Combination chemotherapy in patients with malignant pleural effusions fromnon-small cell lung cancer - Cisplatin, ifosfamide, and irinotecan with recombinant human granulocyte colony-stimulating factor support

Objectives: Malignant pleural effusions develop frequently in patients with non-small cell lung cancer (NSCLC), and the prognosis for these patients i s very poor, We evaluated the role of systemic chemotherapy for patients wi th malignant pleural effusions from NSCLC. Methods: We analyzed 34 patients who were found to have malignant pleural e ffusions in the course of diagnosis of 118 patients enrolled in three conse cutive clinical trials on advanced NSCLC assessing combination chemotherapy of cisplatin, ifosfamide, and irinotecan with recombinant human granulocyt e colony-stimulating factor support. The objective response in the malignan t pleural effusion was evaluated by CT scans every course with the response criteria of the Japan Lung Cancer Society. Results: All patients had adenocarcinoma. The pleural effusion showed a com plete response in 13 patients, a partial response in 7 patients, and no res ponse in ii patients. In the assessment of the efficacy of the treatment fo r the measurable primary or metastatic lesions, there was a partial respons e in 25 patients, no change in 8 patients, and progressive disease in 1 pat ient. The response rate in pleural effusions was 58.8%, and overall respons e in mensurable lesions was 73.5%. The median time to response and duration of response for pleural effusions were 54 days and 151 days, respectively The median survival time and 1-year survival rates were 362 days and 48.5%, respectively. Conclusions: Both the response rate and survival data in this retrospective study suggest a high degree of activity of this combination chemotherapy i n patients with malignant pleural effusions from NSCLC.