Available evidence and new biological perspectives on medical treatment of advanced thymic epithelial tumors

Ann Oncol. 2015 May;26(5):838-847. doi: 10.1093/annonc/mdu527. Epub 2014 Nov 19.

Abstract

Thymic epithelial tumors (TETs) are rare primary mediastinal tumors arising from thymic epithelium. Their rarity and complexity hinder investigations of their causes and therapy development. Here, we summarize the existing knowledge regarding medical treatment of these tumors, and thoroughly review the known genetic aberrations associated with TETs and the present status of potential biological treatments. Epidermal growth factor receptor (EGFR), stem-cell factor receptor, insulin-like growth factor-1 receptor (IGF1R), and vascular endothelial growth factors (VEGF-A, VEGF-B, and VEGF-2) are overexpressed in TETs. EGFR overexpression in TETs is associated with higher stage, and IGF1R overexpression has poor prognostic value. Data indicate that anti-IGF1R monoclonal antibodies, and inhibitors of angiogenesis, somatostatin receptors, histone deacetylase, mammalian target of rapamycin, and cyclin-dependent kinases may be active against TETs. Continued investigations in this field could lead to advancement of targeted and biological therapies for TETs.

Keywords: biological agents; chemotherapy; targeted therapy; thymic carcinoma; thymic epithelial tumors; thymoma.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Biomarkers, Tumor / antagonists & inhibitors*
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • Humans
  • Molecular Targeted Therapy* / adverse effects
  • Neoplasm Staging
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / genetics
  • Neoplasms, Glandular and Epithelial / metabolism
  • Neoplasms, Glandular and Epithelial / pathology
  • Signal Transduction / drug effects*
  • Thymus Neoplasms / drug therapy*
  • Thymus Neoplasms / genetics
  • Thymus Neoplasms / metabolism
  • Thymus Neoplasms / pathology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Biological Products
  • Biomarkers, Tumor

Supplementary concepts

  • Thymic epithelial tumor