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Combination use of paclitaxel and avastin enhances treatment effect for the NSCLC patients with malignant pleural effusion

View Article: PubMed Central - PubMed

ABSTRACT

The current study is conducted to investigate efficacy of the chemotherapy drug paclitaxel in combination with Avastin (Roche Diagnostics GmbH., Mannheim, Germany) (antiangiogenic agent) in treatment of malignant pleural effusions (MPEs).

Twenty-four patients with non–small cell lung cancer were randomly assigned for 2 treatment approaches. Ten patients received paclitaxel (175 mg/m2) alone, and 14 patients took a combination therapy of paclitaxel and Avastin (5 mg/kg). Efficacy of the treatment approaches in the patients was validated with the change in the MPE volume. Pharmacokinetic (PK) profile and urinary excretion rate of paclitaxel were analyzed with serum vascular endothelial growth factor (VEGF) level, and adverse events were examined as well.

The combination therapy reduced the MPE level with a successful rate of 29% and a survival rate of 25% over the single paclitaxel treatment in the study cohort (both P < 0.05). PKs for the combined treatment displayed a rapid distribution of the anticancer drug paclitaxel with an obvious increase in its elimination half-life in the pleural fluid (both P < 0.01). Mean residence time of paclitaxel increased in the presence of Avastin (P < 0.01). Serum VEGF levels significantly reduced in the Avastin-treated patients as compared to the paclitaxel-treated ones (P < 0.01). The urinary excretion rate was similar in the study cohort. Incidence of adverse events for the 2 treatment approaches was similar in the patients.

Intervention of Avastin enhances potency of paclitaxel in treatment of MPEs with the increased survival rate of the patients through inhibiting VEGF production and prolonging time of ongoing interaction between the chemotherapy drug and the tumor tissues.

No MeSH data available.


Related in: MedlinePlus

Efficacy of combination therapy and survival rate. Efficacy (A) of paclitaxel in treatment of malignant pleural effusion and survival rate (B) of the treated patients were examined over time in presence (n = 14) and absence (n = 10) of Avastin. Population distribution was marked in black (effective treatment and survivors) and white (failed treatment and patients’ death). The data were expressed as a percentage of a population proportion in the study cohort. A χ2 test for treatment efficacy and survival rates showed a P value <0.05 between the patients treated with and without Avastin.
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Figure 1: Efficacy of combination therapy and survival rate. Efficacy (A) of paclitaxel in treatment of malignant pleural effusion and survival rate (B) of the treated patients were examined over time in presence (n = 14) and absence (n = 10) of Avastin. Population distribution was marked in black (effective treatment and survivors) and white (failed treatment and patients’ death). The data were expressed as a percentage of a population proportion in the study cohort. A χ2 test for treatment efficacy and survival rates showed a P value <0.05 between the patients treated with and without Avastin.

Mentions: Twenty-four NSCLC patients with MPEs received intrapleural infusion of paclitaxel in presence and absence of Avastin. The pleural fluid level and the degree of dyspnea were used to validate effects of the drugs on the patients. OE and survival rates were expressed with a change of percentage in each treatment approach, and the results are shown in Fig. 1. A combination therapy of paclitaxel and Avastin significantly reduced the pleural fluid level and alleviated the symptom of dyspnea with an OE rate of 78.6% in the treated patients (Fig. 1A). In contrast, only 50% patients in the paclitaxel-treated cohort displayed the rate. Clinical efficacy of the combination therapy was more potent than paclitaxel used alone with a 29% increase in the rate in the investigated population. In terms of survival rates of 1-year follow-up (Fig. 1B), population proportion of survivors was larger in the Avastin-treated patients (45.8%) than in the paclitaxel-treated patients (20.8%). There were statistical differences in these observations between the treatments with and without Avastin (χ2 test, both P < 0.05).


