Thymoma and Thymic Cancer

Question 1

First line combination chemotherapy regimen

Answer 1

CAP(preferred for thymoma)
Cisplatin 50 mg/m2 IV day 1
Doxorubicin 50 mg/m2 IV day 1 Cyclophosphamide 500 mg/m2 IV day 1 Administered every 3 weeks

CAP with prednisone

ADOC
Cisplatin 50 mg/m2 IV day 1 
Doxorubicin 40 mg/m2 IV day 1 
Vincristine 0.6 mg/m2 IV day 3 
Cyclophosphamide 700 mg/m2 IV day 4 Administered every 3 weeks

PE
Cisplatin 60 mg/m2 IV day 1
Etoposide 120 mg/m2/d IV days 1–3
Administered every 3 weeks

VIP 
Etoposide 75 mg/m2 on days 1–4 
Ifosfamide 1.2 g/m2 on days 1–4 
Cisplatin 20 mg/m2 on days 1–4 
Administered every 3 weeks

Carboplatin/Paclitaxel (preferred for thymic carcinoma)
Carboplatin AUC 6
Paclitaxel 225 mg/m2
Administered every 3 weeks

Question 2

SECOND-LINE CHEMOTHERAPY

Answer 2

Sunitinib (Thymic carcinomas only)
Pemetrexed
Everolimus
Paclitaxel
Octreotide (including LAR) +/- prednisone Gemcitabine 5-FU and leucovorin
Etoposide
Ifosfamide