2022 World Conference on Lung Cancer (ePosters)-EP08.02-121. The Landscape of Anti-neoplastic Drugs for Malignant Pleural Effusion in Non-small Cell Lung Cancer: A Systematic Review of Clinical Trials

EP08.02-121. The Landscape of Anti-neoplastic Drugs for Malignant Pleural Effusion in Non-small Cell Lung Cancer: A Systematic Review of Clinical Trials

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Malignant pleural effusion (MPE) is the presence of abnormal pleural fluid and cancer cells, often occurring in patients with advanced non-small cell lung cancer (NSCLC) and associated with poor survival and quality of life. Current management involves draining the effusion and providing palliative care. This systematic review and meta-analysis aimed to evaluate the feasibility of using anti-neoplastic drugs for managing MPE in NSCLC.<br /><br />The analysis included 17 relevant clinical trials with a total of 1278 patients. The study found that both chemotherapy monotherapy and bevacizumab (BEV)-based regimens were effective in treating MPE. Additionally, intrapleural infusion (IP) was found to be superior to intravenous infusion (IV) in both chemotherapy monotherapy and BEV-based regimens.<br /><br />The objective response rate (ORR) in studies using the World Health Organization (WHO) criteria was 59%, and the median overall survival (mOS) ranged from 7 to 27 months across different trials. Adverse events (AEs) were reported in 14.1% of the trials, with nausea, vomiting, leukopenia, and neutropenia being the most common side effects.<br /><br />The studies included in the review were found to be heterogenous, likely due to differences in treatment modalities, sample sizes, and reporting inconsistencies. Adenocarcinoma was found to be more common in the included studies compared to historical cohorts.<br /><br />Based on the clinical response and potential survival benefits observed in the studies, the authors suggest considering survival-prolonging management instead of palliative care in fit MPE patients with NSCLC. They also recommend future trials to investigate new treatment classes, particularly in combination with other drugs.<br /><br />Overall, this study provides insights into the landscape of anti-neoplastic drugs for MPE in NSCLC, highlighting the efficacy of chemotherapy and BEV-based regimens and the importance of using both RECIST and WHO criteria in reporting MPE responses.

Asset Subtitle

Obada Ehab Ababneh

Meta Tag

Speaker Obada Ehab Ababneh

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

Malignant pleural effusion

abnormal pleural fluid

cancer cells

NSCLC

palliative care

chemotherapy monotherapy

bevacizumab-based regimens

intrapleural infusion

objective response rate

overall survival