| Yi Chen,Nan Huang,Kai Qin,Jing Zhao,Huihua Xiong,Shiying Yu,Tingting Huang,QiuYun Guo. Comparison of intra-pleural injection efficac?between Endostar and Bevacizumab combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with ?epidermal growth factor receptor-/anaplastic lymphoma kinase-lung adenocarcinoma. Oncol Transl Med, 2019, 5: 53-57. |
| Comparison of intra-pleural injection efficac?between Endostar and Bevacizumab combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with ?epidermal growth factor receptor-/anaplastic lymphoma kinase-lung adenocarcinoma |
| Received:March 29, 2019 Revised:May 07, 2019 |
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| KeyWord:?Key words: Endostar; bevacizumab; malignant pleural effusion; EGFR-/ALK-lung adenocarcinoma; cisplatin; pemetrexed; intra-pleural injection |
| Author Name | Affiliation | Department | | Yi Chen | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Department of Oncology | | Nan Huang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Allergy Department | | Kai Qin | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Jing Zhao | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Huihua Xiong | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Shiying Yu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Tingting Huang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | QiuYun Guo | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology |
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| Abstract: |
| Objective To compare intra-pleural injection efficacy and safety between Endostar and bevacizumab
combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with epidermal
growth factor receptor (EGFR)-/anaplastic lymphoma kinase (ALK)-lung adenocarcinoma.
Methods Sixty-four pCVatients with EGFR-/ALK- lung adenocarcinoma with malignant pleural effusion
(MPE) were admitted to the authors’ hospital between January 2016 and June 2017. Patients were
randomly divided into two groups: Endostar combined with pemetrexed/cisplatin (Endostar group); and
bevacizumab plus pemetrexed/cisplatin (Bevacizumab group). They underwent thoracic puncture and
catheterization, and MPE was drained as much as possible. Both groups were treated with pemetrexed
500 mg/m2, intravenous drip (d1), cisplatin 37.5 mg/m2 per time, intra-pleural injection (d1, d3). Patients in
the Endostar group were treated with Endostar 30 mg per time, intra-pleural injection (d1, 3), and patients in
the Bevacizumab group were treated with bevacizumab 5 mg/kg per time, intra-pleural injection (d1). Only
one cycle of treatment was applied. MPE was extracted before treatment and on day 7 after treatment. The
levels of vascular endothelial growth factor (VEGF) were determined using ELISA. Efficacy and side effects
were evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and
National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.
Results The objective response rates in the Endostar and Bevacizumab groups were 50.0% and 56.3%,
respectively; there was no statistical difference between the groups (P > 0.05). After one cycle of treatment,
the mean VEGF levels in MPE in both groups decreased significantly, and there was no significant difference
in the degree of decline between the two groups (P > 0.05). In both groups, pre-treatment VEGF levels
for patients achieving complete response were significantly higher than those for patients achieving stable
disease + progressive disease (P < 0.05). No specific side effects were recorded.
Conclusion Endostar and Bevacizumab demonstrated similar efficacy in controlling MPE in patients
with EGFR-/ALK- lung adenocarcinoma through an anti-angiogenesis pathway, with tolerable side effects.
The levels of VEGF in MPE could predict the efficacy of intra-pleural injection of anti-angiogenesis drugs. |
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