In another study, the ADOC regimen (doxorubicin, cisplatin, vincristine, cyclophosphamide) produced a 92% response rate (34 of 37 patients), including complete responses in 43% of patients.
One study of combined chemotherapy with cisplatin and etoposide produced responses in 9 of 16 patients treated, with a median response duration of 3.4 years and a median survival of 4.3 years.
Nine of 28 patients with invasive thymoma or thymic carcinoma who received four cycles of etoposide, ifosfamide, and cisplatin (VIP) at 3-week intervals had partial responses. The median duration of response was 11.9 months (range, <1–26 months), and the median overall survival (OS) rate was 31.6 months. The 1-year and 2-year survival rates were 89% and 70%, respectively.[Level of evidence: 3iiiDiv] Nine of 34 patients treated with VIP had partial responses (32%; 95% confidence interval, 16%–52%). The median follow-up was 43 months (range, 12.8–52.3 months), the median duration of response was 11.9 months (range, <1–26 months), and the median OS rate was 31.6 months. Based on Kaplan-Meier estimates, the 1-year and 2-year survival rates were 89% and 70%, respectively. These results appear to be inferior to other combinations.
Standard treatment options:
- Repeat surgical resection, particularly for local recurrences and, in some cases, pleural and pericardial implants. Postoperative radiation therapy has been used for patients with incomplete resections and has been employed in selected patients following complete resection of recurrent thymoma.
- Radiation therapy (when possible, based on previous treatment).
- Corticosteroids in unresectable tumors that have not responded to radiation therapy.
Treatment options under clinical evaluation:
Areas of active clinical evaluation for patients with recurrent thymoma or thymic carcinoma include:
- New drug regimens.
- Variation of drug doses in current regimens.
- New radiation therapy schedules.
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent thymoma and thymic carcinoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.