Thymic Carcinoma — SCE Medical Oncology MCQ

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HardLung CancerThymic CarcinomaSCE Medical Oncology

A 58-year-old woman is diagnosed with a thymic carcinoma (stage IVa with pleural metastases). ECOG PS 1. What is the standard first-line systemic therapy?

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Correct answer: E — Carboplatin + paclitaxel

For advanced thymic carcinoma, platinum-based doublet chemotherapy (carboplatin + paclitaxel or cisplatin + etoposide) is the standard first-line regimen. Unlike thymoma, thymic carcinomas are more aggressive with lower response rates to chemotherapy. Immunotherapy has some activity (pembrolizumab ORR ~20%) but carries a high risk of irAEs (particularly myasthenia gravis and myocarditis) in thymic epithelial tumours and should be used with caution. Sunitinib/lenvatinib are second-line options.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer