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Lenvatinib in patients with advanced or metastatic thymic carcinoma (REMORA): a multicentre, phase 2 trial

Jun Sato1, Miyako Satouchi2, Shoichi Itoh2

  • 1Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.

The Lancet. Oncology
|June 6, 2020
PubMed
Abstract

Insights

Lenvatinib demonstrated significant activity in treating advanced thymic carcinoma after chemotherapy. This multi-targeted kinase inhibitor offers a potential new standard treatment for patients with previously treated metastatic thymic carcinoma.

Area of Science:

  • Oncology
  • Medical Oncology
  • Clinical Trials

Background:

  • Thymic carcinoma is a rare malignancy with no established standard treatment for advanced or metastatic cases post-platinum-based chemotherapy.
  • Lenvatinib, a multi-targeted kinase inhibitor, targets VEGFR, FGFR, RET, and c-Kit.

Purpose of the Study:

  • To assess the efficacy and safety of lenvatinib as a second-line treatment for advanced or metastatic thymic carcinoma.
  • To evaluate lenvatinib's objective response rate (ORR) in patients who progressed after platinum-based chemotherapy.

Main Methods:

  • A single-arm, phase 2 clinical trial conducted across eight Japanese institutions.
  • Enrolled patients with unresectable, advanced/metastatic thymic carcinoma progressing after platinum-based chemotherapy.
  • Patients received 24 mg of lenvatinib orally daily until disease progression or unacceptable adverse events.

Main Results:

  • The objective response rate (ORR) was 38% (90% CI 25.6-52.0, p<0.0001).
  • Partial response was observed in 38% of patients, and 57% achieved stable disease.
  • Grade 3 hypertension (64%) and palmar-plantar erythrodysaesthesia syndrome (7%) were the most frequent adverse events; no treatment-related deaths occurred.

Conclusions:

  • Lenvatinib showed confirmed activity and a manageable safety profile in advanced or metastatic thymic carcinoma.
  • Lenvatinib may represent a new standard treatment option for patients with previously treated thymic carcinoma.

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