2024 Latin America Conference on Lung Cancer (LALCA) - Posters-PP01.36: Metronomic Oral Cyclophosphamide (MOC) in Patients With Heavily Pretreated Metastatic Thymic Carcinoma: a Case Series

PP01.36: Metronomic Oral Cyclophosphamide (MOC) in Patients With Heavily Pretreated Metastatic Thymic Carcinoma: a Case Series

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This case series examines the use of metronomic oral cyclophosphamide (MOC) in patients with heavily pretreated metastatic thymic carcinoma (TC). Thymic carcinoma is a rare, aggressive cancer, for which treatment options are limited after the failure of initial chemotherapy. MOC involves administering continuous low doses of cyclophosphamide, an alkylating agent that can enhance immune response and potentially inhibit tumor growth.<br /><br />In this study, seven patients with heavily pretreated metastatic TC, between the mean age of 53, were administered MOC. Most had undergone multiple prior lines of treatment, including intensity-modulated radiation therapy (IMRT), and had found limited success. Their disease stages ranged from IVA to IVB, indicating advanced cancer. <br /><br />Of the patients treated, 57.1% achieved stable disease (SD) and 28.6% had a partial response, leading to an overall disease control rate (DCR) of 85%. The median progression-free survival (PFS) was 8.9 months, and the overall survival (OS) was 12.4 months. Treatment with MOC was generally well-tolerated, although 70% of patients developed mild to moderate lymphopenia (grade 1-2).<br /><br />The study concludes that MOC is a promising approach for heavily treated TC patients due to its efficacy, manageable toxicity, and cost-effectiveness. Furthermore, the ease of oral administration enhances patient compliance. These findings support the need for additional research into MOC, either as a standalone treatment or in combination with other therapeutic strategies for thymic neoplasms. Comprehensive monitoring using hematological evaluations and imaging (CT-SCAN or PET/CT) was employed to assess tumor response and toxicity, thereby ensuring patient safety throughout the treatment process.

Asset Subtitle

Liliana Gutierrez

Keywords

metronomic oral cyclophosphamide

thymic carcinoma

metastatic cancer

chemotherapy

disease control rate

progression-free survival

overall survival

lymphopenia

oral administration

tumor response