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Abstract：
BACKGROUND: Several studies have indicated that intrapleural infusion of bevacizumab is an effective treatment for non-small cell lung cancer (NSCLC) with malignant pleural effusion (MPE). However, the impact of bevacizumab administered through an indwelling pleural catheter (IPC) on the prognosis of these patients is unknown.
METHODS: Consecutive advanced NSCLC patients with symptomatic MPE receiving an IPC alone or bevacizumab through an IPC were identified in a tertiary hospital. The patient characteristics and clinical outcomes were collected.
RESULTS: A total of 149 patients were included, and the median age was 60.3 years. Males and nonsmokers accounted for 48.3% and 65.8%, respectively. A total of 69.8% (104/149) of patients harbored actionable mutations, including 92 EGFR-activating mutations, 11 ALK fusions, and 1 ROS1 fusion. A total of 81.9% (122/149) of patients received IPC alone, and 18.1% (27/149) received bevacizumab through an IPC. The incidence of spontaneous pleurodesis during the first 6 months was greater in the bevacizumab-treated group than in the IPC-treated group in the subgroup with actionable mutations (64.3% vs. 46.9%, P = 0.28). The median overall survival (OS) in patients with actionable mutations treated with bevacizumab through an IPC was 42.2 months, which was significantly longer than the 26.7 months in patients who received an IPC alone (P = 0.045). However, the median OS did not differ between the two arms in the subgroup without actionable mutations (10.8 vs. 41.0 months, P = 0.24). No significant difference between the bevacizumab through an IPC group and the IPC group was detected in the number of participants who had adverse events, either in patients with actionable mutations (14.3% vs. 8.4%; P = 0.42) or in patients without actionable mutations (16.7% vs. 12.8%; P = 1.00).
CONCLUSIONS: Bevacizumab through an IPC resulted in a significantly improved prognosis for NSCLC patients with MPE and actionable mutations. However, patients without actionable mutations do not benefit from bevacizumab through IPC.
METHODS: Consecutive advanced NSCLC patients with symptomatic MPE receiving an IPC alone or bevacizumab through an IPC were identified in a tertiary hospital. The patient characteristics and clinical outcomes were collected.
RESULTS: A total of 149 patients were included, and the median age was 60.3 years. Males and nonsmokers accounted for 48.3% and 65.8%, respectively. A total of 69.8% (104/149) of patients harbored actionable mutations, including 92 EGFR-activating mutations, 11 ALK fusions, and 1 ROS1 fusion. A total of 81.9% (122/149) of patients received IPC alone, and 18.1% (27/149) received bevacizumab through an IPC. The incidence of spontaneous pleurodesis during the first 6 months was greater in the bevacizumab-treated group than in the IPC-treated group in the subgroup with actionable mutations (64.3% vs. 46.9%, P = 0.28). The median overall survival (OS) in patients with actionable mutations treated with bevacizumab through an IPC was 42.2 months, which was significantly longer than the 26.7 months in patients who received an IPC alone (P = 0.045). However, the median OS did not differ between the two arms in the subgroup without actionable mutations (10.8 vs. 41.0 months, P = 0.24). No significant difference between the bevacizumab through an IPC group and the IPC group was detected in the number of participants who had adverse events, either in patients with actionable mutations (14.3% vs. 8.4%; P = 0.42) or in patients without actionable mutations (16.7% vs. 12.8%; P = 1.00).
CONCLUSIONS: Bevacizumab through an IPC resulted in a significantly improved prognosis for NSCLC patients with MPE and actionable mutations. However, patients without actionable mutations do not benefit from bevacizumab through IPC.
摘要：
背景：多项研究表明，贝伐单抗胸腔内输注是治疗非小细胞肺癌（NSCLC）伴恶性胸腔积液（MPE）的有效方法。然而,通过留置胸膜导管(IPC)给药贝伐单抗对这些患者预后的影响尚不清楚.
方法：在三甲医院确定了连续的晚期NSCLC患者，有症状的MPE单独接受IPC或通过IPC接受贝伐单抗。收集患者特征和临床结果。
结果：共纳入149例患者，中位年龄为60.3岁.男性和不吸烟者分别占48.3%和65.8%,分别。共有69.8%(104/149)的患者存在可操作的突变，包括92个EGFR激活突变，11ALK融合，和1个ROS1融合。共有81.9%(122/149)的患者单独接受IPC，18.1%（27/149）通过IPC接受贝伐单抗治疗。在具有可操作突变的亚组中，贝伐单抗治疗组的前6个月自发性胸膜固定术的发生率高于IPC治疗组（64.3％vs.46.9%,P=0.28）。通过IPC接受贝伐单抗治疗的可行突变患者的中位总生存期（OS）为42.2个月，明显长于单独接受IPC的患者的26.7个月（P=0.045）。然而,在没有可操作突变的亚组中，两组之间的中位OS没有差异(10.8vs.41.0个月，P=0.24）。通过IPC组和IPC组的贝伐单抗在发生不良事件的参与者人数中没有发现显着差异，在具有可操作突变的患者中(14.3%vs.8.4%；P=0.42）或无可操作突变的患者（16.7%vs.12.8%；P=1.00）。
结论：贝伐单抗通过IPC导致MPE和可行突变的NSCLC患者的预后显著改善。然而,没有可操作突变的患者不能通过IPC从贝伐单抗获益.
方法：在三甲医院确定了连续的晚期NSCLC患者，有症状的MPE单独接受IPC或通过IPC接受贝伐单抗。收集患者特征和临床结果。
结果：共纳入149例患者，中位年龄为60.3岁.男性和不吸烟者分别占48.3%和65.8%,分别。共有69.8%(104/149)的患者存在可操作的突变，包括92个EGFR激活突变，11ALK融合，和1个ROS1融合。共有81.9%(122/149)的患者单独接受IPC，18.1%（27/149）通过IPC接受贝伐单抗治疗。在具有可操作突变的亚组中，贝伐单抗治疗组的前6个月自发性胸膜固定术的发生率高于IPC治疗组（64.3％vs.46.9%,P=0.28）。通过IPC接受贝伐单抗治疗的可行突变患者的中位总生存期（OS）为42.2个月，明显长于单独接受IPC的患者的26.7个月（P=0.045）。然而,在没有可操作突变的亚组中，两组之间的中位OS没有差异(10.8vs.41.0个月，P=0.24）。通过IPC组和IPC组的贝伐单抗在发生不良事件的参与者人数中没有发现显着差异，在具有可操作突变的患者中(14.3%vs.8.4%；P=0.42）或无可操作突变的患者（16.7%vs.12.8%；P=1.00）。
结论：贝伐单抗通过IPC导致MPE和可行突变的NSCLC患者的预后显著改善。然而,没有可操作突变的患者不能通过IPC从贝伐单抗获益.
