Metronomic maintenance chemotherapy in patients presenting with paraneoplastic autoimmune hepatitis with recurrent thymic carcinoma. (April 2016)

• Record Type: Journal Article
• Authors: Kivrak Salim, Derya; Mutlu, Hasan; Karakurt Eryilmaz, Melek; Yalçin Musri, Fatma; Tural, Deniz; Coşkun, Hasan Şenol
• Is Part Of: Journal of oncology pharmacy practice. Volume 22:Number 2(2016:Jun.)
• Page Start: 313
• Page End: 315
• Publication Date: 2016-04
• Subjects: Metronomic therapy -- maintenance therapy -- thymic carcinoma -- paraneoplastic autoimmune hepatitis; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155214551318
• Languages: English
• ISSNs: 1078-1552

Abstract

Autoimmune hepatitis is a rarely seen autoimmune paraneoplastic syndrome of thymic carcinoma. Chemotherapy may be an effective choice in the treatment of primary tumor and paraneoplastic disorder. In this case, we report a 32-year-old man presented with increased liver enzymes and cholestasis with a history of thymoma surgically removed four years ago. Liver biopsy showed chronic active autoimmune hepatitis. Computed tomography scan showed pulmonary metastases and pleural mass as a recurrence of thymic carcinoma, proven by biopsy. After four cycles of cisplatin plus adriamycin plus cyclophosphamide plus vincristine and six cycles of paclitaxel plus gemcitabine, maintenance metronomic cyclophosphamide plus etoposide regimen was offered to the patient. Complete biological signs of hepatitis without need for steroids or immune suppressors and complete radiologic response in primary tumor were achieved. Maintenance metronomic chemotherapy regimens may be an alternative to the current treatment options in patients with thymic carcinomas.