Drug-eluting beads bronchial arterial chemoembolization in advanced and standard treatment-refractory/ineligible NSCLC

Abstract

OBJECTIVES: The treatment strategy for previously standard treated non-small-cell lung cancer (NSCLC) still remained challenge. This study was to evaluate the effectiveness and safety of epirubicin-loaded drug-eluting bead transbronchial artery chemoembolization (D-BACE) plus bronchial artery infusion chemotherapy (BAIC) in patients with refractory advanced NSCLC. METHODS: Between January 2018 and December 2022, 32 patients with refractory advanced NSCLC (26 males; mean age of 64±9.3years [range 41-78]; 19 squamous carcinomas [59.4%]) who had received one or more previous standard treatments and received D-BACE (epirubicin 50mg) plus BAIC (lobaplatin 30 mg/m2) were included in our study. The study evaluated several parameters including local tumor response based on RECIST 1.1 criteria, progression-free survival (PFS), overall survival (OS), and complication rates. To examine the impact of different factors on PFS and OS, Kaplan–Meier and Cox regression analyses were performed. RESULTS: A total of 68 D-BACE plus BAIC sessions (median, 1, range 1-7) were performed. Overall response and disease control rates were 25% and 100%, respectively. The median PFS and median overall survival were 6.0 months (95% confidence interval (CI): 4.1–7.9) and 14.0 months (95% CI: 4.8–23.2), respectively. The number of cycles in the D-BACE plus BAIC treatment was found to be an independent predictor of PFS and OS. There were no instances of severe procedure-related complications or deaths during the study. CONCLUSIONS: The combination of D-BACE and BAIC shows great potential as a treatment choice for patients with refractory advanced NSCLC.