Abstract
Thymic mucoepidermoid carcinoma (MEC) is a rare thymic carcinoma subtype. Current metastatic thymic carcinoma guidelines recommend first-line platinum-based chemotherapy. However, evidence suggests that MECs, including those of the lung and salivary gland, are chemorefractory, highlighting a more nuanced approach to systemic therapy decision-making. Here, we report a case of durable partial response to second-line lenvatinib in a patient with metastatic high-grade thymic MEC, refractory to first-line platinum-based chemotherapy, suggesting a potentially preferred first-line role for lenvatinib for this subtype.