Lenvatinib Plus Pembrolizumab Shows Promising Results in Treating Advanced B3 Thymoma and Thymic Carcinoma

Strategic Insights -

A new research study published in the Lancet Oncology journal has found that the combination of lenvatinib and pembrolizumab may be a potential standard treatment for patients with advanced B3 thymoma and thymic carcinoma. The study, conducted by researchers from Paris-Saclay University, involved 43 patients with relapsed or recurrent histologically confirmed type B3 thymoma or thymic carcinoma who had received at least one line of platinum-based chemotherapy and had progressed during or after the previous line of chemotherapy. The study met its primary endpoint, with 5-month progression-free survival of 88.4% after a median follow-up of 10.6 months.

Key Takeaways:

  • The study involved 43 patients with advanced B3 thymoma and thymic carcinoma who had received at least one line of platinum-based chemotherapy and had progressed during or after the previous line of chemotherapy.
  • The study met its primary endpoint, with 5-month progression-free survival of 88.4% after a median follow-up of 10.6 months.
  • The most common treatment-related adverse events were hypothyroidism (27 participants) and fatigue (25 participants).
  • Grade 3 or worse treatment-related adverse events were reported in 16 (37%) participants, and serious treatment-emergent adverse events occurred in 17 (40%) participants.
  • Lenvatinib combined with pembrolizumab showed potential as a standard treatment for pretreated advanced B3 thymoma and thymic carcinoma, although close monitoring for toxicity is advised.
  • The study was conducted by researchers from Paris-Saclay University, in collaboration with the Department of Cancer Medicine at Gustave Roussy and the Institut Universitaire d'Hematologue.
  • The study was funded by the Investigator-Initiated Studies Program of Merck Sharp & Dohme.

Statistics:

  • 43 patients were enrolled and started study treatment, with 27 (63%) being White, four (9%) Arabic or North African, one (2%) Albanian, one (2%) Black, and ten (23%) ethnicity missing.
  • Median age was 57 years (IQR 45-66).
  • 36 (84%) participants had thymic carcinoma and seven (16%) had B3 thymoma.
  • Masaoka-Koga stage IVA disease was recorded in 15 (35%) participants and stage IVB in 28 (65%).
  • 23 (53%) participants had three or more metastatic sites, and 20 (47%) participants had received two or more previous lines of therapy.
  • The 5-month progression-free survival rate was 88.4% (90% CI 79.8-96.7).

Sources:

  • Lenvatinib plus pembrolizumab in pretreated metastatic B3 thymoma and thymic carcinoma (PECATI): a single-arm, phase 2 trial. Lancet Oncology, 2025;26(9):1215-1226.
  • NewsRx. New Findings from Paris-Saclay University in the Area of Thymic Cancer Reported [Lenvatinib plus pembrolizumab in pretreated metastatic B3 thymoma and thymic carcinoma (PECATI): a single-arm, phase 2 trial]. Immunotherapy Weekly. September 17, 2025; p 2090.