Thymomas and thymic carcinomas are rare tumors that are complex, with issues related to associated conditions, involved structures, understanding of the biology and definition of the optimal treatment. Currently, data stems from single centers, with reports generally spanning many decades, and level one evidence is lacking. To make progress in the treatment and understanding of these unique malignancies, there is a need for an organized collaborative effort, which necessitates creation of an international infrastructure.

In order to enhance international teamwork the Foundation for Thymic Cancer Research organized two meetings of many of the leaders in this field (in NYC in 2007 and at MD Anderson in 2008). The Foundation is a patient and family organization focused on both patient advocacy and promotion of research. These meetings led to several collaborative initiatives and publications, including several meta-analyses and NCCN guidelines for the management of thymic malignancies. These meetings also highlighted the need for greater infrastructure to foster true prospective collaboration. A nucleus of individuals has developed this concept and initiated the process. An initial focal point was to organize an international conference devoted to thymic malignancies and the development of an international organization.

On August 20 and 21, 2009 the 1st International Conference for Thymic Malignancies was convened in Bethesda, cosponsored by the National Cancer Institute and the Foundation for Thymic Cancer Research. Proceedings of this meeting will be published in a special monograph. This meeting also provided a broad forum to discuss the formation of an international organization, which has been named the International Thymic Malignancy Interest Group (ITMIG). This brief report summarizes the status of this effort. Further information is also available at www.itmig.org.

Several organizations have come forward in support of the development of ITMIG, including the American Association of Thoracic Surgery (AATS), the Society of Thoracic Surgery (STS), the International Association for the study of Lung Cancer (IASLC), the European Society of Thoracic Surgeons (ESTS), the European Association of Cardiothoracic Surgery (EACTS) and the Japanese Association for Research on the Thymus (JART). ITMIG has organized several workgroups to address initial projects. A meeting is planned in 2010 to formalize the organization of ITMIG and the structure for the continuation of collaborative projects.

An organizational structure workgroup, with broad international representation is charged with drafting the formal structure of ITMIG. This includes further development of the relationship with other organizations, with which ITMIG will work in very close collaboration. A research committee is developing a list of research priorities and a structure for evaluation of research proposals and to foster fundraising for research. A database workgroup is developing a system for international data collection. This is done in collaboration with the IASLC staging committee, with one of the goals being the eventual validation of a staging system for thymic malignancies. A tissue banking workgroup is developing infrastructure to allow sharing of tissue resources between institutions. Another workgroup is defining standard outcome measures for reporting of clinical experience. A process standards workgroup is defining standard operating procedures for handling of surgical specimens and reporting of operative and pathology results. Another project involves developing a platform for greater interface and cross-education among pathologists in order to form a basis for collaborative thought in dealing with pathology issues. Each of these projects involves an initial workgroup to lead the effort, but broad participation is sought. Individuals interested in contributing to any of these projects are encouraged to contact those involved through the ITMIG website.