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. 2022 Apr;24(4):635-645.
doi: 10.1007/s12094-022-02788-w. Epub 2022 Feb 5.

SEOM-GECP-GETTHI Clinical Guidelines for the treatment of patients with thymic epithelial tumours (2021)

J Remon  1 , R Bernabé  2 , P Diz  3 , E Felip  4 , J L González-Larriba  5 , M Lázaro  6 , X Mielgo-Rubio  7 , A Sánchez  8 , I Sullivan  9 , B Massutti  10
Affiliations

SEOM-GECP-GETTHI Clinical Guidelines for the treatment of patients with thymic epithelial tumours (2021)

J Remon et al. Clin Transl Oncol. 2022 Apr.

Abstract

Thymic epithelial tumours (TET) represent a heterogeneous group of rare malignancies that include thymomas and thymic carcinoma. Treatment of TET is based on the resectability of the tumour. If this is considered achievable upfront, surgical resection is the cornerstone of treatment. Platinum-based chemotherapy is the standard regimen for advanced TET. Due to the rarity of this disease, treatment decisions should be discussed in specific multidisciplinary tumour boards, and there are few prospective clinical studies with new strategies. However, several pathways involved in TET have been explored as potential targets for new therapies in previously treated patients, such as multi-tyrosine kinase inhibitors with antiangiogenic properties and immune checkpoint inhibitors (ICI). One third of patient with thymoma present an autoimmune disorders, increasing the risk of immune-related adverse events and autoimmune flares under ICIs. In these guidelines, we summarize the current evidence for the therapeutic approach in patients with TET and define levels of evidence for these decisions.

Keywords: Chemotherapy; Lenvatinib; Multidisciplinary; Nivolumab; Thymic epithelial tumours.

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Conflict of interest statement

JR reports advisory board membership from MSD, BMS, BOHERING INGLEHEIM, ASTRAZENECA and OSE-IMMUOTHERAPEUTICS. RBC has nothing to disclose. PDT reports advisory board membership and speaker’s fees from BMS, AstraZeneca, Boehringer Ingelheim, ROCHE, MSD and TAKEDA; grant from AstraZeneca and speaker’s fees from Pfizer and Amgen. EF reports consultant fees or advisory position from AMGEN, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GSK, Janssen, Merck Serono, MSD Oncology, Novartis, Pfizer, Roche, Sanofi, Takeda, and Peptomyc. Speaker’s fees from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Medscape, Merck Sharp & Dohme, Peer Voice, Pfizer, Roche, Takeda and CME Outfitters. Research funding from Fundación Merck Salud and Merck KGaA. Other Relationship from GRIFOLS. JLGL has nothing to disclose. MLQ reports advisory board membership and speaker’s fees from BMS, MSD, Boehringer Ingelheim, AstraZeneca and Roche. XMR has nothing to disclose. ASH reports and speaker’s fees from BMS and Roche; Advisory board membership from Sanofi, Astra Zeneca, Novartis, Janssen, Takeda and Pfizer. IS reports advisory board membership, speaker’s fees and grants from Roche, Novartis Boehringer Ingelheim; speaker’s fees and grants from Bristol-Myers Squibb, Pfizer and Merck Sharp & Dohme; speaker’s fees and grants from AstraZeneca. BM has nothing to disclose.

Figures

Fig. 1
Fig. 1
Management of patients with thymic epithelial tumours and resectable disease
Fig. 2
Fig. 2
Management of patients with thymic epithelial tumours and locally advanced disease
Fig. 3
Fig. 3
Management of patients with thymic epithelial tumours and advanced disease not suitable for local strategies
See this image and copyright information in PMC

References

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Supplementary concepts