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Malignant Pleural Effusions in the Era of Immunotherapy and Antiangiogenic Therapy

Terrence Wong1,2, Alexander D Fuld3,4, David J Feller-Kopman1,2

  • 1Department of Medicine, Geisel School of Medicine, Dartmouth, Hanover, New Hampshire.

Seminars in Respiratory and Critical Care Medicine
|June 12, 2023
PubMed

Insights

New immunotherapies and antiangiogenic therapies offer improved survival for malignant pleural effusions (MPE) in lung cancer patients. This review examines their impact, shifting MPE management from palliation to effective treatment.

Area of Science:

  • Oncology
  • Pulmonology
  • Immunotherapy

Background:

  • Malignant pleural effusions (MPE) historically indicate a poor prognosis, necessitating invasive palliative procedures and reducing patient quality of life.
  • Advances in lung cancer treatment, including immunotherapies and antiangiogenic therapies, present new management paradigms for MPE.

Approach:

  • This review synthesizes findings from leading studies on immune checkpoint inhibitors (ICI) and antiangiogenic therapies in lung cancer patients with MPE.
  • It also discusses the diagnostic and prognostic significance of vascular endothelial growth factor and endostatin expression levels in malignancy.

Key Points:

  • Limited phase III trial data exists for immune checkpoint inhibitors (ICI) specifically in lung cancers with MPE.
  • Vascular endothelial growth factor and endostatin levels are important diagnostic and prognostic markers in malignancy.
  • These therapies are transforming MPE management from palliative care to active treatment.

Conclusions:

  • Emerging immunotherapies and antiangiogenic therapies demonstrate potential for durable responses and extended survival in MPE patients.
  • The management of MPE is evolving, offering improved outcomes beyond historical palliative approaches.

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