February 28th is Rare Disease Day and we thought it would be a great time to spotlight our PECATI trial for rare thymic tumors and share an interview we did with Dr. Jordi Remon on thymic cancer and the PECATI trial! This day is used to raise awareness for rare diseases and improve access to treatment and medical representation for those individuals. Unfortunately, because these diseases often affect a small subset of individuals, the available treatment can be insufficient with limited clinical research support, as well as a lack of a social networks to help individuals and their families during this difficult time.
Thymic tumors are rare, effecting only 1.5 cases for every million people each year in the US, which amounts to 400 cases per year. These tumors, also called thymic epithelial tumors (TETs), are cancers that can form in the cells that cover the outside surface of the thymus, a small organ that lies in the upper chest above the heart and under the breastbone. As part of the lymph system, the thymus is responsible for making white blood cells that help fight infection. These patients often do not exhibit any signs or symptoms therefore, many times these tumors are found during a chest x-ray that is done for another reason. Thymic carcinoma is the most aggressive subtype of thymic epithelial tumors, with a greater tendency to metastasize. The standard of care for patients whose thymic cancer has metastasized is a combination of chemotherapy based on platinum salts, but once that stops working, there is no defined strategy.
Many types of cancers make proteins called PD-L1. These proteins bind to PD-1, blocking the ligands that would deactivate it and prevent an immune response. Pembrolizumab is an antibody that binds to and blocks PD-1 located on lymphocytes, thereby inhibiting PD-L1. In other thoracic cancers, pembrolizumab have been proven to be effective. Lenvatinib inhibits several protein kinases, many of which vascularize tumors. The combination of these two drugs could be beneficial in treating thymic tumors.
Therefore, the PECATI study is single arm, phase II trial that is evaluating the efficacy of combining Lenvatinib and pembrolizumab for patients with advanced thymic tumors. Patients enrolling in the trial must have progressed after receiving at least one line of platinum-based chemotherapy. The primary endpoint for the trial is progression free survival at 5-months with secondary endpoints of response rate, disease control rate, duration of response, tumor shrinkage, overall survival and to assess the safety and toxicity profile of the combination. The study will enroll 43 patients over 11 sites in Spain, Italy, and France.
At MEDSIR we are committed to advancing research for all tumor types and believe that all patients deserve support throughout the process. Contact us if you have any questions about our trials!