Development and validation of response markers to predict survival and pleurodesis success in patients with malignant pleural effusion (PROMISE): a multicohort analysis

Psallidas, Ioannis; Kanellakis, Nikolaos I.; Gerry, Stephen; Thézénas, Marie‐Laëtitia; Charles, P. David; Samsonova, Anastasia; Schiller, Herbert B.; Fischer, Román; Asciak, Rachelle; Hallifax, Robert; Mercer, Rachel; Dobson, Melissa; Dong, Tao; Pavord, Ian; Collins, Gary S.; Kessler, Benedikt M.; Pass, Harvey I.; Maskell, Nick A; Stathopoulos, Georgios T.; Rahman, Najib M.

doi:10.1016/s1470-2045(18)30294-8

Cited by 103 publications

(107 citation statements)

References 27 publications

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“…However, a recent study suggested that it underestimates the prognosis in patients with MPE caused by lung adenocarcinoma . The recently published PROMISE score system includes a clinical score method and a biological score method, which is a clinical score plus tissue inhibitor of metalloproteinases 1 (TIMP1). However, this system can only predict the 3‐month mortality, and adding TIMP1 to the score system only contributed very modest effects, which limited its clinical value .…”

Section: Discussionmentioning

confidence: 99%

Thymidine kinase 1 concentration in pleural effusion is a diagnostic marker and survival predictor for malignant pleural effusion

Tian

et al. 2019

Clinical Laboratory Analysis

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Objective Thymidine kinase 1 (TK1) is a key enzyme in the pyrimidine salvage pathway. Increased TK1 concentration correlates with cell division. TK1 is an emerging biomarker in cancer diagnosis; however, its effectiveness in diagnosis and management for malignant pleural effusion (MPE) is unclear. We evaluated the diagnostic efficiency and prognostic value of pleural effusion TK1 (pTK1) concentration for MPE. Methods From 2013 to 2017, 210 pleural effusion samples were collected from 160 patients diagnosed with MPE and 50 patients diagnosed with benign pleural effusion (BPE). TK1 concentrations in pleural effusion were measured by chemiluminescence dot blot assays. The median follow‐up was 12 months. We constructed a receiver‐operating characteristic (ROC) curve to find the optimal cutoff value for MPE diagnosis. The hazard ratios were estimated using a multivariable Cox proportional hazard model. A nomogram was drawn to illustrate the prognostic characteristics of MPE. Results The TK1 concentration in pleural effusion was significantly higher in MPE than BPE (P < 0.001), and patients with MPE could be distinguished by an optimal cutoff value of 3.10 pmol/L with a sensitivity of 0.894 and a specificity of 0.800. The multivariate analysis suggested that pTK1 concentration was an independent predictor of survival in patients with MPE. Conclusions The diagnostic and prognostic prediction of MPE may be improved by measuring pTK1 concentration and utilizing a multivariate nomogram.

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Section: Discussionmentioning

confidence: 99%

Thymidine kinase 1 concentration in pleural effusion is a diagnostic marker and survival predictor for malignant pleural effusion

Tian

et al. 2019

Clinical Laboratory Analysis

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“…Unfortunately, all eight biomarkers examined in the prediction of pleurodesis outcomes were unsuccessful, including tumor necrosis factor (TNF) α, TNFβ, interleukin 6, and fibroblast growth factor 2. 3 Although unsuccessful in predicting pleurodesis outcome in this instance, potential has been shown with the development of a prognostic survival score using biomarkers and further investigation is warranted. 3.…”

Section: Sonographic Pleurodesis: Prediction Unexpandable Lungmentioning

confidence: 98%

“…1,2 This figure is influenced by a number of factors, including performance status and tumor type, but can be risk stratified to predict prognosis using a number of tools including the LENT score and the more recently published and more accurate PROMISE tool. 2,3 Interventions available to patients and clinicians in the management of MPE include therapeutic pleural aspiration, indwelling pleural catheters (IPCs), or talc pleurodesis either using talc slurry instilled via an intercostal chest drain or talc poudrage administered during thoracoscopy. Each management option has various indications, roles and sequelae, and is dependent on multiple factors including availability, the underlying pathophysiology and patient choice among others.…”

Section: Overall Approach and Patient Perspectivementioning

confidence: 99%

Malignant Pleural Effusions: Management Options

McCracken

Porcel

Rahman

2018

Semin Respir Crit Care Med

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Malignant pleural effusion (MPE) represents advanced metastatic malignancy and is associated with poor median survival. Incidence remains high and continues to rise, in part due to changing population demographics. This therefore represents a significant health care burden. Management is predominantly palliative in nature and multiple interventions are available within conventional treatment paradigms, all of which are proven to result in statistically significant patient benefit. This article further explores the methods available in the management of MPE along with the pitfalls, complications, and alternatives. Recent advances within the field are discussed with an exploration of likely future directions, including the role of ultrasound as a prospective predictor and the role of intrapleural fibrinolytic therapy.

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“…46,71,72 The PROMISE score (►Table 3) helped predict survival that appeared to perform better than the LENTscore. 73 Pleurodesis success rates are also affected by tumor types, where those with mesothelioma and lung cancer-associated MPE failing more often when compared with MPE secondary to breast cancer (53 and 58% vs. 75%). 74 This is postulated to be related to a lower tumor load among the latter MPEs.…”

Section: Malignant Pleural Effusionsmentioning

confidence: 99%

Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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Symptomatic pleural disease, specifically malignant pleural effusion, refractory benign pleural effusion, and pneumothoraces are common diseases that often require therapeutic interventions. The spectrum of management strategies often includes selection of a chemical pleurodesis agent administered in combination with an indwelling pleural catheter or chest tube.Additionally, there is a role for minimally invasive techniques which include medical thoracoscopy or more advanced video-assisted thoracoscopic approaches. Ongoing clinical trials continue to evolve best practices regarding the optimal sclerosant agents and procedural approaches in the management of these diseases.

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Development and validation of response markers to predict survival and pleurodesis success in patients with malignant pleural effusion (PROMISE): a multicohort analysis

Abstract: European Respiratory Society, Medical Research Funding-University of Oxford, Slater & Gordon Research Fund, and Oxfordshire Health Services Research Committee Research Grants.

Cited by 103 publications

References 27 publications

Thymidine kinase 1 concentration in pleural effusion is a diagnostic marker and survival predictor for malignant pleural effusion

Thymidine kinase 1 concentration in pleural effusion is a diagnostic marker and survival predictor for malignant pleural effusion

Malignant Pleural Effusions: Management Options

Pleurodesis

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