Chemotherapeutic management of malignant pleural effusion.
The management of malignant pleural effusions are a common, and sometimes difficult, therapeutic problem. This article reviews the currently available sclerosing agents and discusses novel agents that show promise for the future. Talc, tetracycline and bleomycin are currently the most widely used agents but none is an ideal sclerosant and certain adverse effects are of concern. Novel agents, particularly transforming growth factor (TGF)-beta(2) and metalloproteinase inhibitors, are being investigated, and the increase in knowledge into the mechanisms of pleural fluid formation and pleurodesis will hopefully lead to the development of targeted therapy in the future.
Weatherhead
Mark
M
The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.
Antunes
George
G
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D061965:Matrix Metalloproteinase Inhibitors; D016066:Pleural Effusion, Malignant / Q000188:drug therapy*; D018700:Pleurodesis / Q000379:methods; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use; D053781:Transforming Growth Factor beta2
D000276:Adjuvants, Immunologic; D000305:Adrenal Cortex Hormones; D005343:Fibrinolytic Agents; D061965:Matrix Metalloproteinase Inhibitors; D012597:Sclerosing Solutions; C509041:TGFB2 protein, human; D016212:Transforming Growth Factor beta; D053781:Transforming Growth Factor beta2