The efficacy and safety of intrapleural LC9018 (Yakult Co. Ltd., Tokyo, Japan) with or without doxorubicin (Adriamycin; Adria Laboratories, Columbus, OH) were evaluated in a randomized, controlled trial performed in 95 patients with malignant pleural effusions secondary to lung cancer. Seventy-six patients were eligible for the assessment of efficacy. The response rate for treatment with intrapleural doxorubicin plus LC9018 (38 patients) was 73.770, which was significantly higher than the response rate of 39.5% for the control group treated with doxorubicin alone (38 patients) (P < 0.01). The L O 1 8 group also showed a significantly greater improvement in performance status (PS) and symptoms (chest pain, chest discomfort, and anorexia) than the control group (P < 0.05). A significant prolongation of survival was noticed in the LC9018 group ( P < 0.05). The main side effects of L O 1 8 were fever and transient hepatic dysfunction, but there were no serious adverse reactions. These results suggest that the intrapleural instillation of LC9018 can be recommended for the treatment of malignant pleural effusions. Cancer 683495-1500,1991.
ALIGNANT PLEURAL EFFUSION is a common com-M plication of advanced cancer that can severely affect performance status (PS) and shorten survival, making it imperative for the effusion to be controlled promptly by adequate treatment. After drainage, one of a variety of agents is generally instilled into the pleural cavity to prevent fluid reaccumulation, and both intrapleural chemotherapy and pleurodesis have been found to be effective for this purpose.'-h LC90 18 (Yakult Co. Ltd., Tokyo, Japan) is a biologic response modifier prepared from heat-killed and lyophilized Lactobacillus casei Y IT 90 18. It has been shown to From the *