Clinical Research of Intrapleural Combination Therapy with Bevacizumab and Cisplatin for Non-small Cell Lung Cancer Mediated Malignant Pleural Effusion
- VernacularTitle:贝伐单抗联合顺铂治疗非小细胞肺癌恶性胸腔积液的临床研究
- Author:
Bo QU
;
Wei JIANG
;
Zhiming ZHOU
- Publication Type:Journal Article
- Keywords:
non-small-cell lung cancer;
malignant pleural effusion;
VEGF;
bevacizumab
- From:
Journal of China Medical University
2015;(7):648-652
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of combined intrapleural therapy with bevacizumab and cisplatin in controlling malignant pleural effusion(MPE)caused by non?small cell lung cancer(NSCLC). Methods A total of 63 NSCLC study subjects with MPE were randomly assigned to one of two groups(A and B). Group A(bevacizumab,n=32)received intrapleural bevacizumab(5 mg/kg)with cisplatin(40 mg/m2) therapy once a week for a total of three cycles. Group B(cisplatin,n=31)received intrapleural cisplatin therapy alone with the same dose and cycle. Pleural fluid was collected from both groups prior to and after treatment. The levels of VEGF in the pleural fluid were determined by ELISA. The cura?tive effect and adverse reaction were observed and follow?up was conducted. Results In 63 evaluable study subjects,the curative efficacy in the be?vacizumab group was significantly higher than that found in the cisplatin group(84.3%vs 61.3%,respectively,P<0.05). But the overall survival (OS)of the two groups showed no statistically significant difference(13.0 months vs 12.0 months,P>0.05). After treatment,The VEGF levels in the MPE were significantly decreased in both groups. In the bevacizumab group,the levels of VEGF in the pleural fluid were significantly lower com?pared to those of the cisplatin group after treatment,showing greater efficacy(P<0.05). The VEGF levels of the two groups whose treatment was in?valid had no statistically significant difference(P=0.079). There was no significant difference in gradeⅢ/Ⅳadverse events between the two groups. All procedures were well tolerated by the patients. Conclusion Combined intrapleural therapy with bevacizumab and cisplatin was effective and safe in managing NSCLC?mediated MPE. The patients showed high tolerance to the therapy. For prediction of local treatment efficacy of bevaci?zumab using the VEGF expression levels in MPE,further research was needed.