A multidisciplinary approach to treating a unique case of recurrent metastatic thymic carcinoma: case report.

Autor:	Wang C; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd., Hempstead, NY 11549, USA., Erick Elkowitz D; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Esposito MJ; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Shah RD; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Tannous H; Stony Brook Medicine, Stony Brook, NY, USA., Barilla-Labarca ML; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Seetharamu N; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in rare disease [Ther Adv Rare Dis] 2023 Aug 11; Vol. 4, pp. 26330040231190661. Date of Electronic Publication: 2023 Aug 11 (Print Publication: 2023).
DOI:	10.1177/26330040231190661
Abstrakt:	Thymic carcinoma (TC) is a rare and aggressive malignancy of the thymus associated with less than 25% 5 years survivability. Our case report showcases the successful treatment of advanced metastatic TC using a multidisciplinary approach and the utility of checkpoint inhibitors in treatment of recurrent TC. A 50-year-old man presented with Raynaud's phenomenon and was found to have a stage IVb TC (T3N2M0). Eight months after management with neoadjuvant chemotherapy, surgical resection and adjuvant chemoradiotherapy, patient was diagnosed with metastasis of TC to the liver and a concurrent stage III (T2N1M0) primary sigmoid colon adenocarcinoma. Following complete resection of the colon adenocarcinoma, the patient started palliative-intent treatment for TC with pembrolizumab given PD-L1 tumor proportionate score of 100%. This resulted in a sustained complete response for 38 months. Our patient did have immune-related adverse events involving multiple organs but was able to continue pembrolizumab for a standard treatment duration of 2 years with multidisciplinary care. When recurrent disease was noted in a portocaval lymph node, pembrolizumab was reinitiated and a second complete response was achieved. The patient has maintained that complete response while maintaining an acceptable quality of life, showing that treatment with pembrolizumab is effective in patients after discontinuation with prior immunotherapy. Competing Interests: The authors declare that there is no conflict of interest. (© The Author(s), 2023.)
Databáze:	MEDLINE
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