Talc or Minocycline Pleurodesis May Aid managing malignant pleural effusion Management in Lung Cancer with ILD: Study

Researchers have found in a new study that Pleurodesis using talc or minocycline had potential as a treatment option for managing malignant pleural effusion (MPE) in patients with lung cancer complicated by interstitial lung disease (ILD).

What is known and what is new?

• The efficacy rate of pleurodesis with talc and minocycline is about 70%. Acute respiratory distress syndrome (ARDS) after pleurodesis with talc is a concern. The partially expanded lung before pleurodesis is known as the predictor of pleurodesis failure. The efficacy and safety of pleurodesis against MPE complicated with ILD have not been elucidated.

• In this study, excluding the cases of partially expanded lung, the efficacy rate of pleurodesis against MPE complicated with ILD was comparable to that of previous reports. Presenting ground glass opacity and consolidation treated with systemic prednisolone within 6 months before pleurodesis might be the risk factor for developing ARDS.

What is the implication, and what should change now?

• Pleurodesis against MPE might be the therapeutic option for patients complicated with ILD. However, two cases of ARDS were observed in the patients administered systemic prednisolone against ILD within 6 months before pleurodesis. The clinicians should carefully consider the indication for pleurodesis.

Reference:

Hirokazu Iso, Akihiko Miyanaga, Yozo Sato, Yukari Shirakura, Kaoruko Shinbu, Tomoyasu Inoue, Atsuhiro Nagano, Kazuhito Misawa, Takehiro Tozuka, Akari Murata, Efficacy and safety of pleurodesis for lung cancer patients with interstitial lung disease, Journal of Thoracic Disease, DOI: 10.21037/jtd-24-1541.