Holoye PY et al. - In a trial to examine the pharmacology, toxicity, and therapeutic effectiveness of etoposide (VP-16) given by the intrapleural route, it was found that follow-up investigation of pleural fluid characteristics suggested some evidence of local therapeutic benefit Methods
10 pts with malignant pleural effusion received 100, 150, or 225 mg/m2 VP-16 infused over 2 h into the pleural space after drainage of pleural fluid
Results
Administration of VP-16 was tolerated well, with no local pain, increase in cough, dyspnea, or infection
Myelosuppression was mild at doses of 150 mg/m2 or less but severe at 225 mg/m2
Drug levels were followed in both plasma and pleural fluid for up to 12 h
Clearance of VP-16 from the pleural cavity was low at 2 ml/min m2
Peak pleural-fluid drug levels in pts receiving 225 mg/m2 exceeded 300 μg/ml, whereas peak drug concentrations in corresponding plasma samples obtained at the same time amounted to <10 μg/ml
Serial chest X-rays showed no disappearance of pleural effusion in 9 evaluable pts
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