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Efficacy of pemetrexed-based regimen in relapsed advanced thymic epithelial tumors and its association with thymidylate synthase level

Authors Qian X, Song Z

Received 6 February 2016

Accepted for publication 1 May 2016

Published 22 July 2016 Volume 2016:9 Pages 4527—4531

DOI https://doi.org/10.2147/OTT.S105949

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Professor Min Li


Xinyu Qian,1,* Zhengbo Song2,3,*

1Department of Chemotherapy, Hangzhou First People’s Hospital, Hangzhou Cancer Hospital, Hangzhou, 2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Province, 3Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China

*These authors contributed equally to this work

Purpose: Due to the rarity of thymic epithelial tumors (TET), no standard chemotherapy regimen has been identified in the relapsed setting. The aim of this study was to investigate the activity of a pemetrexed-based regimen in advanced TET as palliative treatment after failure of previous chemotherapy, and to detect its association with thymidylate synthetase (TS) level.
Methods: Patients with pathologically confirmed TET and treated with pemetrexed-based regimen were evaluated from 2006 to 2014 in Zhejiang Cancer Hospital. TS mRNA level was detected by real-time polymerase chain reaction. The Kaplan–Meier method was used for survival analysis.
Results: A total of 22 TET patients were identified, of whom eight had thymoma and 14 had thymic carcinoma. In total, the objective response rate and disease control rate of the 22 patients were 22.7% and 68.2%, respectively. Median progression-free survival and overall survival were 4.5 months and 34.9 months, respectively. A trend of lower TS mRNA levels existed in patients with disease control compared to those with progressive disease (268.0±160.5×10-4 vs 567.0±445.0×10-4, P=0.065).
Conclusion: Patients with advanced TET may benefit from pemetrexed-based regimen therapy. TS mRNA level is valuable for predicting the efficacy of pemetrexed in TET.

Keywords: thymic epithelial tumors, pemetrexed, salvage chemotherapy, efficacy, thymidylate synthetase

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