Intrapleural Chemotherapy Without Pleurodesis for Malignant Pleural Effusions

Figlin, Robert A.; Mendoza, Evelyn; Piantadosi, Steven; Rusch, Valerie W.

doi:10.1378/chest.106.6_supplement.363s

Cited by 16 publications

(8 citation statements)

References 34 publications

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“…Although the BTS and NCCN do not recommend it, clinicians widely use intrapleural chemotherapy with cisplatin and other anti‐tumor drugs to treat MPE . There is no cross‐resistance between lobaplatin, cisplatin, and carboplatin.…”

Section: Discussionmentioning

confidence: 99%

Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion

Wang

Gao

et al. 2018

Thoracic Cancer

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BackgroundMalignant pleural effusion is a common complication of non‐small cell lung cancer (NSCLC); however, treatment options remain limited. This study evaluated the safety and efficacy of sequential intrapleural therapy with lobaplatin and erythromycin for NSCLC‐mediated malignant pleural effusion.MethodsFifty‐six patients with NSCLC complicated with malignant pleural effusion were recruited for a prospective single‐arm study from December 2014 to 2016; one patient dropped out. In addition to conventional systemic chemotherapy, lobaplatin and erythromycin were intrapleurally injected into subjects. Short and long‐term responses were analyzed. The concentration of ultrafilterable platinum in the pleural effusion and plasma were detected at different time points. Incidences of severe adverse reactions were observed.ResultsIn the 55 evaluable patients, the effective rate of pleural effusion was 81.8% after six weeks of treatment. Six and twelve months after treatment, the effective rates were 60% and 21.8%, respectively, and the one‐year survival rate was 83.6%. The concentrations of lobaplatin in pleural effusion and plasma two hours after injecting 50 mg lobaplatin into the thoracic cavity were 13.763 ± 1.523 μg/mL and 1.120 ± 0.164 μg/mL, and 17 hours later were 1.961 ± 0.351 μg/mL and 0.578 ± 0.095 μg/mL, respectively. The rate of severe adverse reactions of the first cycle of systemic chemotherapy combined with lobaplatin and erythromycin did not significantly differ from the rate in the second cycle.ConclusionIntrapleural combination therapy with lobaplatin and erythromycin is a safe and efficient treatment for patients with NSCLC‐mediated malignant pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion

Wang

Gao

et al. 2018

Thoracic Cancer

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“…2 In less than 30% of the patients who develop malignant pleural effusion related to breast carcinoma, symptom control may be achieved through chemotherapy and hormonal therapy. 3 Conventional therapies include repeated thoracentheses, closed thoracotomy, pleuredesis, intrapleural chemotherapy with cytotoxic chemotherapeutic agents and pleurectomy. 4 Unlike traditional sclerosing agents, intrapleural chemotherapy may potentially treat the underlying malignancy as well as pleural effusion.…”

Section: To the Editormentioning

confidence: 99%

“…In a study which 46 patients with metastatic malignant pleural effusions were evaluated, they reported grade 3 renal toxicity in 4 patients, grade 3 hematologic toxicity in 4 patients and grade 3 cardiopulmonary toxicities in 5 patients. 3 Although cisplatin has number of side effects that limit its use in heated intrapleural chemotherapy, major concern is nephrotoxicity of intrapleural heated chemotherapy. But nephrotoxicity can be succesfully managed by intravenous fluid treatment without any complications.…”

Section: International Journal Of Hematology and Oncologymentioning

confidence: 99%

Breast Carcinoma With Malignant Pleural Effusion Treated With Intrapleural Heated Cisplatin Mitomycin Chemotherapy After Pleurectomy

Akman¹

2014

UHOD

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“…Many multidrug trials, including four phase II and phase III studies by the Cancer and Leukemia Group B, have shown no clear improvement over single-agent chemotherapy [14,15]. Because systemic chemotherapy has had little effect on the progression of disease, intrapleural chemotherapy also has been evaluated in clinical trials [16,17]. This approach, however, requires a patent pleural space that is often obliterated in patients with mesothelioma, and the effect of chemotherapy is still limited by inadequate tissue penetration [7•,18].…”

Section: Opinion Statementmentioning

confidence: 99%

Photodynamic therapy for mesothelioma

Hahn

Smith

Friedberg

2001

Curr. Treat. Options in Oncol.

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Multiple trials of traditional cancer therapies for malignant pleural mesothelioma (including surgery, radiation therapy, and chemotherapy) have not convincingly demonstrated that any one treatment is superior to supportive care alone. Although there have been reports of long-term survivors who were treated with aggressive surgery combined with radiation and aggressive multi-agent chemotherapeutic regimens, these patient populations are highly selected and results cannot be generalized to a larger population. Despite attempts to use aggressive multimodality therapies, disease recurs in most patients. Local failure in particular is a large part of the natural history of mesothelioma, especially after surgery alone. Therefore, one of the major considerations in the development of new treatments is the inclusion of aggressive local therapies. Photodynamic therapy (PDT), a local treatment modality, is being evaluated as an adjuvant therapy to surgical resection. Clinical use of PDT requires the use of a photosensitizing agent and light of a wavelength specific to the absorption characteristics of the sensitizer in the presence of oxygen. The treatment effect of PDT is superficial, mostly because of the limited depth of light absorption in tissues. Therefore, it is theoretically an ideal treatment for tissue surfaces and body cavities after surgical debulking procedures. One theoretical advantage of PDT is that it can be used to treat the lung surface after a pleurectomy; therefore, patients may be treated with a pleurectomy rather than with an extrapleural pneumonectomy. Several studies have evaluated the efficacy of PDT in the treatment of mesothelioma. Clinical studies have not proven convincingly that the use of PDT is superior to the use of other adjuvant therapies or to surgery alone. The advent of newer photosensitizers and improved laser technology has led to a renewed interest in evaluating PDT. Additional studies are necessary to determine the role of PDT in the treatment of mesothelioma.

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Intrapleural Chemotherapy Without Pleurodesis for Malignant Pleural Effusions

Cited by 16 publications

References 34 publications

Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion

Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion

Breast Carcinoma With Malignant Pleural Effusion Treated With Intrapleural Heated Cisplatin Mitomycin Chemotherapy After Pleurectomy

Photodynamic therapy for mesothelioma

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