We report that thalidomide [11], lenalidomide (an analog of thalidomide) [12] and bortezomib (a proteosome inhibitor) [13] may have potentially important roles for treating refractory pleural effusion accompanying systemic AL amyloidosis because these drugs have been reported to inhibit the expression of VEGF [14-16]. The gene discussed is VEGFA; the disease is Pleural effusion.