2023 World Conference on Lung Cancer (Posters)-EP14.02. Atypical Response to Metronomic Chemotherapy in a Patient with Advanced Thymoma

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This case report describes the atypical response of a patient with advanced thymoma to metronomic chemotherapy after fast progression on a platinum-based scheme. The patient initially received a platinum doublet with paclitaxel but experienced disease progression after four cycles. They were then hospitalized and started on metronomic chemotherapy with oral cyclophosphamide, weekly intravenous 5 fluorouracil, vincristine, and liposomal doxorubicin. After four cycles, the patient developed grade 3 mucositis and was readmitted to the hospital. They recovered and continued the chemotherapy regimen with cyclophosphamide withdrawn and the frequency changed to every 10 days.<br /><br />In April 2022, a major response was achieved, and liposomal doxorubicin was discontinued due to the risk of cardiotoxicity. However, in March 2023, the patient developed progression disease, and subsequent biopsy and genomic analysis revealed a tumor mutational burden of 1 mutation per megabase without pathogenic alterations. Gemcitabine was initiated but only resulted in progression disease in May 2023.<br /><br />Currently, the patient is undergoing treatment with oral metronomic etoposide and awaiting further evaluation by computed tomography. The case report highlights the unexpected and long-lasting response to metronomic chemotherapy in this patient, as well as the need for additional studies and collaborative research to improve treatment options for rare tumors like thymoma.<br /><br />It is important to note that this report is based on a single case and the patient provided informed consent for its submission to the congress. Further investigation is necessary to confirm the efficacy of metronomic chemotherapy, particularly with liposomal doxorubicin, as an alternative for thymoma patients who fail front-line chemotherapy.

Asset Subtitle

Javier Baena

Meta Tag

Speaker Javier Baena

Topic Thymic Malignancy

Keywords

thymoma

metronomic chemotherapy

platinum-based scheme

disease progression

liposomal doxorubicin

mucositis

tumor mutational burden

gemcitabine

etoposide

computed tomography