title: Vandetanib and indwelling pleural catheter for non-small-cell lung cancer with recurrent malignant pleural effusion.
abstract: BACKGROUND
  Non-small-cell lung cancer patients with malignant pleural effusion have a poor overall median survival (4.3 months). VEGF is a key regulator of pleural effusion production. It is unknown if pharmacological inhibition of VEGF signaling modifies the disease course of non-small-cell lung cancer patients with recurrent malignant pleural effusion. We report the final results of a single-arm phase II clinical trial of the VEGF receptor inhibitor, vandetanib, combined with intrapleural catheter placement in patients with non-small-cell lung cancer and recurrent malignant pleural effusion, to determine whether vandetanib reduces time to pleurodesis.
  
  
  METHODS
  Non-small-cell lung cancer patients with proven metastatic disease to the pleural space using pleural fluid cytology or pleural biopsy who required intrapleural catheter placement were eligible for enrollment. On the same day of the intrapleural catheter insertion, the patients were started on a daily oral dose of 300 mg vandetanib, for a maximum of 10 weeks. The primary end point was time to pleurodesis, with response rate as the secondary end point. Exploratory analyses included measurement of pleural fluid cytokines and angiogenic factors before and during therapy.
  
  
  RESULTS
  Twenty eligible patients were included in the trial. Eleven patients completed 10 weeks of treatment. Median time to pleurodesis was 35 days (95% confidence interval, 15-not applicable). Median time to pleurodesis in the historical cohort was 63 days (95% confidence interval, 45-86) when adjusted for Eastern Cooperative Oncology Group performance status ≤ 2.
  
  
  CONCLUSIONS
  Vandetanib therapy was well tolerated; however, it did not significantly reduce time to pleurodesis.
authors.affiliation: Department of Thoracic Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Erminia
authors.initials: E
authors.lastname: Massarelli
authors.affiliation: Institute of Pulmonary Oncology, Sheba Medical Center, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Onn
authors.affiliation: Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Marom
authors.affiliation: Department of Thoracic Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Alden
authors.affiliation: Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.affiliation: Department of Thoracic Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Hai T
authors.initials: HT
authors.lastname: Tran
authors.affiliation: Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mino
authors.affiliation: Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Ignacio I
authors.initials: II
authors.lastname: Wistuba
authors.affiliation: Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Saadia A
authors.initials: SA
authors.lastname: Faiz
authors.affiliation: Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Lara
authors.initials: L
authors.lastname: Bashoura
authors.affiliation: Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: George A
authors.initials: GA
authors.lastname: Eapen
authors.affiliation: Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Rodolfo C
authors.initials: RC
authors.lastname: Morice
authors.affiliation: Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: J
authors.initials: J
authors.lastname: Jack Lee
authors.affiliation: Department of Thoracic Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Waun K
authors.initials: WK
authors.lastname: Hong
authors.affiliation: Section of Medical Oncology, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT.
authors.forename: Roy S
authors.initials: RS
authors.lastname: Herbst
authors.affiliation: Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX. Electronic address: cajimenez@mdanderson.org.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Jimenez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D002408:Catheters, Indwelling; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D018700:Pleurodesis / Q000379:methods; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D012008:Recurrence; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010880:Piperidines; D011799:Quinazolines; D040262:Receptors, Vascular Endothelial Growth Factor; C452423:vandetanib
keywords: Lung cancer; Malignant pleural effusion; NSCLC; Pleural catheter; VEGFR inhibitor