Targeted therapy for thymic epithelial tumors: a new horizon? Review of the literature and two cases reports

Future Oncol. 2015;11(8):1223-32. doi: 10.2217/fon.14.318.

Abstract

Surgical resection remains the cornerstone of therapy for early-stage thymic epithelial tumors (TETs), while in advanced or recurrent forms, a multimodality approach incorporating radiation and chemotherapy is required. Given the absence of effective treatment options for metastatic/refractory TETs and the poor related prognosis, there is a compelling need to identify promising 'drugable' molecular targets. Initial reports of activity from targeted agents in TETs derived from anecdotal cases have been often associated with specific activating mutations. Only in recent years, several agents have been formally investigated into prospective clinical trials, with varying success rates. We reviewed the literature on targeted therapy in TETs along with two cases of thymoma achieving striking responses to sorafenib in combination with lapatinib.

Keywords: cixutumumab; everolimus; sorafenib; sunitinib; targeted therapy; thymic carcinoma; thymic epithelial tumors; thymoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • ErbB Receptors / antagonists & inhibitors
  • Female
  • Histone Deacetylase Inhibitors / therapeutic use
  • Humans
  • Lapatinib
  • Molecular Targeted Therapy*
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / pathology
  • Neoplasms, Glandular and Epithelial / surgery
  • Niacinamide / administration & dosage
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds / administration & dosage
  • Pleural Neoplasms / drug therapy*
  • Pleural Neoplasms / secondary
  • Protein Kinase Inhibitors / therapeutic use*
  • Proto-Oncogene Proteins c-kit / antagonists & inhibitors
  • Quinazolines / administration & dosage
  • Receptor, IGF Type 1
  • Receptors, Somatomedin / antagonists & inhibitors
  • Sorafenib
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • Thymus Neoplasms / drug therapy*
  • Thymus Neoplasms / pathology
  • Thymus Neoplasms / surgery
  • Young Adult

Substances

  • Histone Deacetylase Inhibitors
  • IGF1R protein, human
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Quinazolines
  • Receptors, Somatomedin
  • Lapatinib
  • Niacinamide
  • Sorafenib
  • MTOR protein, human
  • EGFR protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins c-kit
  • Receptor, IGF Type 1
  • TOR Serine-Threonine Kinases

Supplementary concepts

  • Thymic epithelial tumor