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- Title
Metastatic Thymoma Harboring a Deleterious BRCA2 Mutation Derives Durable Clinical Benefit from Olaparib.
- Authors
Principe, Daniel R.; Kamath, Suneel D.; Munshi, Hidayatullah G.; Mohindra, Nisha A.
- Abstract
Thymomas comprise a group of rare epithelial neoplasms of the anterior mediastinum. Whereas localized disease carries a favorable prognosis, the majority of patients with metastatic thymomas experience progression or recurrence over a 10‐year period. Although targeted therapies have become standard of care in many malignancies, no clinically actionable mutations have consistently been identified in metastatic thymomas. Here, we describe a patient with an aggressive thymoma complicated by extensive pleural metastases. Over a 16‐year period, she progressed on multiple treatment regimens. To identify additional treatment options, tissue from a pleural metastasis was sent for next‐generation sequencing, revealing mutations in BRCA2, tyrosine kinase 2, and SET domain containing 2. Based on supporting evidence for poly (ADP‐ribose) polymerase (PARP) inhibition in other BRCA‐mutated tumors, the patient was started on the PARP inhibitor olaparib. She derived significant clinical benefit from treatment, with imaging showing overall stabilization of her disease. Here, we review the genotyping results of her tumor and discuss the functional and clinical significance of the mutations in her cancer as well as implications for managing patients with advanced BRCA‐mutant thymomas. Key Points: Targeted therapy has yet to enter the standard clinical management of metastatic thymomas.Patients with BRCA2‐mutant thymomas may benefit from poly (ADP‐ribose) polymerase inhibition. The case of a patient with aggressive thymoma is described, including the genotyping results of her tumor, the functional and clinical significance of the mutations in her cancer, and the implications for managing patients with advanced BRCA‐mutant thymomas.
- Subjects
ANTINEOPLASTIC agents; ENZYME inhibitors; METASTASIS; GENETIC mutation; BRCA genes; THYMOMA; GENOTYPES
- Publication
Oncologist, 2020, Vol 25, Issue 4, p301
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2019-0393