Chemotherapy versus chemotherapy plus immune checkpoint inhibitors for the first‐line treatment of unresectable thymic carcinoma: A multicenter retrospective study

Author:

Zhang Baishen1ORCID,Liu Yao2,Chen Zhiting3,Chen Jing4,Yu Hui4ORCID,Li Meichen4,Ma Shudong3,Cheng Chao4ORCID,Chen Likun4ORCID

Affiliation:

1. Sun Yat‐Sen University Cancer Center State Key Laboratory of Oncology in South China; Guangdong Provincial Clinical Research Center for Cancer Guangzhou China

2. Department of Thoracic Surgery The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong China

3. Department of Oncology, Nanfang Hospital Southern Medical University Guangzhou China

4. Department of Medical Oncology Sun Yat‐Sen University Cancer Center; State Key Laboratory of Oncology in South China; Guangdong Provincial Clinical Research Center for Cancer Guangzhou China

Abstract

AbstractThymic carcinoma (TC) is a rare malignant tumor with a poor prognosis, and there is currently limited data on the use of immunotherapy in patients with unresectable TC. In this study, data of patients with unresectable TC diagnosed from January 2017 were retrospectively collected from multiple centers. Treatment response, progression‐free survival (PFS), overall survival (OS), survival‐independent prognostic factor, and adverse events (AEs) were further analyzed. As a result, a total of 93 patients with unresectable TC were enrolled, of which 54 received first‐line chemotherapy, and 39 received chemotherapy plus immune checkpoint inhibitors (ICIs). The objective response rate was 50% (27/54) in the chemotherapy group and 76.9% (30/39) in the chemotherapy plus ICIs group. The chemotherapy plus ICIs group achieved significant median PFS benefit (8.8 vs. 34.9 months, p < .001) and median OS benefit (41.8 months vs. not reached, p = .025). Multivariate analysis showed that ICIs and local therapy were independent prognostic factors for PFS. In addition, 17 patients developed immune‐related AEs (IRAEs), of which 15 (38.5%) had Grade 1 or 2 IRAEs and 2 (5.1%) had Grade 3 IRAEs in the chemotherapy plus ICIs group. In conclusion, the efficacy of chemotherapy plus ICIs is superior to chemotherapy, and the adverse effects are manageable in patients with unresectable TC.

Publisher

Wiley

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