Thymoma

Carfilzomib synergized with BCL2 family protein inhibitors (navitoclax or AZD5991), suggesting that drug combinations could be used to reduce the dose of each drug to minimize toxicity. Notably, thymic carcinomas differed from squamous cell carcinomas in other organs by higher levels of β5i (PSMB8) and constitutive proteasome β5 (PSMB5). We hypothesize that TC (and probably many TH) are uniquely suited for treatment with proteasome inhibitors alone or in combination with selective BH3 mimetics.

P2, N=20, Recruiting, The First Affiliated Hospital with Nanjing Medical University | Not yet recruiting --> Recruiting

We present a surgical case of an extremely rare asynchronous, isolated thymic metastasis that occurred over 10 years after initial breast cancer surgery. This case underscores the importance of considering thymic metastasis in the differential diagnosis of anterior mediastinal tumors in patients with a remote history of breast cancer.

Tumors with a CD20 score of 3 demonstrated a tendency towards higher SPT24 or SP141 expression. Different expressions by TTF-1 clone may be diagnostic challenges in type A/AB thymomas, and pathologists should be aware of aberrant TTF-1 expression using SPT24 and SP141 clone in thymomas.

Evaluation revealed hypogammaglobulinemia along with CD4+ T-cell and B-cell lymphopenia, thus indicating Good's syndrome. Our case highlights the importance of including Good's syndrome in the differential diagnosis of HIV-negative, acquired, adult immunodeficiency and elucidates the general principles of management of this rare clinical entity.

She received granulocyte colony-stimulating factor (GCSF), thrombopoietin (TPO) mimetic, and immunosuppressive therapy with prednisone prior to primary cytoreductive surgery to no apparent gross residual disease...She was treated with anti-thymocyte globulin (ATG) and cyclosporine and subsequently received adjuvant chemotherapy with weekly cisplatin and subsequent addition of weekly paclitaxel, resulting in reduction in her serum Cancer Antigen-125 (CA-125) and no radiographic evidence of disease. Despite initial response, her clinical deterioration and her decision to forego further cancer- or aplastic anemia-directed therapy resulted in transition to home hospice care, and she was discharged 119 days after admission. This case report highlights the importance of multi-disciplinary collaboration to manage the medical complexities of paraneoplastic aplastic anemia secondary to a gynecologic malignancy.

Our findings suggest a clonal evolution model in recurrent thymomas, with accumulation of genetic alterations and, in some cases, histological progression. Longitudinal genomic analysis revealed clonal mutations which may inform risk stratification and identify potential therapeutic targets in recurrent TETs.

P3, N=64, Not yet recruiting, Shanghai Zhongshan Hospital

Management required tailored antifungal regimens (amphotericin B, fluconazole, flucytosine) and careful therapeutic drug monitoring to address immunosuppressant interactions...Within this complex clinical scenario, early recognition, multidisciplinary care, and individualized treatment strategies are paramount. They underscore the need for heightened clinical vigilance and further research to optimize outcomes in this vulnerable patient population.

The c.379T > G variant of CTLA4, resulting in a p.Tyr127Asp substitution, is pathogenic and contributes to the development of a CTLA4 haploinsufficiency phenotype. This finding highlights the heterogeneous presentations of the disease, including oncological and neurological manifestations.

In vitro, TGF-β1 stimulation upregulated PD-L1 expression in a dose-dependent manner, accompanied by increased pSmad2/3 activation. These findings indicate that high TGF-β1 expression demarcates a biologically aggressive TET phenotype and, together with PD-L1, refines postoperative risk stratification, while its ability to drive PD-L1 via Smad signaling could support the blockade of these pathways as a potential therapeutic strategy.

He received chemotherapy plus anlotinib for four cycles since May 5, 2023, and underwent radiotherapy from May 23, 2023 to June 30, 2023. Finally, the patient was discharged after treatment with glucocorticoids, immunoglobulin, and pyridostigmine. Although immune checkpoint inhibitors have achieved similar anti-tumor effects in thymomas as in other solid tumors, they may be closely associated with serious immune-related adverse events, so special caution is required when using immune checkpoint inhibitors in thymoma patients.