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NCT06892691 | RECRUITING | Pleural Effusion


Pleuroscopy First Versus Thoracentesis First in Patients with Suspected Malignant Pleural Effusions
Sponsor:

Icahn School of Medicine at Mount Sinai

Information provided by (Responsible Party):

Udit Chadha

Brief Summary:

This is a randomized control trial of patients with suspected malignant pleural effusions to compare whether patients who have a thoracentesis or pleuroscopy (pleural biopsy) obtain an adequate biopsy, achieve a diagnosis, and begin cancer-directed therapy faster.

Condition or disease

Pleural Effusion

Cancer

Intervention/treatment

Pleuroscopy first

Thoracentesis first

Phase

NA

Detailed Description:

This is a randomized control trial of patients with suspected malignant pleural effusions comparing patients who undergo either pleuroscopy or thoracentesis as the first diagnostic test. Both procedures are considered standard of care for this diagnosis but it is unknown which one provides more adequate biopsy samples and achieves faster diagnosis and shorter time to oncologic treatment. Currently, most patients undergo thoracentesis first and, if this is inadequate for diagnosis, they then undergo pleuroscopy for further biopsy samples. This study seeks to assess whether patients who undergo pleuroscopy as the first test obtain adequate biopsy samples and a faster path to further oncologic care compared to patients who undergo thoracentesis first. Patients will be recruited and randomized in a 1:1 manner. Ultrasound is routinely used prior to the procedure and a chest x-ray is done after the procedure. Any other imaging will be determined by clinic need only. No imaging will be done for research purposes. No additional samples will be collected other than what is necessary for diagnostic purposes. In patients who have a non-diagnostic thoracentesis, the participants will be referred for pleuroscopy as the next diagnostic step. In the rare case that pleuroscopy does not achieve adequate diagnosis, the next step would be a liquid biopsy (non-invasive serologic testing for oncologic markers.) The need for liquid biopsy in participants in this study will be determined on a case-by-case basis depending on the clinical concern for malignancy.

Study Type : INTERVENTIONAL
Estimated Enrollment : 98 participants
Masking : NONE
Primary Purpose : DIAGNOSTIC
Official Title : Pleuroscopy First Versus Thoracentesis First in Patients with Suspected Malignant Pleural Effusions
Actual Study Start Date : 2025-03
Estimated Primary Completion Date : 2026-09-17
Estimated Study Completion Date : 2026-09-17

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 18 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Referral for diagnostic pleural procedure.
  • * Age ≥ 18 years.
  • * Suspected malignant pleural effusion (Suggestive radiologic appearance (based on computed tomography or positron emission tomography) OR suspected cancer with associated effusion.)
Exclusion Criteria
  • * Inability to provide informed consent.
  • * Needs emergent drainage.
  • * Pleural effusion is known to be malignant.
  • * Suspected transudative, infectious or inflammatory effusion etiology.
  • * Having prior inconclusive/non-diagnostic thoracentesis or pleuroscopy.
  • * Patient is deemed by the clinical team to be more appropriate for VATS biopsy.
  • * Terminally ill patients in whom a diagnosis will not change management, or who is unlikely to be a candidate for oncological treatment due to significant comorbidities.
  • * Pregnancy

Pleuroscopy First Versus Thoracentesis First in Patients with Suspected Malignant Pleural Effusions

Location Details

NCT06892691


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Locations


RECRUITING

United States, New York

Mount Sinai West

New York, New York, United States, 10019

RECRUITING

United States, New York

Mount Sinai Hospital

New York, New York, United States, 10029

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