{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:02:19Z","timestamp":1790182939861,"version":"4.1.0"},"reference-count":23,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2026,9,15]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Thymic carcinoma is a rare, aggressive malignancy with limited treatment options. First-line platinum-based chemotherapy yields response rates below 40%, and immune checkpoint inhibitors have shown inconsistent efficacy. Ivonescimab, a programmed cell death protein 1\/vascular endothelial growth factor (PD-1\/VEGF) bispecific antibody, may enhance antitumor activity through dual blockade.<\/jats:p>\n                  <jats:p>This single-center, phase II trial enrolled patients with stage IVb, treatment-na\u00efve thymic carcinoma. Patients received ivonescimab (20\u2009mg\/kg) plus paclitaxel (175\u2009mg\/m\u00b2) and carboplatin (area under the curve 5) every 3 weeks for four to six cycles, followed by ivonescimab maintenance. The primary endpoint was objective response rate (ORR) . Secondary endpoints included disease control rate (DCR) and safety. Biomarker analyses were exploratory.<\/jats:p>\n                  <jats:p>\n                    Between January\u202f2025 and April 2026, seven patients were enrolled (median age 61 years; 71% male; 71% squamous). Five had evaluable tissue next-generation sequencing and six had transcriptomic data. After median follow-up of 6.4\u202fmonths, the preliminary ORR was 85.7% (6\/7; 95%\u2009CI 42.1% to 99.6%)\u2009and DCR 100%. The 6-month progression-free survival (PFS) and overall survival (OS) rates were both 100% (two and four patients at risk for PFS and OS, respectively). The only PFS event occurred at 15.7 months in a patient who discontinued treatment due to adverse events (AEs). Grade\u202f\u22653 treatment-related AEs occurred in 57.1% (mainly neutropenia, 42.9%); grade\u202f\u22653 immune-related AEs in 14.3%. No treatment-related deaths occurred. All tumors were microsatellite-stable with low mutational burden. Deep responders (\u226550% reduction) showed a lower exploratory myeloid-derived suppressor cell-related gene-expression score (nominal p=0.10, exact Mann-Whitney U test). Baseline blood CD4\n                    <jats:sup>+<\/jats:sup>\n                    \/CD8\n                    <jats:sup>+<\/jats:sup>\n                    ratio was lower in deep responders and remained stable during treatment, vs an increase in others (nominal p=0.057). Tumorous CXCL1 expression showed an exploratory positive correlation with the CD4\n                    <jats:sup>+<\/jats:sup>\n                    \/CD8\n                    <jats:sup>+<\/jats:sup>\n                    ratio (R=0.84, nominal p=0.035, n=6).\n                  <\/jats:p>\n                  <jats:p>\n                    First-line ivonescimab plus paclitaxel-carboplatin showed promising preliminary antitumor activity and manageable safety in advanced thymic carcinoma. The peripheral blood CD4\n                    <jats:sup>+<\/jats:sup>\n                    \/CD8\n                    <jats:sup>+<\/jats:sup>\n                    ratio showed an exploratory association with depth of response and warrants prospective evaluation in the complete cohort and independent validation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial registration number<\/jats:bold>\n                  <\/jats:p>\n                  <jats:p>ChiCTR2400094398.<\/jats:p>","DOI":"10.1136\/jitc-2026-016280","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:13:50Z","timestamp":1790180030000},"page":"e016280","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ivonescimab plus chemotherapy as first-line treatment for advanced thymic carcinoma: preliminary results of a phase II trial with biomarker analyses"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-7488","authenticated-orcid":false,"given":"Jie-Tao","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le-Tian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Yang","family":"Dong","sequence":"additional","affiliation":[{"name":"Anshan Cancer Hospital, Anshan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Han","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Qi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Yuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ting","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ting","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Tong","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Mei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-6134","authenticated-orcid":false,"given":"Cheng-Bo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 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Sequencing and transcriptomic data from: ivonescimab plus chemotherapy as first-line treatment for advanced thymic carcinoma: preliminary results of a phase ii trial with biomarker analyses. genome sequence archive (gsa), accession number prjca069512."}],"container-title":["Journal for ImmunoTherapy of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jitc-2026-016280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:13:54Z","timestamp":1790180034000},"score":1,"resource":{"primary":{"URL":"https:\/\/jitc.bmj.com\/lookup\/doi\/10.1136\/jitc-2026-016280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,23]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/jitc-2026-016280"],"URL":"https:\/\/doi.org\/10.1136\/jitc-2026-016280","relation":{},"ISSN":["2051-1426"],"issn-type":[{"value":"2051-1426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}