Long-Term Outcome of Treatment With Various Multitargeted Kinase Inhibitors In Metastatic Thymic Carcinoma.

Introduction: Thymic carcinomas are aggressive tumors.Approximately one-third of patients are newly diagnosed with metastatic disease and require systemic therapy.There is no standard treatment after progression to first-line platinum-based chemotherapy, although chemotherapyimmunotherapy and/or antiangiogenic strategies are being investigated. Case presentation:We present an exceptional case of a patient with metastatic thymic carcinoma with extended survival who received lenvatinib as a fourth-line palliative treatment.Lenvatinib was well tolerated, and partial response was observed.Discussion: No randomized clinical trials or guidelines have provided definitive guidance for the management of thymic carcinomas.Many studies and practice guidelines recommend platinum-based chemotherapy as first-line chemotherapy; however, a standard second-line treatment has not been established.As several patients are candidates for multiple lines of treatment, it is essential to obtain a complete genetic sequence profile to identify specific driver mutations that could help in the future to select targeted therapies that improve the prognosis of patients.Lenvatinib and sunitinib have shown efficacy in pre-treated patients with unresectable advanced thymic carcinomas.Conclusions: Lenvatinib and sunitinib are options for unresectable advanced thymic carcinoma after progression to first-line treatment with platinum combination therapy for unresectable advanced thymic carcinoma.