Real-world outcomes of intrapleural platinum-based chemotherapy in lung cancer patients with symptomatic malignant pleural effusion: A multicenter cohort study
Chang Qi, Yalun Li, Ran Wang, Yi Xiang, Hailong Wei, Yong Cao, Ling Peng, Changyi Li, Huifang Song, Hui Ren, Li Jiang, Ran Li, Jia Zeng, Minjiang Chen, Dehe Chen, Yunxiang Zeng, Xueling Wu, Qinghua Liu, Yi Zhang, Huai Liao, Hongmei Zhou, Na Huang, Junhua Wu, Pingfei Wang, Rong Qiu, Taibing Deng, Shuanglin Liu, Yuan Zhang, Jürgen Wolf, Weimin Li, Panwen TianBackground
Intrapleural anticancer therapies are increasingly used in clinical practice; however, their additional benefit over indwelling pleural catheter (IPC) alone and the optimal intrapleural strategy remain uncertain. Platinum-based chemotherapy is a common intrapleural approach.
Objective
This study evaluated the efficacy and safety of IPC combined with intrapleural platinum-based chemotherapy in lung cancer patients with symptomatic malignant pleural effusion (MPE).
Design
A multicenter retrospective real-world cohort study.
Methods
Patients with symptomatic MPE from 27 tertiary care centers received IPC alone, IPC combined with intrapleural platinum-based chemotherapy, or IPC combined with other intrapleural agents. The primary endpoint was progression-free survival of MPE (MPE PFS); secondary endpoints were overall survival (OS), the objective response rate of MPE at 8 weeks (8-week MPE ORR), and safety. Propensity score matching (PSM) was performed as a sensitivity analysis.
Results
Of the 391 patients, 229 received IPC alone, 93 received IPC combined with intrapleural platinum-based chemotherapy, and 69 received other intrapleural agents. Among the evaluated strategies, platinum-based chemotherapy was associated with the longest MPE PFS and the highest 8-week MPE ORR (87.1%). Compared with IPC alone, the hazard ratios (HRs) for MPE PFS and OS were 0.64 (95% confidence interval [CI], 0.46 -0.88;
Conclusions
IPC combined with intrapleural platinum-based chemotherapy was associated with improved pleural control and acceptable safety.