TREATMENT OF PRIMARY OR METASTATIC PLEURAL EFFUSION WITH INTRACAVITARY CYTOSINE-ARABINOSIDE AND CISPLATIN - A PHASE-II STUDY

Thirty-three patients with microscopically verified primary or metasta tic malignant pleural effusion were studied: 7 had malignant mesotheli oma and 26 metastatic pleural disease. The treatment was based on bioc hemical and clinical studies which show a synergy between cytosine-ara binoside (Ara-C) and cisplatin. These drugs were instilled in the pleu ral cavity at the dose of 100 mg for Ara-C and 100 mg/m(2) for cisplat in. The cavity was drained after 4 h. If it was possible, the treatmen t was repeated weekly for 3 times and, after a 6-week rest, it could b e started again with the same schedule. The overall response rate (com plete plus partial remissions) was 74%. Toxicity was mild or moderate. We conclude that the combination of Ara-C and cisplatin is well toler ated and produces a high response rate in the treatment of malignant p leural effusions.