Evidence map›Paper›PMID 42015232›Full record

ReviewCancer cell international2026

Unraveling the multidimensional pleural ecosystem of lung cancer-associated malignant pleural effusion.

Shuting Cui, Guimei Wang, Xiaozhe Sun, Zhenyu Wang, Guoqi Zhou, Hanliang Jiang

Abstract readReview
In one paragraph

Review in Cancer cell international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Shuting CuiDepartment of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
Guimei WangDepartment of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
Xiaozhe SunDepartment of Critical Care Medicine, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Jiangsu, Suzhou, 215006, China.
Zhenyu WangDepartment of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
Guoqi ZhouPulmonary Disease Department, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, China.
Hanliang JiangDepartment of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China. aock@zju.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lung cancer–associated malignant pleural effusion (LC-MPE) is a defining manifestation of advanced disease and a clinically consequential pleural compartment associated with dyspnea, repeated pleural interventions, and poor outcomes. This review synthesizes current evidence across mechanisms, diagnostics, and therapeutics to reframe LC-MPE as an active pleural ecosystem rather than a passive fluid collection. We summarize how partially reversible CD8⁺ T-cell dysfunction, regulatory T-cell and macrophage programs, mesothelial/fibro-inflammatory remodeling, vascular leak with impaired drainage, and lactate- and lipid-linked metabolic reprogramming collectively sustain effusion formation, immune escape, and therapeutic resistance. We then appraise emerging diagnostic strategies according to clinical maturity. Conventional cytology and tissue confirmation remain the diagnostic backbone, whereas pleural supernatant cell-free DNA/circulating tumor DNA currently represents the most clinically mature liquid-biopsy platform; methylation assays are promising adjuncts, while extracellular vesicle-derived analytes, RNA biomarkers, multi-omics, and artificial intelligence-enabled models remain investigational. Therapeutically, drainage procedures, pleurodesis, and indwelling pleural catheters remain the foundation of care. Intrapleural PD-1 blockade and microparticle-based delivery provide early clinical proof of concept for regional pleural control, but should be viewed as adjuncts to, rather than replacements for, systemic therapy. Future progress will depend on biomarker-embedded multicenter trials, standardized pleural biospecimen and pharmacology workflows, and patient-centered endpoints. This mechanism-diagnosis-therapy continuum provides a practical framework for more precise, pleura-anchored management, with the potential to improve symptom control, reduce intervention burden, and ultimately support better patient-centered outcomes.

Indexed as

ImmunometabolismIntrapleural therapyLiquid biopsyLung cancerMalignant pleural effusionPrecision oncologyTumor microenvironment

Identifiers

PMID42015232
PMCPMC13251254

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.