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Bevacizumab plus chemotherapy for advanced non-squamous non-small-cell lung cancer with malignant pleural effusion.

AbstractPURPOSE:
The presence of malignant pleural effusion (MPE) indicates a poorer prognosis for patients with non-small-cell lung cancer (NSCLC) and impairs their quality of life. Because vascular endothelial growth factor (VEGF) is the key mediator MPE production, we evaluated the efficacy and safety of chemotherapy plus bevacizumab, an anti-VEGF antibody, in non-squamous NSCLC patients with MPE, especially regarding the control of pleural effusions.
METHODS:
From November 1, 2009 to September 30, 2011, medical charts of 13 consecutive patients with MPE who received bevacizumab plus chemotherapy as the initial or secondary treatment were retrospectively analyzed.
RESULTS:
Of the 13 patients, 6 did not undergo pleurodesis, 3 were unsuccessfully treated by pleurodesis, 2 had encapsulated pleural effusion, and 2 had no re-expansion of the lung. Twelve patients (92.3 %) achieved MPE control lasting >8 weeks following bevacizumab plus chemotherapy. Five of 10 patients with measurable lesions had confirmed partial responses. Of 3 patients without measurable lesions, one had confirmed CR. Median progression-free survival time without re-accumulation of MPE was 312 days. Grade 3 or 4 neutropenia, thrombocytopenia, hypertension, or proteinuria was observed in 2, 2, 1, or 1 patient, respectively.
CONCLUSIONS:
This is the first study to report that bevacizumab plus chemotherapy is highly effective for the management of MPE in non-squamous NSCLC patients. Prospective clinical trials are warranted to investigate the efficacy of bevacizumab for MPE.
AuthorsKazuhiro Kitamura, Kaoru Kubota, Masahiro Ando, Satoshi Takahashi, Nobuhiko Nishijima, Teppei Sugano, Masaru Toyokawa, Koji Miwa, Seiji Kosaihira, Rintaro Noro, Yuji Minegishi, Masahiro Seike, Akinobu Yoshimura, Akihiko Gemma
JournalCancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 71 Issue 2 Pg. 457-61 (Feb 2013) ISSN: 1432-0843 [Electronic] Germany
PMID23178954 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
Topics
  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized (administration & dosage)
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Bevacizumab
  • Carcinoma, Non-Small-Cell Lung (drug therapy, mortality)
  • Female
  • Humans
  • Lung Neoplasms (drug therapy, mortality)
  • Male
  • Middle Aged
  • Pleural Effusion, Malignant (drug therapy, mortality)
  • Retrospective Studies

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