Abstract
Thymoma and thymic carcinoma are rare thymic epithelial tumors. This study investigated the efficacy of first-line gemcitabine and cisplatin combination chemotherapy in advanced thymoma and thymic carcinoma. Retrospective review of patients with histologically-confirmed invasive, metastatic thymoma or thymic carcinoma treated with gemcitabine plus cisplatin as a first-line therapy between August 2008 and July 2016 at the Department of Respiratory Medicine II Peking University Cancer Hospital and Institute. The objective response rate was the primary end point. Forty patients, 14 with thymoma and 26 with thymic carcinoma, were identified. 19 received gemcitabine and cisplatin combined with Endostar (injectable recombinant human Endostatin); 21 received gemcitabine and cisplatin only. Of the 14 patients with thymoma, five (35.7%) achieved a partial response (PR) and nine (64.3%) had stable disease (SD); no patients had a complete response (CR) or progressive disease (PD). Among the 26 patients with thymic carcinoma, 14 (53.8%) achieved a PR, 12 (46.2%) had SD; no patients had a CR or PD. In thymic carcinoma, median progression free survival (PFS) was 16 months and median survival (OS) was 41 months; in thymoma, median PFS was 29 months and median OS was 68 months. In chemotherapy combined Endostar group, median PFS was 25 months and median OS was 68 months. In chemotherapy only group, median PFS was 18 months and median OS was 31 months. But PFS and OS were not significantly different between chemotherapy combined Endostar and chemotherapy only (P = 0.931, P = 0.184; respectively). This retrospective analysis indicates gemcitabine plus cisplatin has moderate efficacy and could represent a suitable first-line therapy for thymic carcinoma and thymoma, especially for patents who cannot tolerate anthracyclines. Chemotherapy combined with anti-vascular drug Endostar may improve the OS of patients with thymic carcinoma or thymoma, but more patients need to be included in the study.
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