) is a rare but aggressive thymic epithelial neoplasm, with lymphoepithelioma-like histological features resembling nasopharyngeal carcinoma. Epstein–Barr virus is a known etiology of various tumors, including nasopharyngeal carcinoma, in Asian patients. These patients have a significant response to cisplatin plus 5-fluorouracil (5-FU) combination chemotherapy. Interestingly, this regimen seems to be effective for TC s resembling nasopharyngeal carcinoma. Currently, the standard second-line therapy for advanced TC is uncertain. The use of uracil-tegafur (UFT), a combination of uracil and 5-FU prodrug, has not been reported in literature. We analyzed the effectiveness and toxicity of UFT as an optional regimen for recurrent or metastatic TC. Materials and Methods: This retrospective study enrolled patients verified to have recurrent or metastatic TC and who were treated with UFT between 2017 and 2019 in our hospital. All patients were treated with UFT until disease progression, the patients could no longer tolerate the treatment, or patient refusal. We assessed the safety and efficacy of UFT for TC. Results: Four patients were female and seven were male. The age ranged from 41 to 77 years. The histological features of TC were squamous cell carcinoma and poorly differentiated carcinomas. Grade 3 toxicity occurred in one patient. No treatment-related deaths were observed. Among the 11 patients, 6, 2, and 3 had a partial response, stable disease, and progressive disease, respectively. The objective response rate was 54.5%. The median progression-free survival and overall survival of patients who received UFT chemotherapy were 8.16 months (95% confidence interval [CI]: 0.76–15.56 months) and 19.43 months (95% CI: 17.07–21.78 months), respectively. Conclusion: Single-agent UFT seems to have potential effectiveness and good tolerability in patients with recurrent or advanced TC.