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Thymoma and Thymic CarcinomaPhase 2/3NCT07463313

6 vs 3 Cycles of Neoadjuvant Chemotherapy for Potentially Resectable Locally Advanced Thymic Epithelial Tumors

A Phase 2/3 study testing Cyclophosphamide, Doxorubicin, and Cisplatin (CAP) and nab-Paclitaxel and Carboplatin in people with Thymoma and Thymic Carcinoma, run by Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This randomized controlled trial compares 6 versus 3 cycles of neoadjuvant chemotherapy in patients with potentially resectable locally advanced thymic epithelial tumors (TETs, WHO type AB/B/C, AJCC TNM stage IIIA-IVA). Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Thymoma and Thymic Carcinoma
What is being tested?
Cyclophosphamide, Doxorubicin, and Cisplatin (CAP) and nab-Paclitaxel and Carboplatin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
116 participants
Where
1 siteChina
Study dates
Mar 2026to Mar 2032
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically confirmed thymic epithelial tumor (thymoma or thymic carcinoma)
  • Locally advanced, potentially resectable disease (Masaoka-Koga stage III or IVA), as evaluated by a multidisciplinary team (MDT) including thoracic surgery and thoracic oncology
  • Age 18 to 65 years
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Adequate bone marrow function: absolute neutrophil count (ANC) ≥1.5×10⁹/L, platelet count ≥100×10⁹/L, hemoglobin ≥90 g/L
  • Adequate liver function: total bilirubin ≤1.5× upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×ULN
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  • Adequate renal function: creatinine clearance ≥50 mL/min (Cockcroft-Gault formula)
  • No prior systemic anticancer therapy for thymic epithelial tumor
  • At least one measurable lesion per RECIST v1.1
  • Willing to accept randomization and able to comply with study procedures
  • Written informed consent obtained prior to any study-related procedures

Who cannot join

  • Prior chemotherapy, targeted therapy, or immunotherapy for thymic epithelial tumor
  • Prior thoracic radiation therapy
  • Active autoimmune disease requiring systemic treatment within the past 2 years
  • Known hypersensitivity or contraindication to study drugs (cisplatin, epirubicin, etoposide, ifosfamide, or any component of these formulations)
  • Severe cardiac dysfunction: New York Heart Association (NYHA) class III or IV heart failure, or left ventricular ejection fraction (LVEF) <50%
  • Active hepatitis B (HBsAg positive with HBV DNA ≥2000 IU/mL), active hepatitis C, or known HIV infection
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  • Pregnancy or lactation; women of childbearing potential unwilling to use adequate contraception
  • Other malignancy within 5 years prior to enrollment, except for adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix
  • Uncontrolled active infection requiring systemic therapy
  • Any condition that, in the investigator's judgment, would preclude safe participation in the study

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Fan Jiang, MD, PhD contact

86-21-63240090

fan_jiang@sjtu.edu.cn

China1 site
  • Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

    Shanghai, Shanghai Municipality, 200080

    Fan Jiang, MD, PhD, 86-21-63240090, fan_jiang@sjtu.edu.cn

Other trials in China

About this study

Official title: A Randomized Controlled Trial of 6 Versus 3 Cycles of Neoadjuvant Chemotherapy on Event-Free Survival in Patients With Potentially Resectable Locally Advanced Thymic Epithelial Tumors

This randomized controlled trial compares 6 versus 3 cycles of neoadjuvant chemotherapy in patients with potentially resectable locally advanced thymic epithelial tumors (TETs, WHO type AB/B/C, AJCC TNM stage IIIA-IVA). Patients are randomized 1:1 to receive either 6 or 3 cycles of chemotherapy (cisplatin + doxorubicin + cyclophosphamide for type B; nab-paclitaxel + carboplatin for type C thymoma/thymic carcinoma) every 3 weeks, followed by surgical resection when feasible. The primary endpoint is event-free survival (EFS). The study aims to determine whether extended neoadjuvant chemotherapy improves surgical outcomes and long-term survival in this rare malignancy.

Read the detailed description

Thymic epithelial tumors (TETs) are rare mediastinal malignancies. Locally advanced, potentially resectable TETs present a significant clinical challenge, with limited prospective data on optimal neoadjuvant chemotherapy duration. Retrospective data from Shanghai General Hospital suggest that 6 cycles of neoadjuvant chemotherapy may yield higher objective response rates (75% vs 33.3%) and R0 resection rates (68.75% vs 33.33%) compared to 3 cycles.

This is a single-center, prospective, open-label, randomized controlled trial. Eligible patients are adults (18-65 years) with histologically confirmed WHO type AB, B1, B2, B3 thymoma or thymic carcinoma (type C), AJCC TNM stage IIIA-IVA, deemed potentially resectable by multidisciplinary team (MDT) evaluation, ECOG PS 0-1, with adequate organ function, no prior anti-tumor therapy.

Randomization: 1:1, stratified by histological subtype (type B vs type C), using central randomization with block size 4.

Treatment:

  • Type B thymoma arm: cisplatin 50 mg/m² + doxorubicin 50 mg/m² + cyclophosphamide 500 mg/m², Q3W
  • Type C thymic carcinoma arm: nab-paclitaxel 200 mg/m² + carboplatin AUC 5, Q3W
  • Control group: 3 cycles; Experimental group: 6 cycles

Imaging assessment (RECIST 1.1) every 2 cycles. CR/PR: proceed to surgery; SD: continue chemotherapy; PD: radical radiotherapy.

