Management of malignant pleural effusions

Antony, Veena B.; Loddenkemper, R.; Astoul, P.; Boutin, C; Goldstraw, Peter; Hott, J.; Panadero, Francisco Rodríguez; Sahn, Steven A.

doi:10.1183/09031936.01.00225601

Cited by 381 publications

(328 citation statements)

References 181 publications

(182 reference statements)

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“…1 Exudative malignant pleural effusions are characterised by the accumulation of fluid enriched in proteins and by the recruitment of elevated numbers of mononuclear cells into the pleural space. 2 4 or by inducing cell apoptosis via FAS/FAS ligand pathway.…”

Section: Introductionmentioning

confidence: 99%

Altered CD94/NKG2A and perforin expression reduce the cytotoxic activity in malignant pleural effusions

Pace

Sano

Ferraro

et al. 2011

European Journal of Cancer

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This study was aimed at assessing whether cytotoxic lymphocytes (CD8+) and NK cells from malignant pleural effusions have a deregulated expression of CD94/NKG2A.The expression of membrane CD94/NKG2A and perforin was evaluated by flow-cytometry in CD8+ and NK cells from pleural effusions and autologous peripheral blood of cancer (n = 19) and congestive heart failure (CHF) (n = 11) patients. Intracellular CD94/NKG2A expression was evaluated by flow-cytometry in pleural effusion CD8+ and NK cells from cancer patients (n = 10). Cytotoxic activity against cancer cells exerted by pleural and autologous peripheral blood T lymphocytes from cancer patients was assessed by flow-cytometry assay.Pleural CD8+ from cancer patients showed a reduced expression of membrane CD94/ NKG2A and perforin when compared to autologous peripheral blood and CHF pleural effusions. Reduced numbers of NK cells were present in pleural effusions from both cancer and CHF patients. Pleural NK from cancer patients showed a reduced expression of membrane CD94/NKG2A and perforin when compared to autologous peripheral blood. Pleural T lymphocytes from cancer patients exhibited a reduced cytotoxic activity against cancer cells when compared to autologous peripheral blood T lymphocytes. The intracellular expression of CD94/NKG2A in CD8+ and NK cells from cancer patients was higher than membrane expression.In conclusion, this study provides compelling evidences of new mechanisms underlying the reduced host defence against cancer within the pleural space.

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Section: Introductionmentioning

confidence: 99%

Altered CD94/NKG2A and perforin expression reduce the cytotoxic activity in malignant pleural effusions

Pace

Sano

Ferraro

et al. 2011

European Journal of Cancer

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“…One of the standard therapeutic strategies to prevent recurrent MPE is chemical pleurodesis using talcum. However, despite therapeutic intervention, recurrence rate is high and prognosis remains poor [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Lysis of cancer cells by autologous T cells in breast cancer pleural effusates treated with anti-EpCAM BiTE antibody MT110

Witthauer

Schlereth

Brischwein

et al. 2008

Breast Cancer Res Treat

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In the present study, the efficacy of a new drug, i.e. the bispecific single-chain antibody MT110 targeting the epithelial antigen EpCAM and the T-cell antigen CD3 was tested ex vivo in malignant pleural effusions (MPEs). EpCAM ? epithelial cells were found in 78% of the MPEs (n = 18). Ex vivo treatment of seven MPEs resulted in a dose-dependent specific lysis of 37 ± 27% (±SD) EpCAM ? cells with 10 ng/ml (P = 0.03) and 57 ± 29.5% EpCAM ? cells with 1,000 ng/ml MT110 (P = 0.016) after 72 h. As a prerequisite for redirected lysis, stimulation of he autologous CD4 ? and CD8 ? cells in MPE by 1,000 ng/ml MT110 resulted in 21 ± 17% CD4 ? /CD25 ? and 29.4 ± 22% CD8 ? /CD25 ? cells (P = 0.016, respectively) after 72 h. This was confirmed by a 22-fold release of TNF-a and 230-fold release of IFN-c (1,000 ng/ml, 48 h, P = 0.03, respectively). Thus, relapsed breast cancer patients resistant to standard treatment might benefit from targeted therapy using MT110.Keywords Malignant pleural effusion Á Breast cancer Á Bispecific antibody Á EpCAM Á CD3 Á MT110 Á Ex vivo therapy

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“…(4) A definição de derrame pleural maciço implica na presença de derrame pleural ocupando a totalidade do hemitórax, enquanto derrame pleural volumoso pode ser definido como líquido pleural ocupando mais de 50% do hemitórax. (3,7) Em uma série de 46 pacientes com derrames pleurais maciços, 67% eram de etiologia neoplásica. Entretanto, cerca de 15% dos pacientes apresentaram-se com derrames mínimos (< 500 ml) e relativamente assintomáticos.…”

Section: Diagnóstico Imagenológicounclassified

“…(7) A ausência de desvio de mediastino (principalmente em derrames volumosos) implica na presença de um mediastino fixo por obstrução brônquica (atelectasia) ou pelo envol-vimento pleural extenso, encarcerando o pulmão, como observado nos mesoteliomas. (3,7) A tomografia computadorizada de tórax em portadores de neoplasia pode demonstrar precocemente a presença de derrames míninos, não observados na radiografia convencional, sendo auxiliar na avaliação de linfonodomegalias e do parênquima pulmonar, bem como na identificação de metástases pleurais, pulmonares ou à distância. (3,9) Também tem sido utilizada para diferenciar derrame pleural maligno de benigno e guiar procedimentos diagnósticos como biópsias pleurais.…”

Section: Diagnóstico Imagenológicounclassified

“…Em 5% a 10% dos casos de derrame neoplásico o sítio primário não é identificado. (2)(3)(4) O mecanismo do comprometimento pleural metastático mais freqüente é a disseminação vascular das células tumorais de órgãos distantes para o pulmão e para a pleura visceral, com implantes secundários na pleura parietal. A pleura visceral costuma estar envolvida em 87% dos casos de metástases, enquanto que isto ocorre com a pleura parietal em apenas 47% dos casos avaliados por necropsia.…”

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Derrame pleural neoplásico

2006

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O derrame pleural neoplásico é uma complicação freqüente nos pacientes portadores de tumores avançados. A presença de células malignas no líquido pleural ou na biópsia da pleura é indicativa de disseminação da doença primária, com conseqüente redução da expectativa de vida. O diagnóstico e tratamento precoce do derrame pleural maligno são fundamentais para promover uma melhor qualidade de vida aos pacientes portadores de câncer avançado.

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Management of malignant pleural effusions

Cited by 381 publications

References 181 publications

Altered CD94/NKG2A and perforin expression reduce the cytotoxic activity in malignant pleural effusions

Altered CD94/NKG2A and perforin expression reduce the cytotoxic activity in malignant pleural effusions

Lysis of cancer cells by autologous T cells in breast cancer pleural effusates treated with anti-EpCAM BiTE antibody MT110

Derrame pleural neoplásico

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