Systemic treatment of malignant thymoma: a decade experience at a single institution.

Objectives: Thymic malignancies are rare tumors on the superior anterior mediastinum. Treatment of advanced stages includes chemotherapy. The objective of this analysis was to review the treatment of this disease in the past decade.
Methods: This is a retrospective analysis of the results obtained in a total of 29 patients with advanced malignant thymomas who underwent systemic chemotherapy in the past 10 years at our institution. Sixteen received neoadjuvant chemotherapy in the attempt to shrink the tumor and then perform a radical operation. The others received chemotherapy as palliation. Platinum based chemotherapy was mainly used.
Results: The response rate to first-line chemotherapy was 50% in the neoadjuvant setting and 31% in the advanced setting. A better survival was observed in patients who underwent chemotherapy as part of their combined modality treatment, in patients with thymomas, and in patients without visceral metastases. Some patients responded to targeted therapies at relapse.
Conclusions: A better understanding of the biology of this rare tumor may allow in the future the development of better therapies for the more aggressive tumor types (WHO type C), which appear to be increasing in frequency.