Seven previously heavily pretreated patients with malignant pleural disease and effusions were treated with 12 courses of combination intrapleural chemotherapy with cisplatin, cytarabine, and doxorubicin. Two patients with ovarian cancer metastatic to the pleura demonstrated dramatic clinical improvement following therapy. Local pain, nephrotoxicity, or bone marrow suppression were not observed during this trial. Further investigation of intrapleural therapy utilizing an escalated dose of cytarabine is warranted.