WCLC 2025 - Posters & ePosters-EP.14.17 Clinical Outcomes of Patients With Advanced Thymic Malignancies Treated With Carboplatin/Pemetrexed Vs. Pemetrexed Alone

EP.14.17 Clinical Outcomes of Patients With Advanced Thymic Malignancies Treated With Carboplatin/Pemetrexed Vs. Pemetrexed Alone

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This retrospective cohort study from the University of Pennsylvania evaluated clinical outcomes and safety of carboplatin plus pemetrexed (carbo/pem) versus pemetrexed (pem) monotherapy in patients with advanced thymic malignancies from 2006 to 2024. The cohort included 24 patients with unresectable, recurrent, or metastatic thymoma (n=14) or thymic carcinoma (n=10). Primary endpoints were progression-free survival (PFS) and disease control rate (DCR), assessed by RECIST 1.1 criteria.<br /><br />Results showed that carbo/pem was well-tolerated, with 75% experiencing any toxicity (mostly grade 1-2), and no dose reductions required. In contrast, pem alone had a similar toxicity profile but required dose reductions in 18.8% of patients. Hematologic toxicities were somewhat higher in the carbo/pem group but overall manageable.<br /><br />Efficacy outcomes revealed no statistically significant difference in median PFS (mPFS) between groups: mPFS was not reached (NR) for carbo/pem vs. 14.7 months for pem (p=0.27). Among thymoma patients, carbo/pem showed a numerically longer mPFS (NR vs. 15.6 months; p=0.09), suggesting potential benefit in this subgroup, though not statistically significant. For thymic carcinoma, mPFS was shorter with carbo/pem (10.9 months) compared to pem (14.7 months; p=0.88). Disease control rates were higher with carbo/pem (87.5%) versus pem (69%), but objective response rates favored pem (31% vs. 12.5%).<br /><br />The study concludes that carbo/pem is a safe and effective option for advanced thymic malignancies, particularly for patients who may not tolerate standard regimens like CAP (cyclophosphamide, doxorubicin, cisplatin). While carbo/pem did not significantly improve PFS overall, the trend toward longer PFS in thymoma patients warrants further investigation. More data are needed to confirm these findings and optimize treatment strategies.

Asset Subtitle

Melina Marmarelis

Meta Tag

Speaker Melina Marmarelis

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

thymic malignancies

carboplatin

pemetrexed

retrospective cohort study

progression-free survival

disease control rate

thymoma

thymic carcinoma

toxicity profile

advanced cancer treatment