Vascular Endothelial Growth Factor in Plasma and Pleural Effusion Is a Biomarker for Outcome After Bevacizumab plus Carboplatin-Paclitaxel Treatment for Non-small Cell Lung Cancer with Malignant Pleural Effusion.
OBJECTIVE
Malignant effusion is associated with high serum and plasma levels of vascular endothelial growth factor (VEGF). There are no biomarkers of outcome for bevacizumab treatment in patients with malignant pleural effusion (MPE). We previously reported that carboplatin-paclitaxel plus bevacizumab was effective for patients with advanced non-squamous non-small cell lung cancer (NSCLC) and MPE, although we did not evaluate the relationship between treatment outcomes and plasma or pleural effusion levels of VEGF. Therefore, this study evaluated whether plasma or pleural effusion VEGF might predict bevacizumab treatment outcome.


METHODS
We enrolled 23 patients with NSCLC and MPE between September 2010 and June 2012. Plasma VEGF levels were measured in 19 patients and pleural VEGF levels were measured in 22 patients.


RESULTS
Compared to patients with a low plasma VEGF level, patients with a high level exhibited significantly shorter overall survival (OS: 13.8 vs. 6.5 months, p=0.04), progression-free survival (PFS: 8.7 vs. 4.8 months, p<0.01), and period to re-accumulation of MPE (pPFS: 9.7 vs. 6.2 months, p=0.02). Compared to patients with a low VEGF level in pleural effusion, patients with a high VEGF level exhibited significantly shorter OS (19.6 vs. 6.9 months, p<0.01) and pPFS (9.6 vs. 6.7 months, p=0.04), although there was no significant difference in their PFS (6.6 vs. 5.9 months, p=0.18).


CONCLUSIONS
VEGF levels in the plasma and pleural effusion may predict the outcome of bevacizumab treatment in patients with NSCLC and MPE.
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan moto19781205@yahoo.co.jp.
Motohiro
M
Tamiya
Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Sakai, Japan.
Akihiro
A
Tamiya
Clinical Laboratory, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Tomomi
T
Yasue
Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Sakai, Japan.
Keiko
K
Nakao
Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Sakai, Japan.
Naoki
N
Omachi
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Takayuki
T
Shiroyama
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Eriko
E
Tani
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Masanari
M
Hamaguchi
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Naoko
N
Morishita
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Hidekazu
H
Suzuki
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Norio
N
Okamoto
Clinical Research Center, Kinki-Chuo Chest Medical Center, Sakai, Japan.
Kyoichi
K
Okishio
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Tomoya
T
Kawaguchi
Clinical Research Center, Kinki-Chuo Chest Medical Center, Sakai, Japan.
Shinji
S
Atagi
Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
Tomonori
T
Hirashima
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010996:Pleural Effusion / Q000378:metabolism*; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis* / Q000097:blood
D014408:Biomarkers, Tumor; D042461:Vascular Endothelial Growth Factor A; D016190:Carboplatin; D017239:Paclitaxel
Non-small cell lung cancer; bevacizumab; malignant pleural effusion; prognostic marker; vascular endothelial growth factor