INTRAPLEURALLY INSTILLED MITOXANTRONE IN METASTATIC PLEURAL EFFUSIONS- A PHASE-II STUDY

Thirty cases (breast cancer - 20 cases, malignant lymphoma - 4 cases, different malignancies - 6 cases) of histologically/cytologically veri fied malignant pleural effusion (MPE) in 29 patients were treated with intrapleurally instilled mitoxantrone (30 mg). The therapy was well t olerated, At evaluation, 25 patients had died of progressive disease. The median survival was 3 months (range 0.3-21.3 months). There were 2 6 responders (12 complete responses (CR), 14 partial responses (PR)), whereas 4 patients relapsed and 3 of these had an early relapse (withi n 3 months). Patients achieving PR or CR had a low risk (15%) of treat ment failure. Five patients were subjected to a pharmacokinetic evalua tion. This demonstrated rapidly declining plasma and pleural exudate l evels of mitoxantrone within the first 6 hours. At 24 hours after inst illation, mitoxantrone was only detected in circulating mononuclear ce lls. This study shows that mitoxantrone is efficacious in the treatmen t of MPE, and may represent a cost-effective alternative.