Phase2 study of bevacizumab with carboplatin–paclitaxel for non-small cell lung cancer with malignant pleural effusion

Tamiya, Motohiro; Tamiya, Akihiro; Yamadori, Tadahiro; Nakao, Keiko; Asami, Kazuhiro; Yasue, Tomomi; Otsuka, Tomoyuki; Shiroyama, Takayuki; Morishita, Naoko; Suzuki, Hidekazu; Okamoto, Norio; Okishio, Kyoichi; Kawaguchi, Tomoya; Atagi, Shinji; Kawase, Ichiro; Hirashima, Tomonori

doi:10.1007/s12032-013-0676-7

Cited by 37 publications

(55 citation statements)

References 19 publications

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“…However, there are few reports about the influence of systemic treatment on MPE recurrence, specifically in NSCLC (10,11,12,38,39 (38) during a median follow-up period of 1,050 days. Our study did not evaluate any specific treatment such as the abovementioned ones, but the association between the systemic treatment phase in which the patient was and MPE recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Wet M1a non-small cell lung cancer: is it possible to predict recurrence of pleural effusion?

Irlb

et al. 2018

J. Thorac. Dis.

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Background:The propose was to recognize risk factors of malignant pleural effusion (MPE) recurrence in patients with symptomatic M1a non-small cell lung cancer (NSCLC). Methods: All patients with NSCLC and MPE submitted to pleural palliative procedures were enrolled in a prospective study. Group I contained patients who had pleural recurrence, and Group II with no pleural recurrence. Prognostic factors for pleural recurrence were identified by univariable analysis, using Fisher's exact test for categorical variables and Student's t test for quantitative variables. Afterwards the significant variables were entered into a multivariable logistic regression analysis (with P<0.05 considered significant).Receiver operating characteristics (ROC) analysis determined the cutoff points for continuous variables. Results: A total of 82 patients were included in the analysis. There were 15 patients (18.3%) in Group I and 67 patients (81.7%) in Group II. Univariable analysis regarding factors affecting postoperative recurrence was: adenosine deaminase concentration in pleural fluid <16 mg/dL (P=0.04), albumin concentration in pleural fluid <2.4 mg/dL (P=0.03), administration of second-line palliative chemotherapy (P=0.018) and type of procedure [therapeutic pleural aspiration (TPA)] (P=0.023). At the multivariable analysis, only the type of procedure (TPA) (P=0.031) was identified as independent predictor of recurrence. Conclusions:The identification of this factor may assist the choice of the optimal palliative technique; at the first episode of MPE in NSCLC patients and definitive procedure as pleurodesis or indwelling pleural catheter are recommended.

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Section: Discussionmentioning

confidence: 99%

“…Few studies have assessed MPE recurrence in NSCLC patients (10)(11)(12) and aimed to evaluate the influence of systemic Original Article Wet M1a non-small cell lung cancer: is it possible to predict recurrence of pleural effusion? treatment on MPE control.…”

Section: Introductionmentioning

confidence: 99%

Wet M1a non-small cell lung cancer: is it possible to predict recurrence of pleural effusion?

Irlb

et al. 2018

J. Thorac. Dis.

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“…Short-term therapeutic efficacy was evaluated as previously described [7, 15, 17] and according to the Response Evaluation Criteria in Solid Tumors version 1.1. Short-term efficacy was classified as either complete response (CR; effusion and symptoms disappeared and the patient was stable for > 8 weeks), partial response (PR; the size of the effusion was reduced by 50%, symptoms improved, and no subsequent growth in the effusion was observed over an 8-week period); stable disease (SD; the effusion size was reduced by < 50% or remained unchanged; and progressive disease (PD; the effusion size increased).…”

Section: Methodsmentioning

confidence: 99%

“…Symptomatic MSCE is typically treated with paracentesis and intracavitary infusion of chemotherapy, biological response modifiers, or simple puncture to drain the effusion. However, the treatment efficacy is unsatisfactory [6, 7]. …”

