Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report

Based on the results of a multicenter phase II study of patients with previously treated thymic carcinoma, lenvatinib administration for unresectable thymic cancer has been covered under insurance in Japan since 2021. However, patients with interstitial lung disease (ILD) were excluded from that stu...

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Main Authors: Yuki Hatakeyama, Jun Sakakibara-Konishi, Masato Tarumi, Kosuke Tsuji, Hirofumi Takahashi, Megumi Furuta, Yuta Takashima, Hidenori Kitai, Tetsuaki Shoji, Yasuyuki Ikezawa, Satoshi Konno
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Language:English
Published: Elsevier 2025-01-01
Series:Respiratory Medicine Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213007125000176
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author Yuki Hatakeyama
Jun Sakakibara-Konishi
Masato Tarumi
Kosuke Tsuji
Hirofumi Takahashi
Megumi Furuta
Yuta Takashima
Hidenori Kitai
Tetsuaki Shoji
Yasuyuki Ikezawa
Satoshi Konno
author_facet Yuki Hatakeyama
Jun Sakakibara-Konishi
Masato Tarumi
Kosuke Tsuji
Hirofumi Takahashi
Megumi Furuta
Yuta Takashima
Hidenori Kitai
Tetsuaki Shoji
Yasuyuki Ikezawa
Satoshi Konno
author_sort Yuki Hatakeyama
collection DOAJ
description Based on the results of a multicenter phase II study of patients with previously treated thymic carcinoma, lenvatinib administration for unresectable thymic cancer has been covered under insurance in Japan since 2021. However, patients with interstitial lung disease (ILD) were excluded from that study; therefore, the efficacy and safety of lenvatinib in these patients remain unknown. Herein, we report the case of a woman in her 50s who was diagnosed with thymic carcinoma complicated with ILD. In August 2016, the patient developed ILD with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM). She received triple therapy comprising prednisolone, tacrolimus and azathioprine. In October 2021, the patient complained of lateral chest pain and back pain. In January 2022, computed tomography (CT) revealed an anterior mediastinal tumor, and percutaneous biopsy resulted in a diagnosis of thymic carcinoma with Masaoka classification IVb. In March 2022, first-line treatment with four cycles of carboplatin (area under the curve, 6) + paclitaxel (200 mg/m2) was initiated. Although a partial response was achieved, in September 2022, CT demonstrated progressive disease (PD). Therefore, in October 2022, Lenvatinib (24 mg) was started as the second-line treatment. The best response was stable disease; moreover, although lenvatinib dose reduction was required owing to adverse events, such as biliary-tract infection and stomatitis. The patient did not experience ILD exacerbation. Lenvatinib (14 mg) was continued until PD was observed in March 2023. Our findings suggest that lenvatinib is a viable treatment option for thymic carcinoma with ILD.
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spelling doaj-art-ecd7701f38d04ff1bec28622932a65e72025-08-20T03:44:21ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015410218110.1016/j.rmcr.2025.102181Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case reportYuki Hatakeyama0Jun Sakakibara-Konishi1Masato Tarumi2Kosuke Tsuji3Hirofumi Takahashi4Megumi Furuta5Yuta Takashima6Hidenori Kitai7Tetsuaki Shoji8Yasuyuki Ikezawa9Satoshi Konno10Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Medical Network and Welfare Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan; Corresponding author. Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N 15, W 7, Kita-ku, Sapporo, 0608638, Japan.Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanBased on the results of a multicenter phase II study of patients with previously treated thymic carcinoma, lenvatinib administration for unresectable thymic cancer has been covered under insurance in Japan since 2021. However, patients with interstitial lung disease (ILD) were excluded from that study; therefore, the efficacy and safety of lenvatinib in these patients remain unknown. Herein, we report the case of a woman in her 50s who was diagnosed with thymic carcinoma complicated with ILD. In August 2016, the patient developed ILD with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM). She received triple therapy comprising prednisolone, tacrolimus and azathioprine. In October 2021, the patient complained of lateral chest pain and back pain. In January 2022, computed tomography (CT) revealed an anterior mediastinal tumor, and percutaneous biopsy resulted in a diagnosis of thymic carcinoma with Masaoka classification IVb. In March 2022, first-line treatment with four cycles of carboplatin (area under the curve, 6) + paclitaxel (200 mg/m2) was initiated. Although a partial response was achieved, in September 2022, CT demonstrated progressive disease (PD). Therefore, in October 2022, Lenvatinib (24 mg) was started as the second-line treatment. The best response was stable disease; moreover, although lenvatinib dose reduction was required owing to adverse events, such as biliary-tract infection and stomatitis. The patient did not experience ILD exacerbation. Lenvatinib (14 mg) was continued until PD was observed in March 2023. Our findings suggest that lenvatinib is a viable treatment option for thymic carcinoma with ILD.http://www.sciencedirect.com/science/article/pii/S2213007125000176Thymic cancerLenvatinibInterstitial lung disease
spellingShingle Yuki Hatakeyama
Jun Sakakibara-Konishi
Masato Tarumi
Kosuke Tsuji
Hirofumi Takahashi
Megumi Furuta
Yuta Takashima
Hidenori Kitai
Tetsuaki Shoji
Yasuyuki Ikezawa
Satoshi Konno
Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
Respiratory Medicine Case Reports
Thymic cancer
Lenvatinib
Interstitial lung disease
title Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
title_full Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
title_fullStr Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
title_full_unstemmed Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
title_short Efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
title_sort efficacy and safety of lenvatinib in a case of thymic carcinoma complicated with interstitial lung disease and anti melanoma differentiation associated gene 5 antibody positive dermatomyositis a case report
topic Thymic cancer
Lenvatinib
Interstitial lung disease
url http://www.sciencedirect.com/science/article/pii/S2213007125000176
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