Current drug treatment methods and potential significance of glucocorticoid for inoperable advanced thymoma

Thymoma represents the predominant malignant tumor arising from the anterior mediastinal region, constituting roughly 30% of primary tumors in this anatomical area with an estimated annual occurrence of 1.2-2.6 cases per million population. Research consistently highlights the prognostic significance of achieving complete surgical removal (R0 resection) for optimizing survival outcomes in affected individuals. Current clinical practice prioritizes surgical intervention as the frontline therapeutic approach for most thymoma cases. Notably, approximately one-third of patients present with advanced-stage disease (stage III/IV) at diagnosis due to its insidious progression, with the majority of these cases being deemed unresectable during initial evaluation. This clinical reality underscores the critical importance of implementing neoadjuvant therapeutic strategies to facilitate subsequent complete tumor excision and improve long-term prognosis. The current analysis comprehensively examines contemporary management approaches for advanced-stage thymoma cases where primary surgical resection is not feasible, encompassing chemotherapy, targeted therapy, immunotherapy, and systemic glucocorticoids. This study focuses on clarifying the beneficial effects of glucocorticoids in thymoma treatment while examining the underlying mechanisms and identifying potential challenges for future research.