title: EGFR mutations predict a favorable outcome for malignant pleural effusion             of lung adenocarcinoma with Tarceva therapy.
abstract: The aim of the present study was to evaluate the therapeutic effects and             adverse reactions of Tarceva treatment for malignant pleural effusion (MPE) caused             by metastatic lung adenocarcinomas. One hundred and twenty-eight patients who             failed first-line chemotherapy drug treatment were divided into a mutation and             a non-mutation group according to the presence or absence of epidermal growth             factor receptor (EGFR) mutations. Each patient received closed drainage combined             with simple negative pressure suction after thoracoscopic talc poudrage pleurodesis             and oral Tarceva treatment. Short-term and long-term clinical therapeutic effects             of Tarceva were evaluated. The EGFR mutation rate in pleural metastatic tissues             of lung adenocarcinoma acquired through video-assisted thoracoscopic surgery was             higher compared to that in surgical resection specimens, plasma specimens and             pleural effusion specimens compared to previously reported results. There were             significant statistical differences in the average extubation time (p<0.01),             drainage volume of pleural effusion (p<0.05), Karnofsky score and formation             of encapsulated pleural effusion 4 weeks after surgery (p<0.05) between these             two groups. The number of patients with mild pleural hypertrophy in the mutation             group was significantly higher compared to the non-mutation group (p<0.01),             while the number of patients with severe pleural hypertrophy was significantly             reduced (p<0.05). There was significant statistical discrepancy between these             two groups in terms of improvement of peripheral blood carcinoembryonic antigen             and tissue polypeptide antigen after 4 weeks of therapy. The complete remission             rate and the efficacy rate were higher in the mutation group compared to that             in the non-mutation group (p<0.05). There was a longer overall survival time             after Tarceva treatment in patients with EGFR mutations than those without EGFR             mutation. EGFR mutations predict a favorable outcome for malignant pleural effusion             of lung adenocarcinoma with Tarceva therapy. Detection of EGFR mutations may determine             the responsiveness of malignant pleural effusion to Tarceva treatment.
authors: Department of Respiratory Medicine, Shandong Provincial Hospital, Shandong University, Jinan 250021, PR China.
authors: Haisheng
authors: H
authors: Guo
authors: Yunyan
authors: Y
authors: Wan
authors: Guangyan
authors: G
authors: Tian
authors: Qinghua
authors: Q
authors: Liu
authors: Yanmeng
authors: Y
authors: Kang
authors: Yuye
authors: Y
authors: Li
authors: Zhouhong
authors: Z
authors: Yao
authors: Dianjie
authors: D
authors: Lin
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D004322:Drainage; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D000069347:Erlotinib Hydrochloride; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010994:Pleura / Q000187:drug effects / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D019396:Tissue Polypeptide Antigen / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D002272:Carcinoembryonic Antigen; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D019396:Tissue Polypeptide Antigen; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors