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

Xu, Lisheng; Wang, Benjie; Gao, Meimei; Zhang, Yan; Qi, Qian; Li, Tao; Li, Caiyu; Wang, Aihua; Li, Yu

doi:10.1111/1759-7714.12768

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…These results suggest that if the drug is injected into the pleural cavity, the proportion of drug in blood will be low. In our study, the incidence of chest pain in the EG was higher than that of the ITG and CG, but chest pain was the main adverse reaction, and its incidence was consistent with that in our previous study (35.7%) 21 . There was no significant difference in the incidence of gastrointestinal reactions in patients in the EG, ITG, or CG.…”

Section: Discussionsupporting

confidence: 91%

“…We previously used platinum and erythromycin to treat NSCLC patients with MPE. The short‐term ORR of MPE was 81.8%, which was consistent with the PE‐ORR of EG 21 . Animal experiments have shown that animals have pleural fibrosis after intrapleural injection of erythromycin, and clinical experiments have also shown that erythromycin is effective as a sclerosing agent for pleural adhesions 8,9 .…”

Section: Discussionsupporting

confidence: 73%

“…Previous studies have shown that intravenous injection of cisplatin (100 mg/m 2 ) can lead to a peak blood concentration of about 6 μg/ml, 30 while Sakaguchi et al perfused cisplatin (80 mg/m 2 ) within the pleural cavity using hyperthermic‐chemotherapy principles, and the maximum concentration of platinum in blood was 0.66 ± 0.31 μg/ml 31 . In our previous studies, after intravenous injection of lobaplatin (50 mg), the platinum concentration (in μg/ml) in the pleural cavity and plasma was 13.763 ± 1.523 and 1.120 ± 0.164, respectively 21 . These results suggest that if the drug is injected into the pleural cavity, the proportion of drug in blood will be low.…”

Section: Discussionmentioning

confidence: 86%

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Intrapleural treatment in patients with non‐small cell lung cancer with malignant pleural effusions in the real world

Pan

Zhao

et al. 2021

Thoracic Cancer

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Background The aim of the study was to assess the efficacy and side‐effects of intrapleural treatment in non‐small cell lung cancer (NSCLC) patients with malignant pleural effusions (MPEs). Methods The medical records of NSCLC patients with MPEs diagnosed in four Chinese hospitals from October 2014 to December 2019 were searched. The Kaplan–Meier method is used to calculate median overall survival (MOS) and subgroup analyses are done. Results A total of 285 patients were evaluated; 81.1% of patients received intrapleural treatment, and no patients received talc pleurodesis. MOS of the whole cohort was 21 months. Patients were divided into three groups: erythromycin group (EG; intrapleural treatment with drugs and erythromycin); intrathoracic treatment group (ITG; intrapleural treatment with drugs); control group (CG; no drug treatment in the pleural cavity). The MOS of patients in the EG, ITG and CG was 20, 22, and 19 months, respectively. Among patients who received only chemotherapy as systemic therapy, the MOS of intrathoracic administration group (IAG; i.e., EG and ITG) was longer than that of CG (12 vs. 6 months; p = 0.034), and the MOS of patients with a ratio of carcinoembryonic antigen in pleural effusion (PE‐CEA): CEA in blood (B‐CEA) ≤1 is worse than that of patients with a ratio >1 (4 vs. 12 months, p = 0.021) and that of CG (4 vs. 6 months, p = 0.442). Conclusions Intrapleural treatment can prolong the survival of NSCLC patients with MPE who do not receive targeted treatment or who only receive chemotherapy. The PE‐CEA: B‐CEA ratio can be used to predict the efficacy if intrapleural treatment is indicated.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 86%

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Intrapleural treatment in patients with non‐small cell lung cancer with malignant pleural effusions in the real world

Pan

Zhao

et al. 2021

Thoracic Cancer

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“… 25 However, the efficiency of lobaplatin for the treatment of TNBC is largely unknown, although other studies have shown that it is beneficial for the treatment of non-small-cell lung cancer, colorectal cancer, nasopharyngeal carcinoma, and metastatic breast cancer. 16 , 27 – 29 Therefore, the present findings make an important contribution to what is known about the therapeutic effects of lobaplatin.…”

Section: Discussionmentioning

confidence: 53%

Lobaplatin-based neoadjuvant chemotherapy for triple-negative breast cancer: a 5-year follow-up of a randomized, open-label, phase II trial

