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
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 m...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/15/7/889 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Yoichi Nishii |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T10:13:11Z |
| format | Article |
| id | doaj.art-24ae323756b14f8394fa4a9137629b15 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-09T10:13:11Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-24ae323756b14f8394fa4a9137629b152023-12-01T22:33:47ZengMDPI AGPharmaceuticals1424-82472022-07-0115788910.3390/ph15070889Good 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 ReportYoichi Nishii0Kazuki Furuhashi1Kentaro Ito2Tadashi Sakaguchi3Yuta Suzuki4Kentaro Fujiwara5Taro Yasuma6Tetsu Kobayashi7Corina N. D’Alessandro-Gabazza8Esteban C. Gabazza9Osamu Taguchi10Osamu Hataji11Respiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanDepartment of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu 514-8507, JapanDepartment of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu 514-8507, JapanDepartment of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu 514-8507, JapanDepartment of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu 514-8507, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanRespiratory Center, Matsusaka Municipal Hospital, Matsusaka 515-0073, JapanThymic 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.https://www.mdpi.com/1424-8247/15/7/889pembrolizumabthymic carcinomasquamous cell carcinomalung cancer |
| spellingShingle | 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 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 Pharmaceuticals pembrolizumab thymic carcinoma squamous cell carcinoma lung cancer |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | pembrolizumab thymic carcinoma squamous cell carcinoma lung cancer |
| url | https://www.mdpi.com/1424-8247/15/7/889 |
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