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Capecitabine and Celecoxib as a Promising Therapy for Thymic Neoplasms

Wood, Kevin, MD*; Byron, Elizabeth, MD; Janisch, Linda, APN*; Salgia, Ravi, MD, PhD; Sharma, Manish R., MD*,§

American Journal of Clinical Oncology: October 2018 - Volume 41 - Issue 10 - p 963–966
doi: 10.1097/COC.0000000000000400
Original Articles: Thoracic

Objectives: For patients with unresectable or metastatic thymic epithelial neoplasms, few therapy options are available and outcomes are poor. This case series demonstrates that the combination of capecitabine and celecoxib may be a promising therapeutic option for these patients.

Materials and Methods: The current report describes the outcomes of 5 patients with thymic neoplasms treated on a drug-drug interaction study of capecitabine and celecoxib in patients with advanced solid malignancies (NCT01705106) conducted at the University of Chicago, plus a sixth patient treated with the same regimen outside of the protocol.

Results: Six patients with thymic neoplasms were treated with capecitabine 1000 mg/m2 twice daily and celecoxib 200 mg twice daily, day 1 to day 14 on a 21-day cycle. This included 3 patients with thymic carcinoma, 1 with thymic neuroendocrine tumor, and 2 with thymomas. Objective response rates were noted in 3 of 6 patients. Two of the 3 thymic carcinoma patients had complete responses, and the third had a partial response. Best response for the other patients included stable disease for both thymoma patients and progressive disease for the thymic neuroendocrine patient. Other than grade 3 palmar-plantar erythrodysesthesia, which developed in 4 of 6 patients and required dose reductions, the regimen was well tolerated.

Conclusions: This case series suggests that capecitabine plus celecoxib may be an effective and well-tolerated treatment option for patients with thymic carcinoma. Further studies should be carried out to establish the efficacy of capecitabine plus celecoxib in thymic carcinoma, and to determine whether monotherapy with capecitabine would be similarly effective.

*Department of Medicine

§Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL

Florida Cancer Specialists and Research Institute, West Palm Beach, FL

Department of Medical Oncology and Therapeutics Research, City of Hope, and Beckman Research Institute, Duarte, CA

R.S. and M.R.S. contributed equally.

Supported by Award No. K12CA139160 from the National Cancer Institute (M.R.S.) and by the University of Chicago Comprehensive Cancer Center Support Grant no. P30CA014599.

The authors declare no conflicts of interest.

Reprints: Ravi Salgia, MD, PhD, City of Hope, 1500 East Duarte Road, Duarte, CA 91010. E-mail: rsalgia@coh.org.

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