Analysis of the efficacy and safety of immunotherapy in advanced thymoma patients

Cancer Med. 2023 Mar;12(5):5649-5655. doi: 10.1002/cam4.5357. Epub 2022 Nov 16.

Abstract

Background: Immunotherapy has exhibited efficacy in thymic carcinoma patients; however, there are insufficient data to confirm this efficacy in thymoma. The toxicity of immunotherapy also remains to be determined.

Methods: The efficacy and safety of immunotherapy were analyzed in 11 thymoma patients who received PD-1 inhibitors according to a range of relevant indexes including the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and immunotherapy-related adverse events.

Results: The PFS and OS rates for all patients were 12.8 and 56.5 months, respectively. No difference in efficacy was detected between monotherapy and combination therapy (PFS: 12.8 vs 2.2 months, P = 0.787; OS: 73.8 vs 56.5 months, P = 0.367). The ORRs and DCRs for all patients were 27.3% and 90.9%, respectively. The incidence of adverse events was 45.5% among the 11 thymoma patients, including immune-related myocarditis (36.4%), immune-related liver damage (18.2%), and myasthenia gravis (18.2%). In the whole cohort of patients, the rate of adverse events of grade 3 or higher was 36.4%. The rates of adverse events of grade 3 or 4 in B3-type and non-B3-type thymoma patients were 0% and 62.5%, respectively.

Conclusions: Immunotherapy elicited a response in thymoma patients; however, more attention should be paid to the immune-related adverse events.

Keywords: efficacy; immune-related adverse events; immunotherapy; thymoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Combined Modality Therapy
  • Humans
  • Immunotherapy / adverse effects
  • Thymoma* / therapy
  • Thymus Neoplasms* / therapy