Back to Search
Start Over
A randomized clinical study to compare intrapleural infusion with intravenous infusion of bevacizumab in the management of malignant pleural effusion in patients with non‐small‐cell lung cancer
- Source :
- Thoracic Cancer, Vol 11, Iss 1, Pp 8-14 (2020), Thoracic Cancer
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background To compare the efficiency and toxicity of bevacizumab by intrapleural or intravenous infusion in the management of malignant pleural effusion in patients with non-small-cell lung cancer (NSCLC). Methods Sensitizing mutation negative NSCLC patients with malignant pleural effusion were randomized into two groups in 1:1 ratio. The pleural effusion was completely drained in 24 hours; one group received intrapleural infusion and the second group received intravenous infusion of bevacizumab at a dose of 7.5 mg per kg bodyweight. The serum vascular endothelial growth factor (VEGF) was tested before and 72 hours after injection of bevacizumab. Computerized tomography (CT) scan to evaluate pleural effusions was carried out at four weeks for each patient and their survival followed-up. Results A total of 67 patients were screened and 43 enrolled into the study. The response rate was 80% (16 of 20) in the intrapleural group and 66.7% (14 of 21) in the intravenous group. The median duration of response (DoR) of pleural effusion was 4.50 months and 3.70 months, respectively. The median serum VEGF level at 72 hours decreased 67.25% in the intrapleural group and 57.19% in the intravenous group compared to baseline level (P = 0.276). The median serum VEGF level at 72 hours decreased 52.02% compared to baseline level in patients' DoR less than three months and 68.33% in patients' DoR longer than three months, respectively (P = 0.014). The main side effects noted were mild to moderate hypertension, proteinuria and epistaxis. Conclusions Bevacizumab intrapleural infusion had higher efficiency and higher safety than intravenous infusion in the management of malignant pleural effusion caused by NSCLC. The decreased level of serum VEGF at 72 hours after bevacizumab treatment was closely related to the response rate and duration of the response of pleural effusion.
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Lung Neoplasms
Bevacizumab
Pleural effusion
Equivalence Trials as Topic
Gastroenterology
lcsh:RC254-282
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Antineoplastic Agents, Immunological
Internal medicine
Carcinoma, Non-Small-Cell Lung
medicine
Malignant pleural effusion
Humans
In patient
Infusions, Parenteral
malignant pleural effusion
Lung cancer
Infusions, Intravenous
non‐small‐cell lung cancer
Proteinuria
vascular endothelial growth factor
business.industry
General Medicine
Original Articles
Middle Aged
medicine.disease
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Pleural Effusion, Malignant
Vascular endothelial growth factor
030104 developmental biology
Oncology
chemistry
030220 oncology & carcinogenesis
Toxicity
Female
Original Article
medicine.symptom
business
medicine.drug
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 17597706 and 17597714
- Volume :
- 11
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Thoracic Cancer
- Accession number :
- edsair.doi.dedup.....f81f91ecd87d7bb2d0ed19156a451cd3