{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T16:16:38Z","timestamp":1770653798042,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lenvatinib is recommended for the treatment of advanced and recurrent thymic carcinomas. However, there is a paucity of data on lenvatinib's use in real\u2010world clinical practice. The aim of this study was to evaluate the efficacy and safety of lenvatinib in patients with thymic carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective cohort study assessed the efficacy and tolerability of lenvatinib in the treatment of patients with advanced or recurrent thymic carcinoma between March 2021 and March 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients from six institutions in Japan were enrolled in this study. The median progression\u2010free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were 9.0\u2009months (95% confidence interval [CI] 4.8\u201314.5), 33% (95% CI 16.5%\u201354%), and 85% (95% CI 66.3%\u201395.8%), respectively. Although the number of patients was small, the median PFS of the first\u2010, second\u2010, and third\u2010 or later\u2010line treatment groups was 21.3\u2009months (<jats:italic>n<\/jats:italic>\u2009=\u20095), 9.0\u2009months (<jats:italic>n<\/jats:italic>\u2009=\u200913), and 5.8\u2009months (<jats:italic>n<\/jats:italic>\u2009=\u20099) (<jats:italic>p<\/jats:italic>\u2009=\u20090.171), respectively. Dose reduction was required in all patients, with 17 (63%) presenting grade \u2265\u20093 adverse events, including hypertension in seven patients and proteinuria in six. No grade \u2265\u20094 adverse events were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The real\u2010world efficacy and safety of lenvatinib are consistent with those reported in previous clinical trials of second\u2010line lenvatinib. Furthermore, despite the relatively small sample size, our findings suggest that lenvatinib may be effective for the treatment of thymic carcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.70047","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T06:51:03Z","timestamp":1742799063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Real\u2010World Efficacy and Safety of Lenvatinib in Advanced or Recurrent Thymic Carcinoma: A Multicenter Retrospective Study in Japan"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6397-0207","authenticated-orcid":false,"given":"Satoshi","family":"Miyamoto","sequence":"first","affiliation":[{"name":"Department of Thoracic Oncology NHO Osaka Toneyama Medical Center  Osaka Japan"},{"name":"Department of Respiratory Medicine and Clinical Immunology Graduate School of Medicine, Osaka University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Tsukaguchi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NHO Kinki\u2010Chuo Chest Medical Center  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanako","family":"Kuhara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saito Yukoukai Hospital  Ibaraki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiichiro","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Hematology Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Shiroyama","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology Graduate School of Medicine, Osaka University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motohiro","family":"Tamiya","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Tamiya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NHO Kinki\u2010Chuo Chest Medical Center  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumi","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshito","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology Graduate School of Medicine, Osaka University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kijima","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Hematology Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meinoshin","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery NHO Osaka Toneyama Medical Center  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Kumanogoh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology Graduate School of Medicine, Osaka University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahide","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology NHO Osaka Toneyama Medical Center  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/ejcts\/ezv239","article-title":"Long\u2010Term Outcome and Prognostic Factors of Surgically Treated Thymic Carcinoma: Results of 306 Cases From a Japanese Nationwide Database Study","volume":"49","author":"Hishida T.","year":"2016","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"issue":"3","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"S1749","DOI":"10.1097\/JTO.0b013e31821ea5f7","article-title":"Chemotherapy Definitions and Policies for Thymic Malignancies","volume":"6","author":"Girard N.","year":"2011","journal-title":"Journal of Thoracic Oncology"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/S0003-4975(03)00555-1","article-title":"Therapy for Thymic Epithelial Tumors: A Clinical Study of 1, 320 Patients From Japan","volume":"76","author":"Kondo K.","year":"2003","journal-title":"Annals of Thoracic Surgery"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.athoracsur.2012.09.006","article-title":"Thymic Carcinoma: A Multivariate Analysis of Factors Predictive of Survival in 290 Patients","volume":"95","author":"Weksler B.","year":"2013","journal-title":"Annals of Thoracic Surgery"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"562","DOI":"10.6004\/jnccn.2013.0072","article-title":"Thymomas and Thymic Carcinomas","volume":"11","author":"Ettinger D. S.","year":"2013","journal-title":"Journal of the National Comprehensive Cancer Network"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.annonc.2021.01.003","article-title":"Lung and Thymic Carcinoids: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow\u2010Up","volume":"32","author":"Baudin E.","year":"2021","journal-title":"Annals of Oncology"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2108330"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S1470-2045(23)00276-0","article-title":"Pembrolizumab Plus Lenvatinib as First\u2010Line Therapy for Advanced Non\u2010Clear\u2010Cell Renal Cell Carcinoma (KEYNOTE\u2010B61): A Single\u2010Arm, Multicentre, Phase 2 Trial","volume":"24","author":"Albiges L.","year":"2023","journal-title":"Lancet Oncology"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406470"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/S0140-6736(18)30207-1","article-title":"Lenvatinib Versus Sorafenib in First\u2010Line Treatment of Patients With Unresectable Hepatocellular Carcinoma: A Randomised Phase 3 Non\u2010Inferiority Trial","volume":"391","author":"Kudo M.","year":"2018","journal-title":"Lancet"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S1470-2045(20)30162-5","article-title":"Lenvatinib in Patients With Advanced or Metastatic Thymic Carcinoma (Remora): A Multicentre, Phase 2 Trial","volume":"21","author":"Sato J.","year":"2020","journal-title":"Lancet Oncology"},{"key":"e_1_2_9_13_1","unstructured":"National Comprehensive Cancer Network (NCCN) \u201cThymomas and Thymic Carcinomas.\u201d NCCN; Version 1.2024[cited September 14 2024]."},{"issue":"3","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"S1710","DOI":"10.1097\/JTO.0b013e31821e8cff","article-title":"The Masaoka\u2010Koga Stage Classification for Thymic Malignancies: Clarification and Definition of Terms","volume":"6","author":"Detterbeck F. C.","year":"2011","journal-title":"Journal of Thoracic Oncology"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.lungcan.2024.107557","article-title":"Long\u2010Term Follow\u2010Up and Exploratory Analysis of Lenvatinib in Patients With Metastatic or Recurrent Thymic Carcinoma: Results From the Multicenter, Phase 2 REMORA Trial","volume":"191","author":"Niho S.","year":"2024","journal-title":"Lung Cancer"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12041010"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s12032-018-1088-5","article-title":"Factors Involved in Early Lenvatinib Dose Reduction: A Retrospective Analysis","volume":"35","author":"Suyama K.","year":"2018","journal-title":"Medical Oncology"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000014774","article-title":"Efficacy and Tolerability of Initial Low\u2010Dose Lenvatinib to Treat Differentiated Thyroid Cancer","volume":"98","author":"Yamazaki H.","year":"2019","journal-title":"Medicine"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"5149","DOI":"10.21873\/anticanres.13710","article-title":"Impact of Relative Dose Intensity of Early\u2010Phase Lenvatinib Treatment on Therapeutic Response in Hepatocellular Carcinoma","volume":"39","author":"Takahashi A.","year":"2019","journal-title":"Anticancer Research"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T06:44:48Z","timestamp":1743144288000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.70047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/1759-7714.70047"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.70047","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"value":"1759-7706","type":"print"},{"value":"1759-7714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70047"}}