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Oncomycin (lipoteichoic acid-T, LTA-T) is a biological immunostimulatory agent derived from gram-positive bacterial cell wall components. Developed by the Oxford Pleural Unit at the University of Oxford with funding from Lunamed, it is being investigated for the treatment of malignant pleural effusion. The drug acts as an agonist for Toll-like receptor 2 (TLR-2), triggering NF-κB signalling and a localized pro-inflammatory response within the pleural cavity. This inflammation promotes fibrin production and subsequent collagen deposition, leading to pleurodesis (adhesion of the pleural membranes) to prevent fluid re-accumulation. It is administered intrapleurally via an indwelling pleural catheter.
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