Nedaplatin, a second-generation platinum-based drug, may be associated with less toxicity than cisplatin when treating malignant pleural effusion (MPE) caused by malignant tumors. Researchers are reporting in OncoTargets and Therapy that nedaplatin was found to be noninferior to cisplatin in treating malignancy-induced MPE and associated with less toxicity.

Li-Zhe Zhong, of the Department of Cardiothoracic Surgery, Affiliated Hospital of Beihua University in China, and colleagues evaluated the efficacy and safety of nedaplatin vs cisplatin in treating MPE caused by cancers. Malignant pleural effusion is a common complication in patients with advanced malignancies that can severely compromise heart and lung functions.

The authors note that MPE often responds poorly to systemic treatment, and the standard of care is intrapleural perfusion chemotherapy. The efficacy of cisplatin and carboplatin is well established. However, both agents are associated with gastrointestinal (GI) side effects and myelosuppression.


The researchers retrospectively analyzed clinical data from 219 consecutive patients (114 males, 105 females; mean age, 52 years [range, 28-77 years]) with MPE caused by malignant tumors. All the patients were treated between January 2013 and December 2016 at a single institution.

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The patients were treated via intrapleural infusion with nedaplatin 80 mg/m2 (110 patients) or cisplatin 40 mg/m2 (109 patients). Both arms were similar in regard to gender, age, body mass index (BMI), diabetes, and cardiovascular disease. In addition, both arms were similar in terms of Karnofsky score, underlying malignancy, tumor pathology, mediastinal metastasis, and pleural effusion volume. The underlying malignancies in these patients included lung cancer (115 cases), breast cancer (52 cases), and gastrointestinal cancer (52 cases). One hundred and sixty-two patients received systemic chemotherapy 6 months prior to treatment, and 39 patients received systemic chemotherapy within 1 month. Eighteen patients received systemic chemotherapy concomitantly with the intrapleural perfusion.