Background: Thymic epithelial tumors (TETs) are rare neoplasms with a particular biological behavior, treated with a combination of therapeutic strategies such as surgery, chemotherapy, radiotherapy and target agents. No continuation maintenance therapy exists for these rare tumors. A high uptake of indium-labeled octreotide (111In-DTPA-D-Phe1-octreotide) and curative application of somatostatin analogs in thymic tumors have been widely demonstrated.
Methods: Eighteen patients (nine women and nine men, median age 54.5 years; range, 32–78 years) with advanced thymic tumors (seven patients with stage III; seven with IVa; four with IVb according to the Masaoka-Koga staging system), histotype sec. WHO revised by central review (three AB, two B1, three B2, five B3, three B2/B3, two thymic carcinoma) with a partial response or stable disease to conventional chemotherapeutic regimens platinum or not platinum-based, after performed OctreoScan, were enrolled in this monocentric referral center study. The schedule includes administration of long-acting analog octreotide (30 mg/every 28 days intramuscularly), until progression of disease was documented. Median time to progression and toxicity were evaluated.
Results: Median follow-up was of 43 months with a median time to progression of 14.5 months (range, 2–77 months). Treatment was generally well tolerated with acceptable toxicity: grade 1 diarrhea (five patients), grade 2 hyperglycemia (four patients). No patients interrupted treatment because of toxicity.
Conclusions: The current study indicates that single-agent somatostatin analogs maintenance therapy is a potential treatment strategy for advanced TETs OctreoScan positive which respond to previous conventional chemotherapy. In particular, somatostatin analogs may provide effective maintenance treatment duration regardless of histotype and stage of disease with an acceptable toxicity and an improved patients’ compliance.
