Thymus cancer

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Research in thymus cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help treat thymus cancer.

The following is a selection of research showing promise in treating and studying thymoma and thymic carcinoma. We’ve included information from PubMed, which is the research database of the National Library of Medicine (NLM). Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year. You can find information about ongoing clinical trials in Canada from CanadianCancerTrials.ca and ClinicalTrials.gov. Clinical trials are given an NLM identifier called a national clinical trial (NCT) number. The NCT number links to information about the clinical trial.

Treatment

Researchers are looking for new ways to improve treatment for thymus cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for thymus cancer.

Surgery

Doctors are looking at new ways of doing surgery that cause less injury to the body (called minimally invasive surgery) and fewer complications.

Video-assisted thoracoscopic surgery (VATS) is a type of thoracoscopy. There is a small video camera attached to the thoracoscope to help guide surgeons as they remove tissue from the chest. VATS can be used to remove part or all of the thymus (called a thymectomy). Researchers compared VATS to a traditional open thymectomy in people with early stage thymus cancer. They found that VATS is safe and has better surgical outcomes, including less blood loss and a shorter hospital stay. The survival rate was similar for both approaches to surgery (Journal of Thoracic Disease, PMID 27114834; Journal of Thoracic Oncology, PMID 26762737; Annals of Surgical Oncology, PMID 25256127).

Chemotherapy

Chemotherapy is mainly used to treat stage 4 and recurrent thymus cancer. Researchers continue to look for ways to improve how effective it is in treating thymus cancer.

Neoadjuvant chemotherapy or chemoradiation may be an option for stage 3 or stage 4 thymomas and thymic carcinomas that can’t be removed with surgery (called unresectable tumours). Researchers found that giving chemotherapy or chemoradiation to these tumours increased the chance that they could be completely removed with surgery (Journal of Thoracic Oncology, PMID 23722169; The Journal of Thoracic and Cardiovascular Surgery, PMID 24139613; ClinicalTrials.gov, NCT02636556).

Certain combinations of chemotherapy drugs help treat and improve survival for thymus cancer. Researchers found this was true for the following combinations: cisplatin (Platinol AQ) and gemcitabine (Gemzar), carboplatin (Paraplatin, Paraplatin AQ) and paclitaxel (Taxol), and capecitabine (Xeloda) and gemcitabine (Thoracic Cancer, PMID 27042218; Annals of Oncology, PMID 25403584; Future Oncology, PMID 25471029).

Heated chemotherapy given directly into the chest is called hyperthermic intrathoracic chemotherapy perfusion. Researchers looked at giving this treatment after surgery for advanced thymus cancer. Some studies show that it helped control growth of the cancer and improve long-term survival (OncoTargets and Therapy, PMID 23690692; European Journal of Cardio-Thoracic Surgery, PMID 22885228; ClinicalTrials.gov, NCT01163552).

Find out more about research in chemotherapy.

Radiation therapy

Giving radiation therapy after surgery is called adjuvant radiation therapy. Researchers are studying the following specialized types of radiation therapy as adjuvant therapy to see if they can improve survival for thymus cancer.

Intensity-modulated radiation therapy (IMRT) and 3-D conformal radiation therapy (3-D CRT) allow doctors to accurately target the tumour without damaging the normal tissue around it. A small study looked at giving IMRT or 3-D CRT after surgery for stage 3 thymoma. It found that, compared to conventional radiation therapy, these treatments improved survival. In addition, fewer cancers came back (recurred) after IMRT or 3-D CRT (Radiation Oncology, PMID 23937886).

Proton beam radiation therapy uses high-energy, or charged, proton particles. These particles can be aimed more precisely at the tumour than the x-ray beams used in conventional radiation therapy. Research shows that proton beam radiation therapy can control the growth of thymus cancer with few side effects. It also causes less damage to nearby tissues (such as the lungs, heart and esophagus) than IMRT. More research is needed to study the long-term response to and side effects from proton beam radiation therapy (Radiotherapy and Oncology, PMID 26895711; Clinical Lung Cancer, PMID 27372386).

Find out more about research in radiation therapy.

Targeted therapy

Researchers are studying the following types of targeted therapy drugs to see if they can stop the growth of thymus cancer cells. Most of the research studies are in early phases, so their results may not be available. But some studies show that these drugs may be effective in treating advanced thymus cancer or thymus cancer that doesn’t respond to chemotherapy (called refractory cancer).

Monoclonal antibodies are substances that find and bind to particular target molecules on cancer cells. By blocking the target molecule, these drugs can interfere with how the cell works. Researchers are studying the following monoclonal antibodies as treatment for thymus cancer: bevacizumab (Avastin), cetuximab (Erbitux), pembrolizumab (Keytruda) and cixutumumab (ClinicalTrials.gov, NCT00369889, NCT01025089, NCT02607631; The Lancet Oncology, PMID 24439931).

Protein kinase inhibitors block chemicals called kinases. These chemicals are part of the signalling process within cells. When this process is blocked, the cell stops growing and dividing. Erlotinib (Tarceva), sunitinib (Sutent), saracatinib and milciclib are some protein kinase inhibitors that researchers are studying for thymus cancer (The Lancet Oncology, PMID 25592632; Lung Cancer, PMID 26009269; ASCO, Abstract 7526).

Histone deacetylase inhibitors prevent cells from growing and dividing by blocking a group of enzymes called histone deacetylases. Researchers found that the histone deacetylase inhibitor belinostat combined with chemotherapy may be an effective treatment for advanced and unresectable thymus tumours (Clinical Cancer Research, PMID 25189481).

Find out more about research in targeted therapy.

Molecular profiling

Molecular profiling is a type of testing that looks at the unique features of the genes in cancer cells, as well as any related biomarkers. Researchers hope that molecular profiling will help doctors predict a prognosis and find the best treatments for certain cancers. Molecular profiling will also help doctors create targeted therapies for each cancer based on the specific genetic makeup of the tumour. A clinical trial found that researchers were better able to study and find abnormal genes in thymus cancer using molecular profiling (Journal of Clinical Oncology, PMID 25667274; ClinicalTrials.gov, NCT01306045).

Learn more about cancer research

Researchers continue to try to find out more about thymus cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage thymus cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for thymus cancer were first shown to be effective through clinical trials.

Find out more about cancer research and clinical trials.

thoracoscopy

A procedure that uses an endoscope (a thin, tube-like instrument with a light and lens) to examine or treat organs inside the thorax (chest).

Cells, tissue or small portions of the organs inside the chest may be removed for examination under a microscope.

The type of endoscope used for this procedure is called a thoracoscope.

chemoradiation

Treatment that combines chemotherapy with radiation therapy. Chemotherapy is given during the same time period as radiation therapy. Some types of chemotherapy make radiation therapy more effective.

Also called chemoradiotherapy.

enzyme

A protein that speeds up certain chemical reactions in the body.

For example, enzymes in the intestines help to digest food.

biomarker

Any cellular, molecular, chemical or physical change that can be measured and used to study a normal or abnormal process in the body. Biomarkers are used to check the risk for, presence of or progress of a disease or the effects of treatment.

For example, prostate-specific antigen (PSA) can be used as a biomarker for prostate cancer or blood sugar levels can be used to monitor diabetes.

Also called biological marker (a molecular biomarker may be called molecular marker or signature molecule).

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