Combination use of paclitaxel and avastin enhances treatment effect for the NSCLC patients with malignant pleural effusion
Efficacy of combination therapy and survival rate. Efficacy (A) of paclitaxel in treatment of malignant pleural effusion and survival rate (B) of the treated patients were examined over time in presence (n = 14) and absence (n = 10) of Avastin. Population distribution was marked in black (effective treatment and survivors) and white (failed treatment and patients’ death). The data were expressed as a percentage of a population proportion in the study cohort. A χ2 test for treatment efficacy and survival rates showed a P value <0.05 between the patients treated with and without Avastin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134869&req=5

Figure 1: Efficacy of combination therapy and survival rate. Efficacy (A) of paclitaxel in treatment of malignant pleural effusion and survival rate (B) of the treated patients were examined over time in presence (n = 14) and absence (n = 10) of Avastin. Population distribution was marked in black (effective treatment and survivors) and white (failed treatment and patients’ death). The data were expressed as a percentage of a population proportion in the study cohort. A χ2 test for treatment efficacy and survival rates showed a P value <0.05 between the patients treated with and without Avastin.
Mentions: Twenty-four NSCLC patients with MPEs received intrapleural infusion of paclitaxel in presence and absence of Avastin. The pleural fluid level and the degree of dyspnea were used to validate effects of the drugs on the patients. OE and survival rates were expressed with a change of percentage in each treatment approach, and the results are shown in Fig. 1. A combination therapy of paclitaxel and Avastin significantly reduced the pleural fluid level and alleviated the symptom of dyspnea with an OE rate of 78.6% in the treated patients (Fig. 1A). In contrast, only 50% patients in the paclitaxel-treated cohort displayed the rate. Clinical efficacy of the combination therapy was more potent than paclitaxel used alone with a 29% increase in the rate in the investigated population. In terms of survival rates of 1-year follow-up (Fig. 1B), population proportion of survivors was larger in the Avastin-treated patients (45.8%) than in the paclitaxel-treated patients (20.8%). There were statistical differences in these observations between the treatments with and without Avastin (χ2 test, both P < 0.05).

View Article: PubMed Central - PubMed

ABSTRACT

The current study is conducted to investigate efficacy of the chemotherapy drug paclitaxel in combination with Avastin (Roche Diagnostics GmbH., Mannheim, Germany) (antiangiogenic agent) in treatment of malignant pleural effusions (MPEs).

Twenty-four patients with non&ndash;small cell lung cancer were randomly assigned for 2 treatment approaches. Ten patients received paclitaxel (175&#8202;mg/m2) alone, and 14 patients took a combination therapy of paclitaxel and Avastin (5&#8202;mg/kg). Efficacy of the treatment approaches in the patients was validated with the change in the MPE volume. Pharmacokinetic (PK) profile and urinary excretion rate of paclitaxel were analyzed with serum vascular endothelial growth factor (VEGF) level, and adverse events were examined as well.

The combination therapy reduced the MPE level with a successful rate of 29% and a survival rate of 25% over the single paclitaxel treatment in the study cohort (both P&#8202;&lt;&#8202;0.05). PKs for the combined treatment displayed a rapid distribution of the anticancer drug paclitaxel with an obvious increase in its elimination half-life in the pleural fluid (both P&#8202;&lt;&#8202;0.01). Mean residence time of paclitaxel increased in the presence of Avastin (P&#8202;&lt;&#8202;0.01). Serum VEGF levels significantly reduced in the Avastin-treated patients as compared to the paclitaxel-treated ones (P&#8202;&lt;&#8202;0.01). The urinary excretion rate was similar in the study cohort. Incidence of adverse events for the 2 treatment approaches was similar in the patients.

Intervention of Avastin enhances potency of paclitaxel in treatment of MPEs with the increased survival rate of the patients through inhibiting VEGF production and prolonging time of ongoing interaction between the chemotherapy drug and the tumor tissues.

No MeSH data available.


Related in: MedlinePlus