The following is a summary of “Efficacy of bevacizumab through an indwelling pleural catheter in non-small cell lung cancer patients with symptomatic malignant pleural effusion,” published in the February 2024 issue of Pulmonology by Zeng et al.
Numerous studies have demonstrated the efficacy of intrapleural bevacizumab in treating non-small cell lung cancer (NSCLC) patients with malignant pleural effusion (MPE). However, the prognostic implications of administering bevacizumab via an indwelling pleural catheter (IPC) remain unclear. In this study conducted at a tertiary hospital, the researchers identified 149 consecutive advanced NSCLC patients with symptomatic MPE who received either IPC alone or bevacizumab through an IPC. The median age of the patients was 60.3 years, with a predominance of males (48.3%) and nonsmokers (65.8%).
The majority of patients (69.8%) harbored actionable mutations, primarily EGFR-activating mutations. Among them, 81.9% received IPC alone, while 18.1% received bevacizumab via IPC. Interestingly, in the subgroup with actionable mutations, the incidence of spontaneous pleurodesis within 6 months was higher in the bevacizumab-treated group compared to the IPC-treated group (64.3% vs. 46.9%, P = 0.28). Moreover, patients with actionable mutations who received bevacizumab through an IPC demonstrated a significantly prolonged median overall survival (OS) of 42.2 months compared to 26.7 months in those receiving IPC alone (P = 0.045). Conversely, there was no significant difference in OS between the two groups among patients without actionable mutations (10.8 vs. 41.0 months, P = 0.24). Importantly, the incidence of adverse events did not significantly differ between the bevacizumab through the IPC group and the IPC-alone group, both in patients with actionable mutations (14.3% vs. 8.4%; P = 0.42) and those without actionable mutations (16.7% vs. 12.8%; P = 1.00).
In conclusion, the findings suggest that bevacizumab administered via IPC may confer a survival benefit specifically to NSCLC patients with MPE and actionable mutations, highlighting its potential as a therapeutic strategy in this subgroup. However, for patients without actionable mutations, the addition of bevacizumab does not offer significant prognostic advantages.
Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02886-1