Objective Response to Epirubicin and Lonidamine: A Case of Advanced Thymoma Previously Treated with the ADOC Scheme and Unresponsive to Paclitaxel Plus Cyclophosphamide

Abstract

Malignant thymomas are uncommon neoplasms of the anterior mediastinum. 1 Lewis J.E. Wick M.R. Scheithauer B.W. et al. Thymoma: a clinicopathologic review. Cancer. 1987; 60: 2727-2743 Crossref PubMed Scopus (445) Google Scholar Most thymomas are encapsulated and can be cured by complete surgical resection either followed or not followed by radiation therapy. 2 Maggi G. Casadio C. Cavallo A. et al. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991; 51: 152-156 Abstract Full Text PDF PubMed Scopus (328) Google Scholar Cisplatin and anthracycline regimens have been proven to be highly active as first-line approach, with overall response rates ranging from 50 to 90%. 3 Fornasiero A. Daniele O. Ghiotto C. et al. Chemotherapy of invasive thymoma. J Clin Oncol. 1990; 8: 1419-1423 Crossref PubMed Scopus (94) Google Scholar ADOC scheme (cisplatin 50 mg/m 2 Maggi G. Casadio C. Cavallo A. et al. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991; 51: 152-156 Abstract Full Text PDF PubMed Scopus (328) Google Scholar , doxorubicin 40 mg/m 2 Maggi G. Casadio C. Cavallo A. et al. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991; 51: 152-156 Abstract Full Text PDF PubMed Scopus (328) Google Scholar , vincristine 0.6 mg/m 2 Maggi G. Casadio C. Cavallo A. et al. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991; 51: 152-156 Abstract Full Text PDF PubMed Scopus (328) Google Scholar and cyclophosphamide 700 mg/m 2 Maggi G. Casadio C. Cavallo A. et al. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991; 51: 152-156 Abstract Full Text PDF PubMed Scopus (328) Google Scholar ) is widely used in Italy, being able to obtain 80% and 91% response rates in two single institutional experiences. 3 Fornasiero A. Daniele O. Ghiotto C. et al. Chemotherapy of invasive thymoma. J Clin Oncol. 1990; 8: 1419-1423 Crossref PubMed Scopus (94) Google Scholar , 4 Berruti A. Borasio P. Roncari A. et al. Neoadjuvant chemotherapy with adriamycin, cisplatin, vincristine and cyclophosphamide (ADOC) in invasive thymomas: results in six patients. Ann Oncol. 1993; 4: 429-431 Abstract Full Text PDF PubMed Scopus (42) Google Scholar Unfortunately, second-line therapy (using either cytotoxic agents or steroids) in patients progressing to ADOC has been reported to be totally ineffective, probably because the ADOC regimen contains all or nearly all the active drugs. 3 Fornasiero A. Daniele O. Ghiotto C. et al. Chemotherapy of invasive thymoma. J Clin Oncol. 1990; 8: 1419-1423 Crossref PubMed Scopus (94) Google Scholar