Impact of relative dose intensity of first-line platinum-based chemotherapy in patients with thymic epithelial tumors: a retrospective study

Background: Platinum-based chemotherapy is the first-line treatment choice for advanced thymic epithelial tumors (TETs), with the expected objective response rate (ORR) ≈of 50% in thymoma and ≈20% in thymic carcinoma. Objective: To evaluate the impact of relative dose intensity (RDI) on first-line treatment outcomes in TET patients. Design: Retrospective cohort referred between 2016 and 2022 at the University of Naples Federico II, Italy. Methods: Advanced TETs treated with first-line platinum chemotherapy; RDI calculated as delivered/planned dose intensity and categorized as low (<85%) or high (⩾85%). Outcomes: ORR, time to next treatment (TTNT), overall survival (OS). Results: Thirty-three patients (15 thymoma, 18 carcinoma); 22 low RDI, 11 high RDI. RDI was not associated with ORR. High RDI showed longer TTNT (6.6 vs 5.0 months; p = 0.042) and numerically longer OS (86.4 vs 32.2 months; p = 0.361). Conclusion: Maintaining ⩾85% RDI during first-line platinum chemotherapy may offer clinical benefits and warrants further validation in larger cohorts.