Yan

Wang

et al. 2022

Ther Adv Med Oncol

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Purpose: We report the 5-year follow-up findings of a randomized, open-label, phase II trial of lobaplatin-based neoadjuvant chemotherapy plus adjuvant therapy for triple-negative breast cancer (TNBC). Patients and methods: This study included patients aged ⩾18 years with untreated, operable stage I–III TNBC and an Eastern Cooperative Oncology Group performance status of 0 or 1. One group of patients (TE group, n = 99) received four cycles of docetaxel (T, 75 mg/m²) plus epirubicin (E, 80 mg/m²) every 3 weeks, and another group (TEL group, n = 101) received the same treatment with the addition of lobaplatin (L, 30 mg/m2). Two cycles of the corresponding treatments were administered after surgery in both groups. The primary endpoints were total pathological complete response (tpCR) rate and overall response rate (ORR), and the secondary endpoints were disease-free survival, overall survival, and long-term safety. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-14005019). Results: The median follow-up was 48.2 months (interquartile range: 31.1–60.0). The tpCR rate was 41.4% and 17.8% in the TEL group and TE group, respectively ( p < 0.001). The HR for comparison of DFS between the TEL group and TE group was 0.44 (95% CI: 0.21–0.90, P p = 0.028). The addition of lobaplatin resulted in an HR of 0.44 (95% CI: 0.18–1.02, P = 0.061) for the difference in OS between the two groups. The ORR, which included complete response and partial response, was 92.9% in the TEL group and 74.3% in the TE group ( p = 0.001). The TEL group patients were more likely to develop grade III–IV anemia and thrombocytopenia. No lobaplatin-related deaths or increased risk of long-term toxicity was observed. Conclusion: Neoadjuvant lobaplatin therapy can improve the tpCR and ORR rates of TNBC with tolerable side effects and have a tendency to improve the long-term survival.

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“…Han et al reported that low-dose interleukin-2 improved response rate and disease control rate in patients (89). Moreover, combination therapy with lobaplatin and erythromycin has been shown to be a safe and efficient treatment for patients with NSCLC-mediated MPE (90). A previous study demonstrated the low intensity of effusion immune cell PD-L1 expression in these neoplasms, which is associated with poor survival in patients with lung cancer (91).…”

Section: Discussionmentioning

confidence: 99%

Multiplexed molecular profiling of lung cancer with malignant pleural effusion using next generation sequencing in Chinese patients

Ruan

Sun²,

Wang³

et al. 2020

Oncol Lett

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Lung cancer is the most common type of cancer and the leading cause of cancer-associated death worldwide. Malignant pleural effusion (MPE), which is observed in ~50% of advanced non-small cell lung cancer (NSCLC) cases, and most frequently in lung adenocarcinoma, is a common complication of stage III-IV NSCLC, and it can be used to predict a poor prognosis. In the present study, multiple oncogene mutations were detected, including 17 genes closely associated with initiation of advanced lung cancer, in 108 MPE samples using next generation sequencing (NGS). The NGS data of the present study had broader coverage, deeper sequencing depth and higher capture efficiency compared with NGS findings of previous studies on MPE. In the present study, using NGS, it was demonstrated that 93 patients (86%) harbored EGFR mutations and 62 patients possessed mutations in EGFR exons 18-21, which are targets of available treatment agents. EGFR L858R and exon 19 indel mutations were the most frequently observed alterations, with frequencies of 31 and 25%, respectively. In 1 patient, an EGFR amplification was identified and 6 patients possessed a T790M mutation. ALK + EML4 gene fusions were identified in 6 patients, a ROS1 + CD74 gene fusion was detected in 1 patient and 10 patients possessed a BIM (also known as BCL2L11) 2,903-bp intron deletion. In 4 patients, significant KRAS mutations (G12D, G12S, G13C and A146T) were observed, which are associated with resistance to afatinib, icotinib, erlotinib and gefitinib. There were 83 patients with ERBB2 mutations, but only two of these mutations were targets of available treatments. The results of the present study indicate that MPE is a reliable specimen for NGS based detection of somatic mutations.

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

Cited by 5 publications

References 26 publications

Intrapleural treatment in patients with non‐small cell lung cancer with malignant pleural effusions in the real world

Intrapleural treatment in patients with non‐small cell lung cancer with malignant pleural effusions in the real world

Lobaplatin-based neoadjuvant chemotherapy for triple-negative breast cancer: a 5-year follow-up of a randomized, open-label, phase II trial

Multiplexed molecular profiling of lung cancer with malignant pleural effusion using next generation sequencing in Chinese patients

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