Advances in Pleural Disease in 2025

Gary Lee
University of Western Australia, Perth, Australia

Knowledge from clinical trials has revolutionised the management of pleural diseases in recent decades. These advances have made pleural medicine as one of the most rapidly evolving sub specialties within respiratory medicine. The global expansion of pleural units and specialist-led services has driven progress in research, training, and clinical care. Diagnostic accuracy has been enhanced through widespread use of bedside thoracic ultrasound and the discovery of novel pleural fluid biomarkers. Less invasive, and increasingly non-invasive approaches have replaced traditional surgical interventions, particularly those shown to be ineffective or harmful in randomised controlled trials. This lecture will highlight key advances across the pleural disease spectrum, with a focus on malignant effusions, pneumothorax, and pleural infection, and explore how new evidence is reshaping everyday clinical practice.