{
  "abstract": "Malignant pleural effusion (MPE) is a frequent complication of advanced lung cancer with poor prognosis. The optimal first-line systemic treatment for these patients remains unclear. This study aimed to evaluate first-line systemic treatment patterns and outcomes in lung cancer patients with MPE. This multicenter retrospective study across 27 centers in China evaluated the efficacy and safety of first-line systemic therapy in lung cancer patients with MPE from 2013 to 2024. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Of 1,029 patients included, 88.1% had non-small cell lung cancer (NSCLC) and 11.9% had small cell lung cancer (SCLC); 87.4% received first-line systemic therapy. SCLC patients received chemotherapy alone (50.8%; 62/122) or combined with immunotherapy (47.5%; 58/122). Most driver gene-positive NSCLC patients received targeted therapy (91.4%; 415/454). Driver gene-negative NSCLC patients primarily received chemotherapy alone (27.8%; 126/453), chemotherapy plus immunotherapy (15.9%; 72/453), or chemotherapy plus bevacizumab (17.9%; 81/453). Median OS for the overall cohort was 26.1 months. Systemic therapy significantly extended median OS compared to no systemic therapy (28.1 vs. 12.7 months; P<0.001). Driver gene-positive NSCLC had longer OS than driver gene-negative patients (34.1 vs. 22.6 months; P<0.001). In SCLC, no significant PFS or OS difference was observed between the two regimens. After adjustment, targeted combination therapy versus monotherapy showed non-significant trends for PFS [hazard ratio (HR), 0.74; P=0.09] and OS (HR, 0.67; P=0.10) among driver gene-positive NSCLC. Among driver gene-negative NSCLC, chemotherapy plus bevacizumab significantly improved median OS versus chemotherapy alone (41.8 vs. 21.4 months; P=0.04) and was an independent predictor of favorable OS [HR, 0.59; 95% confidence interval (CI): 0.38-0.90; P=0.02], despite no significant PFS improvement (HR, 0.72; 95% CI: 0.51-1.01; P=0.055), with a manageable safety profile [grade ≥3 treatment-related adverse events (TRAEs): 14.8%]. First-line systemic therapy was associated with improved survival in lung cancer patients with MPE, though outcomes differed according to histologic and molecular subtypes. The addition of bevacizumab to chemotherapy was independently associated with longer OS among patients with driver gene-negative NSCLC with MPE.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.",
    "Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, China.",
    "Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.",
    "Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.",
    "Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.",
    "Department of Pulmonary and Critical Care Medicine, The People's Hospital of Leshan, Leshan, China.",
    "Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Sciences and Technology, Wuhan, China.",
    "Department of General Medicine, Sichuan Cancer Hospital, Chengdu, China.",
    "Department of Pulmonary Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.",
    "Department of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, Hohhot, China.",
    "Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.",
    "Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.",
    "Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.",
    "Department of Respiratory and Critical Care Medicine, Guangyuan Central Hospital, Guangyuan, China.",
    "Department of Respiratory and Critical Care Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.",
    "Department of Pulmonary and Critical Care Medicine, Bazhong Center Hospital, Bazhong, China.",
    "Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.",
    "Department of Pulmonary, Shanghai Jiao Tong University School of Medicine, Renji Hospital, Shanghai, China.",
    "Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.",
    "The Second Ward of Pulmonary and Critical Care Medicine, The First Hospital of Lanzhou University, Lanzhou, China.",
    "Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.",
    "Department of Pulmonary Intervention Center, Southern University of Science and Technology Hospital, Shenzhen, China.",
    "Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.",
    "Department of Respiratory and Critical Care Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.",
    "Department of Pulmonary and Critical Care Medicine, Dazhou Central Hospital, Dazhou, China.",
    "Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suining, China.",
    "Department of Pulmonary and Critical Care Medicine, Guang'an People's Hospital, Guang'an, China.",
    "Department of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China.",
    "Department of Pulmonary and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 30,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yuanyuan Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Ran Wang"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Yi Xiang"
    },
    {
      "affs": [
        5
      ],
      "name": "Hailong Wei"
    },
    {
      "affs": [
        6
      ],
      "name": "Yong Cao"
    },
    {
      "affs": [
        7
      ],
      "name": "Ling Peng"
    },
    {
      "affs": [
        8
      ],
      "name": "Changyi Li"
    },
    {
      "affs": [
        9
      ],
      "name": "Huifang Song"
    },
    {
      "affs": [
        10
      ],
      "name": "Hui Ren"
    },
    {
      "affs": [
        11
      ],
      "name": "Li Jiang"
    },
    {
      "affs": [
        12
      ],
      "name": "Ran Li"
    },
    {
      "affs": [
        13
      ],
      "name": "Jia Zeng"
    },
    {
      "affs": [
        14
      ],
      "name": "Minjiang Chen"
    },
    {
      "affs": [
        15
      ],
      "name": "Dehe Chen"
    },
    {
      "affs": [
        16
      ],
      "name": "Yunxiang Zeng"
    },
    {
      "affs": [
        17
      ],
      "name": "Xueling Wu"
    },
    {
      "affs": [
        18
      ],
      "name": "Qinghua Liu"
    },
    {
      "affs": [
        19
      ],
      "name": "Yi Zhang"
    },
    {
      "affs": [
        20
      ],
      "name": "Huai Liao"
    },
    {
      "affs": [
        21
      ],
      "name": "Hongmei Zhou"
    },
    {
      "affs": [
        22
      ],
      "name": "Na Huang"
    },
    {
      "affs": [
        23
      ],
      "name": "Junhua Wu"
    },
    {
      "affs": [
        24
      ],
      "name": "Pingfei Wang"
    },
    {
      "affs": [
        25
      ],
      "name": "Rong Qiu"
    },
    {
      "affs": [
        26
      ],
      "name": "Taibing Deng"
    },
    {
      "affs": [
        27
      ],
      "name": "Shuanglin Liu"
    },
    {
      "affs": [
        28
      ],
      "name": "Yuan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Weimin Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yalun Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Panwen Tian"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4er8re40spmps.bib",
  "cited_by": 0,
  "doi": "10.21037/jtd-2026-1790",
  "fulltext_url": "https://europepmc.org/articles/PMC13740805",
  "id": "4er8re40spmps",
  "issns": [
    "2072-1439",
    "2077-6624"
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  "landing_url": "https://europepmc.org/article/MED/42997006",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "2740|Lung Cancer Diagnosis and Treatment"
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  "openalex": "W7223837989",
  "pdf_url": "https://europepmc.org/articles/PMC13740805?pdf=render",
  "pmcid": "PMC13740805",
  "pmid": "42997006",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4er8re40spmps.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42997006",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997006"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "First-line systemic treatment patterns and outcomes in lung cancer patients with malignant pleural effusion: a retrospective multicenter study.",
  "title_text": "First-line systemic treatment patterns and outcomes in lung cancer patients with malignant pleural effusion: a retrospective multicenter study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/4er8re40spmps",
  "venue": "Journal of thoracic disease",
  "versions": []
}