Amrubicin as Second-line and Beyond Treatment for Platinum-refractory Advanced Thymic Carcinoma

Objective: Thymic carcinoma is a rare mediastinal neoplasm, and the prognosis of patients with advanced thymic carcinoma is poor. No standard chemotherapeutic regimen has yet been established for the disease. This is the first report to evaluate the role of amrubicin, a novel anthracycline anticancer drug, in second-line and beyond treatment for patients with platinum-refractory advanced thymic carcinoma. Methods: This study was a review of thymic carcinoma patients who had received amrubicin monotherapy between June 2003 and December 2011 for the progression of disease previously treated with platinum-based chemotherapy. Amrubicin was administered at 35 or 40 mg/m2 for three consecutive days every 3 weeks, until progression. Results: Nine patients with recurrent thymic carcinoma were registered. Their median age was 61 years (range 45–72), and the patients included five males and four females. All nine patients had Masaoka’s Stage IVb disease. There were three squamous cell carcinomas, one adenocar-cinoma, one small-cell carcinoma and two other histological types. The mean number of chemo-therapy cycles was five (range 2–13). Grade 3 or higher toxicities included mainly neutropenia (55.5%), anemia (25.0%) and febrile neutropenia (11.1%). No treatment-related deaths wer