Comparing pleuroscopy and thoracentesis for diagnosing malignant pleural effusions

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

NA · Icahn School of Medicine at Mount Sinai · NCT06892691

This study is testing whether pleuroscopy or thoracentesis is better for diagnosing cancer in patients with fluid buildup in the chest.

Quick facts

PhaseNA
Study typeInterventional
Enrollment98 (estimated)
Ages18 Years and up
SexAll
SponsorIcahn School of Medicine at Mount Sinai (other)
Locations2 sites (New York, New York and 1 other locations)
Trial IDNCT06892691 on ClinicalTrials.gov

What this trial studies

This randomized control trial aims to determine whether pleuroscopy or thoracentesis is more effective as the first diagnostic procedure for patients with suspected malignant pleural effusions. Participants will be randomly assigned to undergo either pleuroscopy or thoracentesis first, with the goal of assessing which method yields more adequate biopsy samples and leads to a quicker diagnosis and initiation of cancer treatment. Standard imaging techniques, such as ultrasound and chest x-ray, will be utilized as part of the procedure, but no additional research imaging will be performed. The study will also evaluate the need for further diagnostic steps if the initial procedure is inconclusive.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who are referred for a diagnostic pleural procedure due to suspected malignant pleural effusion.

Not a fit: Patients who have a known malignant pleural effusion or those with other specific conditions that preclude participation will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to faster and more accurate diagnoses for patients with suspected malignant pleural effusions, facilitating timely oncologic treatment.

How similar studies have performed: While both pleuroscopy and thoracentesis are standard procedures, this study's direct comparison of their effectiveness as first-line diagnostics is a novel approach.

Eligibility criteria

Show full inclusion / exclusion 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

Where this trial is running

New York, New York and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Pleural Effusion, Cancer

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.