The current study is conducted to investigate efficacy of the
chemotherapy drug
paclitaxel in combination with
Avastin (Roche Diagnostics GmbH., Mannheim, Germany) (
antiangiogenic agent) in treatment of
malignant pleural effusions (MPEs).Twenty-four patients with
non-small cell lung cancer were randomly assigned for 2 treatment approaches. Ten patients received
paclitaxel (175 mg/m) alone, and 14 patients took a combination
therapy of
paclitaxel and
Avastin (5 mg/kg). Efficacy of the treatment approaches in the patients was validated with the change in the MPE volume. Pharmacokinetic (PK) profile and urinary excretion rate of
paclitaxel were analyzed with serum
vascular endothelial growth factor (
VEGF) level, and adverse events were examined as well.The combination
therapy reduced the MPE level with a successful rate of 29% and a survival rate of 25% over the single
paclitaxel treatment in the study cohort (both P < 0.05). PKs for the combined treatment displayed a rapid distribution of the anticancer drug
paclitaxel with an obvious increase in its elimination half-life in the pleural fluid (both P < 0.01). Mean residence time of
paclitaxel increased in the presence of
Avastin (P < 0.01). Serum
VEGF levels significantly reduced in the
Avastin-treated patients as compared to the
paclitaxel-treated ones (P < 0.01). The urinary excretion rate was similar in the study cohort. Incidence of adverse events for the 2 treatment approaches was similar in the patients.Intervention of
Avastin enhances potency of
paclitaxel in treatment of MPEs with the increased survival rate of the patients through inhibiting
VEGF production and prolonging time of ongoing interaction between the
chemotherapy drug and the
tumor tissues.