Post-operative radiotherapy as indicated (R0: 45-50 Gy; R1: 54 Gy; R2: 60-70 Gy).

Primary endpoint: Event-Free Survival (EFS), defined as time from randomization to first occurrence of tumor recurrence, progression, or death.

Sample size: 116 patients (58 per arm), based on ORR comparison (25% vs 50%, α=0.05, power=0.80, 5% dropout/year).

Follow-up: 3 years post-enrollment (total study duration 6 years).

Being tested
Cyclophosphamide, Doxorubicin, and Cisplatin (CAP), nab-Paclitaxel and Carboplatin
Keywords
Neoadjuvant Chemotherapy, Thymic Epithelial Tumor, Thymic Carcinoma, Event-Free Survival, Mediastinal Tumor
Medical subject headings
Thymoma, Thymic epithelial tumor, Mediastinal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cyclophosphamide, Doxorubicin, and Cisplatin (CAP)Drug

    Chemotherapy regimen for WHO type B thymoma. Cyclophosphamide 500 mg/m2 IV + Doxorubicin 50 mg/m2 IV + Cisplatin 50 mg/m2 IV, administered every 3 weeks. Experimental arm receives 6 cycles; Control arm receives 3 cycles prior to surgery.

  • nab-Paclitaxel and CarboplatinDrug

    Chemotherapy regimen for thymic carcinoma. nab-Paclitaxel 260 mg/m2 IV + Carboplatin AUC 5 IV, administered every 3 weeks. Experimental arm receives 6 cycles; Control arm receives 3 cycles prior to surgery.

Study groups in NCT07463313
Study groupRoleWhat they receive
6-Cycle Neoadjuvant ChemotherapyExperimentalParticipants receive 6 cycles of neoadjuvant chemotherapy prior to surgery. For WHO type B thymoma: cyclophosphamide 500 mg/m2 IV + doxorubicin 50 mg/m2 IV + cisplatin 50 mg/m2 IV (CAP regimen), every 3 weeks. For thymic carcinoma: nab-paclitaxel 260 mg/m2 IV + carboplatin AUC 5 IV, every 3 weeks.
Receives: Drug: Cyclophosphamide, Doxorubicin, and Cisplatin (CAP); Drug: nab-Paclitaxel and Carboplatin
3-Cycle Neoadjuvant ChemotherapyActive comparatorParticipants receive 3 cycles of neoadjuvant chemotherapy prior to surgery. For WHO type B thymoma: cyclophosphamide 500 mg/m2 IV + doxorubicin 50 mg/m2 IV + cisplatin 50 mg/m2 IV (CAP regimen), every 3 weeks. For thymic carcinoma: nab-paclitaxel 260 mg/m2 IV + carboplatin AUC 5 IV, every 3 weeks.
Receives: Drug: Cyclophosphamide, Doxorubicin, and Cisplatin (CAP); Drug: nab-Paclitaxel and Carboplatin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Event-Free Survival (EFS)

    EFS is defined as the time from randomization to the first occurrence of any of the following events: disease progression precluding surgery, incomplete resection (R1/R2), local or distant recurrence after surgery, or death from any cause.

    Measured: 3 years from randomization

Secondary outcomes (6)
  1. Objective Response Rate (ORR)

    Proportion of participants achieving complete response (CR) or partial response (PR) per RECIST v1.1 criteria after neoadjuvant chemotherapy.

    Measured: After completion of neoadjuvant chemotherapy (approximately 9 weeks for 3-cycle arm; approximately 18 weeks for 6-cycle arm)

  2. 3-Year Event-Free Survival Rate

    Proportion of participants who remain free of events (disease progression, incomplete resection, recurrence, or death) at 3 years after randomization.

    Measured: 3 years from randomization

  3. R0 Resection Rate

    Proportion of participants achieving complete (R0) resection, defined as microscopically negative surgical margins at the time of surgery.

    Measured: At the time of surgery

  4. Pathological Complete Response (pCR) Rate

    Proportion of participants achieving pathological complete response (pCR), defined as no viable tumor cells in the surgical resection specimen, as assessed by central pathology review.

    Measured: At the time of surgery

  5. Major Pathological Response (MPR) Rate

    Proportion of participants achieving major pathological response (MPR), defined as ≤10% residual viable tumor cells in the surgical resection specimen, as assessed by central pathology review.

    Measured: At the time of surgery

  6. Incidence and Severity of Adverse Events

    Incidence, nature, and severity of adverse events and serious adverse events as assessed by NCI CTCAE v5.0, including hematologic toxicity, non-hematologic toxicity, and treatment-related deaths.

    Measured: Throughout the study, from first dose to 30 days after last dose of chemotherapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Mar 2026
  2. Study startMar 2026 (estimated)
  3. Primary completionMar 2029 (estimated)
  4. Study completionMar 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
116 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07463313
Sponsor's protocol ID
20251109101922438
Other IDs
2026HS060
Status last verified
Mar 2026
First submitted
6 Mar 2026
Last updated
11 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared at this time due to patient privacy concerns and regulatory requirements. Aggregate data will be published in peer-reviewed journals.

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Cyclophosphamide, Doxorubicin, and Cisplatin (CAP) and nab-Paclitaxel and Carboplatin in people with Thymoma and Thymic Carcinoma, run by Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 11 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Fan Jiang, MD, PhD (86-21-63240090, fan_jiang@sjtu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Event-Free Survival (EFS) (time frame: 3 years from randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Mar 2026.

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