Thymic carcinoma: lines of therapy

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5 standard-of-care settings across 5 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers
Early / localised	1
Locally advanced	1
Advanced, first line	1
Second line	1
Other settings	1

Early / localised

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Resectable disease	Complete resection with thymectomy and involved structures; postoperative radiotherapy for all stages of thymic carcinoma; chemotherapy considered after incomplete resection.	Robotic & minimally invasive surgeryIMRT / IGRT (modern external beam)Proton therapy	NCCN Guidelines: Thymomas and Thymic Carcinomas	93

Locally advanced

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Borderline resectable	Induction chemotherapy (carboplatin-paclitaxel or CAP) followed by surgery or radiotherapy according to response.	CarboplatinPaclitaxel / nab-paclitaxelCisplatinDoxorubicinCyclophosphamide	NCCN Guidelines: Thymomas and Thymic Carcinomas	82

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Advanced, first line	Carboplatin and paclitaxel; CAP or platinum-etoposide as alternatives.	CarboplatinPaclitaxel / nab-paclitaxelCytotoxic chemotherapy	NCCN Guidelines: Thymomas and Thymic Carcinomas	94

Second line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	After platinum	Sunitinib; lenvatinib (approved in Japan, REMORA); pembrolizumab with cardiac and autoimmune monitoring; everolimus; imatinib for KIT-mutant tumours.	SunitinibLenvatinibPembrolizumabEverolimusImatinibImmune-related adverse events (irAEs)Small-molecule kinase inhibitorsImmune checkpoint inhibitors	NCCN Guidelines: Thymomas and Thymic Carcinomas	99

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Trials	KC1036, sacituzumab tirumotecan, CAR-NK cells, ramucirumab combinations.	A Study of KC1036 in Patients with Advanced Thymic TumorsSacituzumab Tirumotecan in Participants With Locally Advanced or Metastatic Thymic CarcinomaTarget-Selected CAR-NK Cells (CD30, CD5, or Mesothelin) for Relapsed/Refractory B2 Thymoma or Thymic CarcinomaKC1036EB-CAR30-NK	NCCN Guidelines: Thymomas and Thymic Carcinomas	41

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.