Evaluation of efficacy and safety for bevacizumab in treating malignant pleural effusions caused by lung cancer through intrapleural injection

Abstract

Some clinical investigations have assessed the efficacy and safety of bevacizumab combined with platinum anti-cancer drugs versus platinum drugs alone in treating malignant pleural effusion (MPE) caused by lung cancer through intrapleural injection. This report is a meta-analysis of independent research conclusions. Eleven controlled trials with 769 MPE patients were included in this report. Pooled odds ratios and standardized mean difference with 95% confidence intervals were estimated using the fixed or random effects model of meta-analysis. For treating MPE through intrapleural injection, bevacizumab combined with platinum chemotherapy drugs increased the overall response rate (p = 0.003), decreased the incidence of chest pain (p < 0.001) and relieved the dyspnea of patients with MPE (p = 0.002), as compared with platinum chemotherapy drugs alone. In addition, intrapleural injection of bevacizumab participation decreased the expression of vascular endothelial growth factor in MPE (p < 0.001). The main adverse effects of two groups were myelotoxicity, hypertension, digestive reaction and damage of liver and kidney. However, the presence of bevacizumab did not show an extra influence on the incidence of adverse effects (p > 0.05). In summary, bevacizumab combined with platinum chemotherapy drugs for treating MPE caused by lung cancer through intrapleural injection has a better benefit of overall response rate and quality of life. And, the participation of bevacizumab did not increase adverse effects.

Nab-paclitaxel in combination with Bevacizumab in patients with non-squamous non-small cell lung cancer after failure of at least one prior systemic regimen

“…This association might be due to an improved response to the nab-PTX plus bevacizumab regimen in patients with pleural metastasis. Bevacizumab injection into the pleural cavity has been used for the management of pleural effusion and showed good benefits [52]. The combination of sb-PTX with bevacizumab has also been shown to be better than docetaxel for the management of pleural effusion from NSCLC [53].…”

Narrative review of theoretical considerations regarding HITHOC between past and future

“…Recently, intrapleural immunotherapy ushers new indications (19). Monoclonal antibodies such as bevacizumab and similar actors, cope with the metastasizing tumor causing MPE offers a logical bifocal action (39). To make a complicated picture more confusing, there is an accumulating number of observations in reference to beneficial alterations regarding therapy resistance in both directions of immunotherapies and chemotherapies as seen in pulmonary malignancies.…”

Novel insights into the systemic treatment of lung cancer malignant pleural effusion

“…Intrapleural use of bevacizumab has also been studied and seems to improve MPE control. A recent meta‐analysis has assessed efficacy and safety of intrapleural bevacizumab combined with platinum‐based systemic chemotherapy . The analysis included 11 controlled trials with 769 patients.…”

“…A recent meta-analysis has assessed efficacy and safety of intrapleural bevacizumab combined with platinum-based systemic chemotherapy. 48 The analysis included 11 controlled trials with 769 patients. Overall results showed that there was an increase in overall response rates (P = 0.003), with a decrease in the incidence of chest pain (P < 0.001) and relieved of dyspnea (P = 0.002) as compared to patients with platinum chemotherapy alone.…”