Faculty Opinions recommendation of What is the best treatment for malignant pleural effusions?

Introduction: Cancer-related fatigue is well described. Fatigue in patients with a malignant pleural effusion (MPE) has not been directly studied. Methods: A prospective observational cohort pilot study ‘Do Interventions for Malignant Pleural Effusions (MPE) impact on patient reported fatigue levels (IMPE-F study)’ is planned to determine whether pleural interventions reduce fatigue in MPE. Fatigue will be assessed with a validated patient reported outcome measure, FACIT-F. Discussion: MPE-F has funding from Rocket Medical Plc, and is part of a Masters in Clinical Research at Newcastle University. Respondent fatigue will be addressed by the investigators going through the questionnaire with the participants. Inclusion criteria are all patients above 18 years of age with a presumed MPE undergoing a procedure and able to consent. The expected number of participants is 50. Trial registration: The IMPE-F study has Research Ethics Committee (REC) [20/YH/0224] and Health Research Authority (HRA) and Health and Care Research Wales (HCRW) approvals [IRAS project ID: 276451]. The study has been adopted on National Institute for Health Research portfolio [CPMS ID 46430].

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Quality assessment of the guidelines for the management of malignant pleural effusions and ascites

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02097-y ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Jia-Xi Li ◽

Yan-Mei Shi ◽

Li-Ya An ◽

Jin-Xu Yang ◽

Yu-Xing Qi ◽

...

Keyword(s):

Quality Assessment ◽

Malignant Ascites ◽

Systematic Search ◽

Measurement Scale ◽

Pleural Effusions ◽

Management Guidelines ◽

Malignant Pleural Effusions

Abstract Objectives To fully assess the quality of the guidelines for the management of malignant pleural effusions (MPE) and ascites and reveal the heterogeneity of recommendations and possible reasons among guidelines. Methods A systematic search was performed in the database to obtain guidelines for the management of MPE and ascites. The AGREE IIGtool was used to assess the quality of these guidelines. The Measurement Scale of Rate of Agreement (MSRA) was introduced to assess the scientific agreement of formulated recommendations for the management of MPE and ascites among guidelines, and evidence supporting these recommendations was extracted and analyzed. Results Nine guidelines were identified. Only 4 guidelines scored more than 60% and are worth recommending. Recommendations were also heterogeneous among guidelines for the management of MPE, and the main reasons were the different emphases of the recommendations for the treatment of MPE, the contradictions in recommendations, and the unreasonably cited evidence for MPE. Conclusions The quality of the management guidelines for patients with MPE and malignant ascites was highly variable. Specific improvement of the factors leading to the heterogeneity of recommendations will be a reasonable and effective way for developers to upgrade the recommendations in the guidelines for MPE.

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A retrospective review of management of malignant pleural effusions with indwelling pleural catheters in Dorset

Lung Cancer ◽

10.1016/s0169-5002(20)30222-1 ◽

2020 ◽

Vol 139 ◽

pp. S83

Author(s):

R. Punwani ◽

P. Isola ◽

J. Graves ◽

D. Edwards ◽

A. Grey ◽

...

Keyword(s):

Retrospective Review ◽

Pleural Effusions ◽

Malignant Pleural Effusions

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Diving into the Pleural Fluid: Liquid Biopsy for Metastatic Malignant Pleural Effusions

Cancers ◽

10.3390/cancers13112798 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2798

Author(s):

Maria Alba Sorolla ◽

Anabel Sorolla ◽

Eva Parisi ◽

Antonieta Salud ◽

José M. Porcel

Keyword(s):

Pleural Fluid ◽

Liquid Biopsy ◽

Cell Types ◽

Circulating Tumor Dna ◽

Therapeutic Interventions ◽

Driver Mutations ◽

Pleural Effusions ◽

Malignant Pleural Effusions ◽

Micro Rnas ◽

Low Sensitivity

Liquid biopsy is emerging as a promising non-invasive diagnostic tool for malignant pleural effusions (MPE) due to the low sensitivity of conventional pleural fluid (PF) cytological examination and the difficulty to obtain tissue biopsies, which are invasive and require procedural skills. Currently, liquid biopsy is increasingly being used for the detection of driver mutations in circulating tumor DNA (ctDNA) from plasma specimens to guide therapeutic interventions. Notably, malignant PF are richer than plasma in tumor-derived products with potential clinical usefulness, such as ctDNA, micro RNAs (miRNAs) and long non-coding RNAs (lncRNAs), and circulating tumor cells (CTC). Tumor-educated cell types, such as platelets and macrophages, have also been added to this diagnostic armamentarium. Herein, we will present an overview of the role of the preceding biomarkers, collectively known as liquid biopsy, in PF samples, as well as the main technical approaches used for their detection and quantitation, including a proper sample processing. Technical limitations of current platforms and future perspectives in the field will also be addressed. Using PF as liquid biopsy shows promise for use in current practice to facilitate the diagnosis and management of metastatic MPE.

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