P08: Somatostatin analogs plus prednisone in aggressive histotype and advanced stage of thymic epithelial tumors
Margaret Ottaviano1, Vincenzo Damiano1, Lucia Nappi2, Pasquale Rescigno3, Mirella Marino4, Silvana Del Vecchio5, Irene Tucci1, Claudia von Arx1, Giuliano Palumbo1, Giovannella Palmieri1
Background: Thymic epithelial tumors (TETs) are rare neoplasms characterized by histological variability and different expression at the molecular level. Several biological agents have been evaluated in TETs in small phase II trials. Efficacy of octreotide/lanreotide with or without prednisone in TETs OctreoScan positive has been widely demonstrated in thymoma, but no clearly in thymic carcinoma.
Methods: Twelve patients (five men, seven women; median age 47 years; range, 27–70 years) with advanced stage disease according to the Masaoka-Koga staging system (seven with IVa stage; five with IVb stage), and aggressive histotype according to WHO classification, revised by central review (two B2/B3; five B3; one B3/thymic carcinoma; four thymic carcinoma) were enrolled in this monocentric referral study. All the patients showed a progressive disease according to RECIST 1.1 criteria to previous conventional chemotherapeutic regimens platinum or not platinum-based. All the patients performed OctreoScan. The schedule includes administration of long-acting analog octreotide (30 mg/every 28 days intramuscularly) plus prednisone 0.2 mg/kg/day until progression of disease was documented. Overall response rate and toxicity were evaluated.
Results: The median time to progression was 6 months (range, 3–24 months), the overall response rate was 74.9%, particularly three patients (25%) obtained stable disease; four patients (33.3%) partial response; two patients (16.6%) complete response; three patients (25%) progression disease. One patient with Good Syndrome interrupted treatment after 6 months for infection disease. One patient has been lost to follow-up after 24 months of treatment. One patient died after progression disease for PRCA. Treatment was generally well tolerated with acceptable toxicity: no symptomatic cholelithiasis (one patient), grade 1 diarrhea (two patients) hyperglycemia (one patient). One patient with thymic carcinoma and IVB stage had PS improvement from 2 to 1 sec ECOG, and one patient had complete remission of pericardial and pleural effusion after six months treatment with symptomatic relief.
Conclusions: These results show that the association of somatostatin analogs plus prednisone is an effective treatment in aggressive histotype and advanced stage disease of TETs.
Keywords: Somatostatin analogs; prednisone; thymic epithelial tumors
doi: 10.3978/j.issn.2072-1439.2015.AB077