Xuan Yin Ning Plus Bevacizumab for Malignant Pleural Effusion

Inclusion Criteria

• •Patients with advanced non-squamous non-small cell lung cancer who have failed at least first-line systemic therapy;
• •Presence of unilateral pleural effusion confirmed as malignant by pathology or cytology, with at least moderate volume requiring drainage (moderate pleural effusion defined as: supine ultrasound examination showing pleural effusion ≥3 cm, or sitting ultrasound examination showing pleural effusion ≥4 cm,accompanied by clinical symptoms such as chest tightness and dyspnea);
• •Age 18-75 years;
• •ECOG performance status 0-2;
• •Traditional Chinese Medicine (TCM) syndrome differentiation classified as Xuanyin (suspension fluid) with fluid retention in the chest and hypochondrium;
• •Expected survival of at least 3 months;
• •Voluntarily signed informed consent before treatment;
• •No contraindications to chest tube placement for drainage;
• •Adequate major organ function, including:
• •1. Complete blood count:
• •White blood cell count ≥ 4.0×10⁹/L Absolute neutrophil count ≥ 1.5×10⁹/L Platelet count ≥ 100×10⁹/L Hemoglobin ≥ 90 g/L
• •2. Blood biochemistry:
• •Total bilirubin ≤ 1.5×ULN ALT ≤ 2.5×ULN, AST ≤ 2.5×ULN Serum creatinine ≤ 1.5×ULN, or creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula)
• •3. Coagulation function:
• •International normalized ratio (INR) ≤ 1.5×ULN Activated partial thromboplastin time (APTT) ≤ 1.5×ULN
• •4. Blood glucose: within normal range, or diabetic patients under treatment with stable blood glucose control;
• •Female subjects of childbearing potential must have a negative serum pregnancy test within 72 hours before starting study drug administration, and must use effective contraception (e.g., intrauterine device, contraceptive pills, or condoms) during the study period and for at least 3 months after the last dose. -Male subjects with a partner of childbearing potential must use effective contraception during the study period and for 3 months after the last dose;
• •Good subject compliance, able to follow up for efficacy and adverse events/reactions as required by the protocol.