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
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 rand...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13238 |
| _version_ | 1828154781748690944 |
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| author | Keke Nie Zhen Zhang Yunhong You Xingjun Zhuang Chunling Zhang Youxin Ji |
| author_facet | Keke Nie Zhen Zhang Yunhong You Xingjun Zhuang Chunling Zhang Youxin Ji |
| author_sort | Keke Nie |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T22:44:48Z |
| format | Article |
| id | doaj.art-ed663cb83c404ad98d36a256eeb53ead |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-11T22:44:48Z |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-ed663cb83c404ad98d36a256eeb53ead2022-12-22T03:58:48ZengWileyThoracic Cancer1759-77061759-77142020-01-0111181410.1111/1759-7714.13238A 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 cancerKeke Nie0Zhen Zhang1Yunhong You2Xingjun Zhuang3Chunling Zhang4Youxin Ji5Department of Oncology Qingdao Cancer Hospital Qingdao ChinaDepartment of Oncology Qingdao Cancer Hospital Qingdao ChinaDepartment of Oncology Qingdao Cancer Hospital Qingdao ChinaDepartment of Oncology PLA 971 Hospital Qingdao ChinaDepartment of Oncology Qingdao Central Hospital, the Affiliated Qingdao Central Hospital of Qingdao University Qingdao ChinaDepartment of Oncology Qingdao Central Hospital, the Affiliated Qingdao Central Hospital of Qingdao University Qingdao ChinaBackground 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.https://doi.org/10.1111/1759-7714.13238Bevacizumabmalignant pleural effusionnon‐small‐cell lung cancervascular endothelial growth factor |
| spellingShingle | Keke Nie Zhen Zhang Yunhong You Xingjun Zhuang Chunling Zhang Youxin Ji 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 Thoracic Cancer Bevacizumab malignant pleural effusion non‐small‐cell lung cancer vascular endothelial growth factor |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Bevacizumab malignant pleural effusion non‐small‐cell lung cancer vascular endothelial growth factor |
| url | https://doi.org/10.1111/1759-7714.13238 |
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