# TIME2

Source: https://onco.cc/trials/time2/  
OnCo record `time2` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Compared a permanent drain you empty at home with the older operation that glues the lung to the chest wall, and found both relieve breathlessness equally, so the choice is about what a patient wants.

## Summary

A malignant pleural effusion is one of the commonest causes of disabling breathlessness in lung cancer, and it recurs. TIME2 recruited 106 of 143 patients at seven United Kingdom hospitals between April 2007 and February 2011 and randomised them to an indwelling pleural catheter, inserted as an outpatient with a large initial drainage, education and subsequent home drainage, or to admission for chest tube insertion and talc slurry pleurodesis. Patients scored their breathlessness daily on a 100 mm visual analogue scale for 42 days; 10 mm is the minimum clinically important difference.

Breathlessness improved in both groups and there was no significant difference over the first 42 days: mean score 24.7 mm (95 percent confidence interval 19.3 to 30.1) with the catheter against 24.4 mm (19.4 to 29.4) with talc, a difference of 0.16 mm (-6.82 to 7.15, p=0.96). The catheter group spent fewer days in hospital; the talc group needed fewer further pleural procedures.

TIME2 is why an indwelling pleural catheter is offered as a first-line option rather than a salvage one, and why the decision is framed around hospital time and trapped lung rather than around symptom control, which the two methods deliver equally.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-25
- Also known as: Second Therapeutic Intervention in Malignant Effusion Trial
- Registry id: ISRCTN87514420
- Phase: 3
- Setting: Malignant pleural effusion without previous pleurodesis: an indwelling pleural catheter inserted as an outpatient with home drainage, versus admission for chest tube and talc slurry pleurodesis, with daily 100 mm visual analogue breathlessness scores over 42 days as the primary outcome
- Sponsor: Oxford Radcliffe Hospitals and the UK pleural research collaboration
- Enrolled: 106
- Result: No significant difference in breathlessness over 42 days (24.7 against 24.4 mm on a 100 mm scale, difference 0.16 mm, p=0.96); fewer hospital days with the catheter.
- Outcomes: Mean breathlessness, 0-42 days (100 mm visual analogue scale): Indwelling pleural catheter 24.7 vs Chest tube and talc pleurodesis 24.4
- Replication: AMPLE reproduced the equivalence for symptom control and showed the catheter reduces total hospital days.

## Sources

- TIME2 (JAMA 2012): https://doi.org/10.1001/jama.2012.5535
- ISRCTN87514420: https://www.isrctn.com/ISRCTN87514420

## Connected records

- cancers: [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Pleural mesothelioma](https://onco.cc/cancers/pleural-mesothelioma/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- technologies: [Early integrated palliative care](https://onco.cc/technologies/palliative-care/)
- terms: [Malignant pleural effusion and ascites](https://onco.cc/terms/pleural-effusion/), [Palliation in lung cancer: breathlessness, pleural effusion, blocked airway, bone and brain](https://onco.cc/terms/lung-palliation-breathlessness-effusion-obstruction/), [Palliative](https://onco.cc/terms/palliative-treatment/)
- trials: [AMPLE](https://onco.cc/trials/ample/)

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