Monoclonal anti‐vascular endothelial growth factor antibody reduces fluid volume in an experimental model of inflammatory pleural effusion

Abstract

This study showed that bevacizumab interferes in the acute phase of pleural inflammation induced by silver nitrate or talc, reinforcing the role of VEGF as a key mediator in the production of pleural effusions. The results also suggest that bevacizumab should probably be avoided in patients requiring pleurodesis.

Blockage of vascular endothelial growth factor (VEGF) reduces experimental pleurodesis

“…Previously we confirmed these findings demonstrating that bevacizumab interferes in the acute phase of inflammation induced by talc or silver nitrate. In summary, the anti-VEGF reduces the production of pleural fluid, pleural vascular permeability and IL-8 pleural fluid levels [8]. Both studies highlight the importance of VEGF in pleural fluid production and suggest that anti-VEGF agents should be avoided in patients requiring pleurodesis.…”

“…The role of the vascular endothelial growth factor in the formation of pleural effusion is widely known, whether by increasing vascular permeability or by formation of new blood vessels. Within this context, the use of VEGF blockers produces a reduction in the volume of fluid [8,9]. However, this finding was not confirmed in patients with malignant pleural effusion due to nonsmall cell lung cancer [16].…”

“…Using groups of 30 animals each, 400 mg/kg of talc (USP Pharmacy; São Paulo, Brazil) or 0.5% silver nitrate (Merck, Germany) was injected (2 mL) into the right pleural cavity. Half of the animals of each group received, according to previous studies, 5 mg/kg of bevacizumab (Avastin®, Roche, Switzerland) intravenously 30 min before the sclerosing agents [8,11].…”

“…In addition to its action in vascular permeability, it has the capacity to activate endothelial cells, stimulating the formation of new blood vessels [4][5][6][7]. Experimental studies have demonstrated that the administration of anti-VEGF produces a significant reduction in the volume of pleural fluid in the first week after the intrapleural injection of talc or nitrate [8] and a reduction in angiogenesis and pleural adhesions 14 days after instillation of the transformation growth factor-beta (TGF-␤) [9] or doxycycline [10].…”

Perfil biomolecular do derrame pleural maligno experimentalmente induzido: frequência de mutações e impacto de terapias-alvo

“…23 Até há algum tempo, havia poucos modelos experimentais para o seu estudo, a maioria utilizando animais com pleura normal. [90][91][92] Entretanto, na ausência de doença pleural maligna, não era possível avaliar a evolução natural do câncer, as interações neoplasia-hospedeiro e possíveis respostas a diferentes estratégias. [23][24][25] Em 2006, Stathopoulos e colaboradores caracterizaram um novo modelo experimental de derrame pleural maligno, através da injeção de 1,5x10 5 células LLC em camundongos imunocompetentes.…”