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Clin Lung Cancer. 2014 Sep;15(5):379-86. doi: 10.1016/j.cllc.2014.04.002. Epub 2014 May 14.

Vandetanib and indwelling pleural catheter for non-small-cell lung cancer with recurrent malignant pleural effusion.

Author information

  • 1Department of Thoracic Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
  • 2Institute of Pulmonary Oncology, Sheba Medical Center, Tel Aviv, Israel.
  • 3Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
  • 4Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
  • 5Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
  • 6Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
  • 7Section of Medical Oncology, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT.
  • 8Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX. Electronic address: cajimenez@mdanderson.org.

Abstract

INTRODUCTION/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.

PATIENTS AND 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.

CONCLUSION:

Vandetanib therapy was well tolerated; however, it did not significantly reduce time to pleurodesis.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Lung cancer; Malignant pleural effusion; NSCLC; Pleural catheter; VEGFR inhibitor

PMID:
24913066
[PubMed - in process]
PMCID:
PMC4160385
[Available on 2015-09-01]
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