Nivolumab a potential treatment for metastatic thymic epithelial tumours

Nivolumab is a promising therapy for patients with thymic epithelial tumours who have received multiple-line treatments, suggests a study. However, the high rate of severe toxicities specifies a need to find out a reliable marker to predict patients who will derive benefit or exhibit toxicity.

Forty-six patients with unresectable or recurrent thymic tumours who used at least one dose of nivolumab at any line of treatment were retrospectively evaluated in this study. The authors used a low-dose regimen for most of the participants even though nivolumab was administered at 3 mg/kg in the PRIMER study.

Of the participants with thymic epithelial tumours, three patients with thymic carcinoma, four with thymoma, and one with mixed histology were included in the review. Three patients had a history of myasthenia gravis that had to be controlled prior to treatment.

Four patients experienced moderate (n=2) or severe (n=2) adverse events with nivolumab. The two severe adverse events happened at first dose even with 40-mg nivolumab, which resulted in treatment discontinuation permanently.

Patients received a median number of four (range, 1–18) nivolumab medications and showed a partial response at best. Two of them progressed at the third and fifth month of treatment. The best response duration for one patient with thymic carcinoma and another with thymoma B2 were 9 and 14 months, respectively. Median survival time was 7.4 months (range, 2–22.1).

“After the results of the previous study could be supported by randomized prospective studies with more patients, nivolumab may be considered as an option in patients with thymic epithelial tumours who have received multiple-line treatments,” the authors said.