Section: Introductionmentioning

confidence: 99%

“…Additionally, there is no direct evidence that intracavitary bevacizumab is better than the traditional treatments. Intravenous administration of bevacizumab in combination with systemic chemotherapy was effective for the treatment of MPE in NSCLC patients [7, 14]. Here, we assessed the efficacy and toxicity of intracavitary infusion of bevacizumab compared to several chemotherapeutic agents, biological response modifiers, and simple puncture to drain the effusion.…”

Section: Introductionmentioning

confidence: 99%

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Greater efficacy of intracavitary infusion of bevacizumab compared to traditional local treatments for patients with malignant cavity serous effusion

et al. 2016

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Intracavitary infusion of bevacizumab is one effective treatment for malignant serous cavity effusion (MSCE). In this study, we retrospectively evaluated the efficacy of local treatments in 996 advanced cancer patients with MSCE who received paracentesis and intracavitary bevacizumab, or chemotherapy, biological response modifiers, or simple puncture to drain the effusion. The median progression-free survival (PFS) time in patients treated with bevacizumab was 189 days (range, 13-522 days), which was longer than in patients who received one of the other three treatments (p < 0.05). Subgroup analysis revealed that intracavitary infusion of bevacizumab was advantageous for patients with malignant pleural, pericardial, or peritoneal effusions. The median PFS in patients receiving intracavitary bevacizumab did not significantly differ from that of patients receiving a combination of intracavitary and intravenous bevacizumab. Thus the efficacy did not depend on whether patients received intravenous bevacizumab. Only mild related adverse events were observed in all cases, and they did not differ between groups. Proteinuria (severity grade < 3) was most likely to occur in patients who received a combination of intracavitary and intravenous bevacizumab, but no obvious symptoms were observed. Thus, intracavitary infusion of bevacizumab was effective for controlling MSCE without apparent toxicity.

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Clinical predictors of bevacizumab-associated intestinal perforation in non-small cell lung cancer

Tamiya

Suzuki²,

Shiroyama³

et al. 2018

Invest New Drugs

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Background Bevacizumab (Bev) is generally well-tolerated, and Bev-associated intestinal perforation (BAP) is a rare albeit serious side effect in cases of non-small cell lung cancer (NSCLC). Therefore, the present study aimed to identify clinical predictors of BAP to help predict and manage the development of life-threatening intestinal complications among patients receiving Bev. Methods This retrospective study evaluated demographic, clinical, and treatment factors for patients with NSCLC who were treated with Bev between February 2010 and August 2015 at our center. Results We identified 314 regimens (208 patients; median age: 65 years; 115 women) for analysis, which included 119 first-line regimens, 74 s-line regimens, and 121 third-line or later regimens. BAP occurred in 7 cases (2.23% among all regimens and 3.37% among all patients), which generally occurred during first- or second-line treatment and was caused by ulcerative colitis (1 case), colon diverticulitis (1 case), and idiopathic perforations (5 cases). Univariate analyses revealed that BAP was significantly associated with deteriorating PS during the first cycle of chemotherapy (odd ratio [OR]: 11.07, 95% confidence interval [CI]: 2.37-51.63, p = 0.0022), grade ≥ 3 diarrhea (OR: 11.37, 95% CI: 2.37-54.50, p = 0.0024), febrile neutropenia (OR: 9.16, 95% CI: 1.98-42.49, p = 0.0047), and stomatitis (OR: 4.60, 95% CI: 1.01-21.04, p = 0.0492). Conclusions Among patients with NSCLC, BAP was associated with deteriorating PS during the first cycle of chemotherapy, grade ≥ 3 diarrhea, febrile neutropenia, and stomatitis. Therefore, careful observation is needed for patients with NSCLC who receive Bev in any line of treatment, especially if they develop serious side effects that affect their PS or mucous membrane.

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Phase2 study of bevacizumab with carboplatin–paclitaxel for non-small cell lung cancer with malignant pleural effusion

Cited by 37 publications

References 19 publications

Wet M1a non-small cell lung cancer: is it possible to predict recurrence of pleural effusion?

Wet M1a non-small cell lung cancer: is it possible to predict recurrence of pleural effusion?

Greater efficacy of intracavitary infusion of bevacizumab compared to traditional local treatments for patients with malignant cavity serous effusion

Clinical predictors of bevacizumab-associated intestinal perforation in non-small cell lung cancer

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