Role of bevacizumab in the management of the patient with malignant pleural effusion: more questions than answers.

Role of bevacizumab in the management of the patient with malignant pleural effusion: more questions than answers. Expert Rev Respir Med. 2017 Dec 13;: Authors: Sabang RL, Gandhiraj D, Fanucchi M, Epelbaum O Abstract INTRODUCTION: Malignant pleural effusion (MPE) is a feature of metastatic cancer that is associated with significant morbidity and healthcare costs. The typical current management of MPE involves the combination of systemic chemotherapy and mechanical intervention in the pleural space. Vascular endothelial growth factor (VEGF), an extremely potent inducer of vascular permeability, has been shown to mediate fluid formation in pleural malignancy. Therefore, bevacizumab, an inhibitor of VEGF activity, offers theoretical promise as a means of abolishing fluid formation in MPE. Areas covered: This review begins with a summary of VEGF physiology and the evidence supporting its role in MPE pathogenesis. This is followed by a brief overview of bevacizumab and the major trials that put it on the map of non-small cell lung cancer (NSCLC) therapeutics. The majority of the article is devoted to a review of the current evidence base for the use of bevacizumab administered intravenously or intrapleurally for MPE control in metastatic pleural malignancy. The review concludes with a discussion of considerations pertinent to patient selection and toxicity. Expert commentary: Evidence in support of bevacizumab administration for MPE manag...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research