title: Amrubicin as second-line and beyond treatment for platinum-refractory advanced thymic carcinoma.
abstract: 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/m(2) 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 adenocarcinoma, one small-cell carcinoma and two other histological types. The mean number of chemotherapy 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 were observed. The response rate was 44.4% (95% confidence interval: 19-73). The median progression-free survival after the amrubicin monotherapy was 4.9 months, while the median overall survival was 6.4 months.
  
  
  CONCLUSIONS
  Single-agent amrubicin was found to be potentially useful as second-line and beyond chemotherapy for patients with advanced thymic carcinoma. Further multi-institutional prospective studies are warranted.
authors.affiliation: *Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan. tseto@nk-cc.gp.jp.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hirai
authors.forename: Takashi
authors.initials: T
authors.lastname: Seto
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Ryo
authors.initials: R
authors.lastname: Toyozawa
authors.forename: Eiko
authors.initials: E
authors.lastname: Inamasu
authors.forename: Miyako
authors.initials: M
authors.lastname: Kojo
authors.forename: Gouji
authors.initials: G
authors.lastname: Toyokawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Morodomi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Shiraishi
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Takenaka
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takenoyama
authors.forename: Yukito
authors.initials: Y
authors.lastname: Ichinose
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage / Q000627:therapeutic use*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017671:Platinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D013945:Thymoma / Q000188:drug therapy* / Q000473:pathology; D013953:Thymus Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D017671:Platinum Compounds; C055866:amrubicin
keywords: amrubicin; second-line chemotherapy; thymic cancer