Thymic carcinoma (TC) is a rare malignant tumor with a poor prognosis, and there is currently limited data on the use of immunotherapy in patients with unresectable TC. In this study, data of patients with unresectable TC diagnosed from January 2017 were retrospectively collected from multiple centers. Treatment response, progression‐free survival (PFS), overall survival (OS), survival‐independent prognostic factor, and adverse events (AEs) were further analyzed. As a result, a total of 93 patients with unresectable TC were enrolled, of which 54 received first‐line chemotherapy, and 39 received chemotherapy plus immune checkpoint inhibitors (ICIs). The objective response rate was 50% (27/54) in the chemotherapy group and 76.9% (30/39) in the chemotherapy plus ICIs group. The chemotherapy plus ICIs group achieved significant median PFS benefit (8.8 vs. 34.9 months, p < .001) and median OS benefit (41.8 months vs. not reached, p = .025). Multivariate analysis showed that ICIs and local therapy were independent prognostic factors for PFS. In addition, 17 patients developed immune‐related AEs (IRAEs), of which 15 (38.5%) had Grade 1 or 2 IRAEs and 2 (5.1%) had Grade 3 IRAEs in the chemotherapy plus ICIs group. In conclusion, the efficacy of chemotherapy plus ICIs is superior to chemotherapy, and the adverse effects are manageable in patients with unresectable TC.

中文翻译：

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化疗与化疗加免疫检查点抑制剂一线治疗不可切除胸腺癌的比较：多中心回顾性研究

胸腺癌（TC）是一种罕见的恶性肿瘤，预后较差，目前关于不可切除的TC患者使用免疫治疗的数据有限。本研究回顾性收集了2017年1月以来多个中心确诊的不可切除TC患者的数据。进一步分析治疗反应、无进展生存期（PFS）、总生存期（OS）、生存独立预后因素和不良事件（AE）。结果，共有93例不可切除的TC患者入组，其中54例接受一线化疗，39例接受化疗加免疫检查点抑制剂（ICIs）。化疗组的客观缓解率为50%（27/54），化疗加ICIs组的客观缓解率为76.9%（30/39）。化疗加 ICI 组取得了显着的中位 PFS 获益（8.8 个月与 34.9 个月，p< .001）和中位 OS 获益（41.8 个月与未达到，p= .025)。多变量分析显示 ICI 和局部治疗是 PFS 的独立预后因素。此外，化疗加 ICI 组中有 17 名患者出现免疫相关 AE（IRAE），其中 15 名患者（38.5%）出现 1 级或 2 级 IRAE，2 名患者（5.1%）出现 3 级 IRAE。总之，对于不可切除的 TC 患者，化疗联合 ICI 的疗效优于化疗，且不良反应是可控的。