Intrapleurally instilled mitoxantrone in metastatic pleural effusions: a phase II study.
Thirty cases (breast cancer-20 cases, malignant lymphoma-4 cases, different malignancies-6 cases) of histologically/cytologically verified malignant pleural effusion (MPE) in 29 patients were treated with intrapleurally instilled mitoxantrone (30 mg). The therapy was well tolerated. At evaluation, 25 patients had died of progressive disease. The median survival was 3 months (range 0.3-21.3 months). There were 26 responders (12 complete responses (CR), 14 partial responses (PR)), whereas 4 patients relapsed and 3 of these had an early relapse (within 3 months). Patients achieving PR or CR had a low risk (15%) of treatment failure. Five patients were subjected to a pharmacokinetic evaluation. This demonstrated rapidly declining plasma and pleural exudate levels of mitoxantrone within the first 6 hours. At 24 hours after instillation, mitoxantrone was only detected in circulating mononuclear cells. This study shows that mitoxantrone is efficacious in the treatment of MPE, and may represent a cost-effective alternative.
Aasebø
U
U
Department of Pulmonary Medicine, University Hospital of Tromsø, Norway.
Norum
J
J
Sager
G
G
Slørdal
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000191:economics; D003362:Cost-Benefit Analysis; D004322:Drainage; D005122:Exudates and Transudates / Q000166:cytology / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007322:Instillation, Drug; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000378:metabolism / Q000532:radiotherapy; D010997:Pleural Neoplasms / Q000378:metabolism / Q000401:mortality / Q000556:secondary*; D012189:Retrospective Studies; D015996:Survival Rate
D000970:Antineoplastic Agents; D008942:Mitoxantrone