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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Pembrolizumab as a novel therapeutic option for patients with refractory thymic epithelial tumor: A case report
Jonathan Wong-Chong, Maureen Bernadach, Angeline Ginzac, Hugo Veyssière, Xavier Durando
Jonathan Wong-Chong, Maureen Bernadach, Xavier Durando, Département d’Oncologie Médicale, Centre Jean PERRIN, Clermont-Ferrand 63011, France
Jonathan Wong-Chong, Xavier Durando, UFR Médecine, Université Clermont Auvergne, Clermont-Ferrand 63011, France
Maureen Bernadach, Angeline Ginzac, Hugo Veyssière, Xavier Durando, Division de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand 63011, France
Maureen Bernadach, Angeline Ginzac, Hugo Veyssière, Xavier Durando, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, Clermont-Ferrand 63011, France
Maureen Bernadach, Xavier Durando, Centre d’Investigation Clinique, UMR501, Clermont-Ferrand 63011, France
Author contributions: Wong-Chong J, Bernadach M, and Durando X were involved in the patient’s case management; Wong-Chong J designed and wrote the report; Bernadach M and Durando X were responsible for revising the manuscript for important intellectual content; Ginzac A and Veyssière H were responsible for the manuscript layout and submission; all authors read and approved the final manuscript and were involved in the review and editing of the manuscript.
Informed consent statement: Written consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare having no conflicts of interest in relation to this case or its publication.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hugo Veyssière, Division de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre Jean PERRIN, 58 rue Montalembert, Clermont-Ferrand 63011, France. hugo.veyssiere@clermont.unicancer.fr
Received: October 26, 2020
Peer-review started: October 26, 2020
First decision: November 3, 2020
Revised: November 12, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: February 16, 2021
BACKGROUND
Thymic epithelial carcinomas are rare and have a poor prognosis. Treatment of thymic epithelial carcinoma is multimodal and includes surgery, post-operative radiation therapy, adjuvant and neoadjuvant chemotherapy, or exclusive chemotherapy based on disease resectability. However, there is currently no standard treatment regimen for metastatic and recurrent thymic carcinoma.
CASE SUMMARY
A 45-year-old Caucasian male, with no past medical history, presented with hepatalgia and a cervical mass. A computed tomography (CT) scan showed multiple suspect lesions in the lungs, liver, and anterior mediastinum associated with mediastinal and cervical adenopathy. CT-guided percutaneous biopsies of the liver lesions and anterior mediastinal mass were performed, confirming the histopathology of thymic epithelial carcinoma. Management consisted of several chemotherapy regimens and radiation therapy, administered between April 2016 and December 2018. The patient achieved complete metabolic response. Fluorodeoxyglucose positron emission tomography/CT performed in June 2019 showed disease relapse, with reappearance of a large hypermetabolic hepatic mass and involvement of mediastinal and axillary lymph nodes. Intravenous pembrolizumab (200 mg, every 3 wk) was administered after two prior systemic therapies. The patient’s response to treatment was last documented on March 5, 2020.
CONCLUSION
Pembrolizumab was successful in treatment of a patient with programmed death-ligand 1-negative metastatic thymic carcinoma, pretreated with chemotherapy.
Core Tip: Thymic epithelial carcinomas are rare and have poor prognosis. The overall 5-year survival rate for patients with thymic carcinoma is about 30%-50%. We present the case of a 45-year-old Caucasian male who presented with hepatalgia and a cervical mass, and was diagnosed with programmed death-ligand 1-negative metastatic thymic carcinoma. The patient underwent pretreatment with platinum-based chemotherapy, after which pembrolizumab was administered as salvage therapy and complete metabolic response was achieved.
