Emerging treatments
Other immune checkpoint inhibitors
Thymic epithelial tumours may express programmed death ligand-1 (PD-L1) and programmed death-1 (PD-1), which are established immunotherapeutic targets in oncology. Drugs targeting the PD-L1/PD-1 pathway, such as avelumab, nivolumab, and atezolizumab are approved for the treatment of several solid organ malignancies including skin and lung cancer.[89] Avelumab is a monoclonal antibody targeting PD-L1. Avelumab demonstrated anti-tumour activity in a phase 1 trial in patients with relapsed, advanced thymic epithelial tumours.[90] A phase 2 pilot trial of avelumab in patients who have relapsed on or are refractory to platinum-based chemotherapy is ongoing. There is some concern that, given the association of thymic malignancy with autoimmune disease, treatment with immunotherapy may result in greater rates of autoimmune toxicity than is seen with other cancer types.
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