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Good Response of Advanced Thymic Carcinoma with Low PD-L1 Expression to Chemotherapy plus Pembrolizumab as First-Line Therapy and to Pembrolizumab as Maintenance Therapy: A Case Report

Authors :
Yoichi Nishii
Kazuki Furuhashi
Kentaro Ito
Tadashi Sakaguchi
Yuta Suzuki
Kentaro Fujiwara
Taro Yasuma
Tetsu Kobayashi
Corina N. D’Alessandro-Gabazza
Esteban C. Gabazza
Osamu Taguchi
Osamu Hataji
Source :
Pharmaceuticals. 15:889
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Thymic carcinoma is a rare malignant tumor with a poor prognosis. No standard treatment is currently available. The present case was a 64-year-old male smoker with no symptoms referred to our hospital because of abnormal chest radiological findings. The CT study showed a tumor between the anterior mediastinum and the right lung upper lobe, multiple nodular shadows along the right pleura, and pleural effusion. A CT-guided needle biopsy revealed squamous cell carcinoma. However, the differential diagnosis between thymic carcinoma and primary lung cancer was difficult. Treatment with carboplatin, nanoparticle albumin-bound paclitaxel, and pembrolizumab was initiated. The CT scan showed tumor shrinkage and good clinical response after four treatment cycles. Therapy was switched to maintenance therapy with pembrolizumab alone. Imaging studies showed further tumor shrinkage after twelve cycles of maintenance therapy with pembrolizumab. Sixteen cycles of maintenance therapy were continued without performance status deterioration. An abnormal radiological finding was detected after a twelve-month exacerbation-free period. The diagnosis was thymic carcinoma. Treatment with lenvatinib was initiated, and tumor-size reduction was observed. This is the first report of a case showing a successful maintenance therapy with pembrolizumab after effective first-line therapy with a combination of carboplatin-based chemotherapy plus pembrolizumab in advanced thymic carcinoma.

Details

ISSN :
14248247
Volume :
15
Database :
OpenAIRE
Journal :
Pharmaceuticals
Accession number :
edsair.doi...........5b6e55b89075d824a997d410820f9a15
Full Text :
https://doi.org/10.3390/ph15070889