TY - JOUR
T1 - The 2021 WHO Classification of Tumors of the Thymus and Mediastinum
T2 - What Is New in Thymic Epithelial, Germ Cell, and Mesenchymal Tumors?
AU - Marx, Alexander
AU - Chan, John K.C.
AU - Chalabreysse, Lara
AU - Dacic, Sanja
AU - Detterbeck, Frank
AU - French, Christopher A.
AU - Hornick, Jason L.
AU - Inagaki, Hiroshi
AU - Jain, Deepali
AU - Lazar, Alexander J.
AU - Marino, Mirella
AU - Marom, Edith M.
AU - Moreira, Andre L.
AU - Nicholson, Andrew G.
AU - Noguchi, Masayuki
AU - Nonaka, Daisuke
AU - Papotti, Mauro G.
AU - Porubsky, Stefan
AU - Sholl, Lynette M.
AU - Tateyama, Hisashi
AU - Thomas de Montpréville, Vincent
AU - Travis, William D.
AU - Rajan, Arun
AU - Roden, Anja C.
AU - Ströbel, Philipp
N1 - Funding Information:
Disclosure: Dr. Dacic reports receiving personal fees from AstraZeneca, Takeda, and Janssen, outside the submitted work. Dr. French reports receiving grants from Boehringer Ingelheim, personal fees from Boehringer Ingelheim, and other support from Epigenetix, outside the submitted work. Dr. Hornick reports receiving personal fees from Aadi Biosciences and Tracon Pharmaceuticals, outside the submitted work. Dr. Nicholson reports receiving grants and personal fees from Pfizer and personal fees from Merck, Boehringer Ingelheim, Novartis, AstraZeneca, Bristol Myers Squibb, Roche, AbbVie, Oncologica, UpToDate, European Society of Oncology, and Liberum, outside the submitted work. Dr. Papotti reports receiving personal fees from Pfizer, Eli Lilly, and AAA/Novartis, outside the submitted work. Dr. Sholl reports receiving grants from Genentech and Eli Lilly and personal fees from GV20 Therapeutics. The remaining authors declare no conflict of interest.
Funding Information:
Disclosure: Dr. Dacic reports receiving personal fees from AstraZeneca , Takeda, and Janssen, outside the submitted work. Dr. French reports receiving grants from Boehringer Ingelheim, personal fees from Boehringer Ingelheim, and other support from Epigenetix, outside the submitted work. Dr. Hornick reports receiving personal fees from Aadi Biosciences and Tracon Pharmaceuticals, outside the submitted work. Dr. Nicholson reports receiving grants and personal fees from Pfizer and personal fees from Merck, Boehringer Ingelheim, Novartis , AstraZeneca , Bristol Myers Squibb , Roche , AbbVie , Oncologica, UpToDate, European Society of Oncology, and Liberum, outside the submitted work. Dr. Papotti reports receiving personal fees from Pfizer , Eli Lilly, and AAA/ Novartis , outside the submitted work. Dr. Sholl reports receiving grants from Genentech and Eli Lilly and personal fees from GV20 Therapeutics. The remaining authors declare no conflict of interest.
Publisher Copyright:
© 2021 International Association for the Study of Lung Cancer
PY - 2022/2
Y1 - 2022/2
N2 - This overview of the fifth edition of the WHO classification of thymic epithelial tumors (including thymomas, thymic carcinomas, and thymic neuroendocrine tumors [NETs]), mediastinal germ cell tumors, and mesenchymal neoplasms aims to (1) list established and new tumor entities and subtypes and (2) focus on diagnostic, molecular, and conceptual advances since publication of the fourth edition in 2015. Diagnostic advances are best exemplified by the immunohistochemical characterization of adenocarcinomas and the recognition of genetic translocations in metaplastic thymomas, rare B2 and B3 thymomas, and hyalinizing clear cell carcinomas. Advancements at the molecular and tumor biological levels of utmost oncological relevance are the findings that thymomas and most thymic carcinomas lack currently targetable mutations, have an extraordinarily low tumor mutational burden, but typically have a programmed death-ligand 1high phenotype. Finally, data underpinning a conceptual advance are illustrated for the future classification of thymic NETs that may fit into the classification scheme of extrathoracic NETs. Endowed with updated clinical information and state-of-the-art positron emission tomography and computed tomography images, the fifth edition of the WHO classification of thymic epithelial tumors, germ cell tumors, and mesenchymal neoplasms with its wealth of new diagnostic and molecular insights will be a valuable source for pathologists, radiologists, surgeons, and oncologists alike. Therapeutic perspectives and research challenges will be addressed as well.
AB - This overview of the fifth edition of the WHO classification of thymic epithelial tumors (including thymomas, thymic carcinomas, and thymic neuroendocrine tumors [NETs]), mediastinal germ cell tumors, and mesenchymal neoplasms aims to (1) list established and new tumor entities and subtypes and (2) focus on diagnostic, molecular, and conceptual advances since publication of the fourth edition in 2015. Diagnostic advances are best exemplified by the immunohistochemical characterization of adenocarcinomas and the recognition of genetic translocations in metaplastic thymomas, rare B2 and B3 thymomas, and hyalinizing clear cell carcinomas. Advancements at the molecular and tumor biological levels of utmost oncological relevance are the findings that thymomas and most thymic carcinomas lack currently targetable mutations, have an extraordinarily low tumor mutational burden, but typically have a programmed death-ligand 1high phenotype. Finally, data underpinning a conceptual advance are illustrated for the future classification of thymic NETs that may fit into the classification scheme of extrathoracic NETs. Endowed with updated clinical information and state-of-the-art positron emission tomography and computed tomography images, the fifth edition of the WHO classification of thymic epithelial tumors, germ cell tumors, and mesenchymal neoplasms with its wealth of new diagnostic and molecular insights will be a valuable source for pathologists, radiologists, surgeons, and oncologists alike. Therapeutic perspectives and research challenges will be addressed as well.
KW - Germ cell tumor
KW - NET G3
KW - Thymic carcinoma
KW - Thymic neuroendocrine tumor
KW - Thymoma
KW - WHO classification
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UR - http://www.scopus.com/inward/citedby.url?scp=85119931358&partnerID=8YFLogxK
U2 - 10.1016/j.jtho.2021.10.010
DO - 10.1016/j.jtho.2021.10.010
M3 - Review article
C2 - 34695605
AN - SCOPUS:85119931358
VL - 17
SP - 200
EP - 213
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 2
ER -