To evaluate the safety and efficacy of intravenous injection of intrapericardial bevacizumab (BEV) for treating symptomatic malignant pericardiac effusion (MPCE) in seven advanced lung cancer patients, who had previously undergone multiple lines of systemic therapy.

Seven advanced lung cancer patients with medium or large amount of MPCE admitted to our hospital from January 2014 to April 2019 were enrolled for this study. All the patients received intravenous injection of bevacizumab (400 mg every day) for two or three weeks until the symptoms were improved. Systemic therapy for the primary lung cancer was continued for all the patients during the BEV treatment. The medical record, including disease progression, progression-free survival, overall survival and side effects, had been reported until the patient died.

The MPCE in five patients increased no more after BEV treatment. Among the five patients, complete remission was found in the symptoms of two patients and partial remission was found in three patients. Two patients showed no response with regard to the MPCE after BEV treatment. The median overall survival time was 214 days, and the progression-free survival time was 24.28 months. One patient suffered from thrombosis, which was remissed after the patient received anticoagulant therapy. The toxicity associated with BEV treatment of six patients was mild and manageable.

BEV may be an effective and safe treatment for MPCE in the patients with advanced lung cancer, which needs further verifications in large-scale clinical studies.