title: c-kitmutation-positive advanced thymic carcinoma successfully treated as a mediastinal gastrointestinal stromal tumor: A case report.
abstract: Thymic carcinoma is an exceptionally rare tumor, which has a very poor prognosis, differing from thymoma. Although cytotoxic chemotherapy is commonly used to treat advanced thymic carcinoma, its effectiveness has not been found to be sufficient. There are several reports that thymic carcinoma also harbors an oncogenic driver mutation, similar to lung cancer. A patient with ac-kitmutation-positive thymic carcinoma received imatinib followed by sunitinib consecutively, which are both c-Kit inhibitors. Although the patient had achieved long-term disease control for 21 months, the primary lesion and pulmonary metastases had increased in size by November, 2014. Following failure of imatinib treatment, the patient received sunitinib, a multiple kinase inhibitor, initiated in December, 2014. Following administration of sunitinib, a computed tomography scan revealed a partial response and the disease was effectively controlled with continued sunitinib treatment for 6 months, up to June, 2015. The patient achieved long-term disease control (~27 months) with imatinib followed by sunitinib. The efficacy of consecutive molecular-targeted therapy for thymic carcinoma was demonstrated in this case. Therefore, thymic carcinoma with oncogenic driver mutations should be treated with molecular-targeted agents rather than with cytotoxic drugs, and it may be suitable to treatc-kitmutation-positive thymic carcinoma as a mediastinal gastrointestinal stromal tumor.
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hirai
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Edagawa
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shimamatsu
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Toyozawa
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Gouji
authors.initials: G
authors.lastname: Toyokawa
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Kaname
authors.initials: K
authors.lastname: Nosaki
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yamaguchi
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Seto
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Twakenoyama
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Fukuoka 811-1395, Japan.
authors.forename: Yukito
authors.initials: Y
authors.lastname: Ichinose
keywords: c-Kit mutation; gastrointestinal stromal tumor; imatinib; sunitinib; thymic carcinoma