title: Bevacizumab plus chemotherapy for advanced non-squamous non-small-cell lung cancer with malignant pleural effusion.
abstract: OBJECTIVE
  The presence of malignant pleural effusion (MPE) indicates a poorer prognosis for patients with non-small-cell lung cancer (NSCLC) and impairs their quality of life. Because vascular endothelial growth factor (VEGF) is the key mediator MPE production, we evaluated the efficacy and safety of chemotherapy plus bevacizumab, an anti-VEGF antibody, in non-squamous NSCLC patients with MPE, especially regarding the control of pleural effusions.
  
  
  METHODS
  From November 1, 2009 to September 30, 2011, medical charts of 13 consecutive patients with MPE who received bevacizumab plus chemotherapy as the initial or secondary treatment were retrospectively analyzed.
  
  
  RESULTS
  Of the 13 patients, 6 did not undergo pleurodesis, 3 were unsuccessfully treated by pleurodesis, 2 had encapsulated pleural effusion, and 2 had no re-expansion of the lung. Twelve patients (92.3 %) achieved MPE control lasting >8 weeks following bevacizumab plus chemotherapy. Five of 10 patients with measurable lesions had confirmed partial responses. Of 3 patients without measurable lesions, one had confirmed CR. Median progression-free survival time without re-accumulation of MPE was 312 days. Grade 3 or 4 neutropenia, thrombocytopenia, hypertension, or proteinuria was observed in 2, 2, 1, or 1 patient, respectively.
  
  
  CONCLUSIONS
  This is the first study to report that bevacizumab plus chemotherapy is highly effective for the management of MPE in non-squamous NSCLC patients. Prospective clinical trials are warranted to investigate the efficacy of bevacizumab for MPE.
authors.affiliation: Division of Pulmonary Medicine, Infection and Oncology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ando
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nishijima
authors.forename: Teppei
authors.initials: T
authors.lastname: Sugano
authors.forename: Masaru
authors.initials: M
authors.lastname: Toyokawa
authors.forename: Koji
authors.initials: K
authors.lastname: Miwa
authors.forename: Seiji
authors.initials: S
authors.lastname: Kosaihira
authors.forename: Rintaro
authors.initials: R
authors.lastname: Noro
authors.forename: Yuji
authors.initials: Y
authors.lastname: Minegishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Seike
authors.forename: Akinobu
authors.initials: A
authors.lastname: Yoshimura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab