Ishida 2006.

Methods	Single centre RCT of intrapleural cisplatin vsOK‐432 vs combination (Japan)
Participants	Inclusion criteria: symptomatic, histocytologically confirmed pleural malignancy secondary to Non‐small cell lung cancer(NSCLC), ECOG performance score 0‐3, adequate renal, haematological and cardiac function Exclusion Criteria: previous intrapleural therapy, trapped lung or atelectasis after chest tube inserted 49 participants randomised
Interventions	All participants underwent pleural fluid drainage via a 20 Fr chest tube. After administration of the allocated treatment, chest drain was clamped for six hours and then connected to 20 cm H2O suction. Drain removed when < 100 ml/day Cisplatin group: 50 mg cisplatin via chest tube on day 1 and 4 ok‐432 group: one dose of 5 KEOK‐432 via chest tube Combination group: 50 mg cisplatin on day 1 and 4, followed by 5 KEOK‐432 on day 7
Outcomes	Effusion recurrence (as defined by a newly detected effusion needing drainage or occupying > 33% of pleural space on CXR); mortality; adverse events
Notes	people with trapped lung excluded from the study Study authors contacted for further information, but no response Not included in network meta‐analysis
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not stated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding of participants and personnel (performance bias) All outcomes	High risk	No mention of blinding but participants received different dosing regimes depending on study arm
Blinding of outcome assessment (detection bias) All outcomes	High risk	Adverse event reporting could be affected by knowledge of treatment allocation. Not stated whether CXR interpretation was performed in a blinded fashion for definition of pleurodesis efficacy
Incomplete outcome data (attrition bias) All outcomes	Low risk	Number of deaths clearly stated. If participants died, still included in analysis for pleurodesis success prior to death
Selective reporting (reporting bias)	Low risk	All pre‐defined outcomes reported
Other bias	High risk	Drain left in for different duration in the three groups. Steroids were given to participants who received cisplatin