Drug-eluting beads bronchial arterial chemoembolization/bronchial arterial infusion chemotherapy with and without PD-1 blockade for advanced non-small cell lung cancer: a comparative single-center cohort study

Figures

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  Figure 1. Patient selection flowchart. NSCLC, non-small cell lung cancer; DEB-BACE, drug-eluting beads bronchial artery chemoembolization; BAI, bronchial artery infusion chemotherapy; PD-1, programmed cell death protein 1; PD-L1, programmed cell death ligand 1.

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  Figure 2. Comparison of median PFS or OS between groups A and B. (A) The estimated median PFS was 12.0 months for patients in group A, while that was 3.0 months for patients in group B. (B) The estimated median OS was 27.0 months for patients in group A, while that was 8.0 months for patients in group B. Group A: combination therapy group; Group B: DEB-BACE/BAI group. PFS, progression-free survival; OS, overall survival; NSCLC, non-small cell lung cancer; DEB-BACE, drug-eluting beads bronchial artery chemoembolization; BAI, bronchial artery infusion chemotherapy.

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  Figure 3. A typical case of advanced NSCLC treated with DEB-BACE/BAI plus PD-1 blockade. (A,B,C) A patient with tumor subtype of adenocarcinoma and primary tumor stage of IV (T1N2M1) has received first-line systemic chemotherapy (pemetrexed plus carboplatin) and anti-angiogenesis therapy (bevacizumab). The CT scans presented with the enlarged pulmonary lesion (white arrow), a new diagnosis of liver metastasis (black arrow), which reveals the resistance to standard treatments. (D) DEB-BACE/BAI was undergone, with a microcatheter being used for super-selective catheterization (white arrow). Right bronchial artery was detected as the tumor-feeding artery and abundant tumor staining was found during the angiography (black arrow). The 300–500 µm CalliSpheres microspheres loaded with gemcitabine (800 mg) were injected into the target arteries via microcatheter for chemoembolization (white arrow). (E) The procedure was terminated when the disappearance of tumor staining (black arrow). A total of 3 cycles of DEB-BACE/BAI and concurrent PD-1 blockades of camrelizumab (200 mg) were performed and additional 6 cycles of immunotherapy were administered per month. (F,G) The CT scans at 3 months after…

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  Figure 4. Kaplan-Meier analyses of PFS in advanced NSCLC treated with DEB-BACE/BAI. (A) The estimated median PFS was 12 months for patients treated with immunotherapy, compared with 3 months for those patients without. (B) The estimated median PFS was 6 months for patients with tumor diameter <6 cm, compared with 4 months for patients with tumor diameter ≥6 cm. (C) The estimated median PFS was 3 months for patients treated with a single cycle of DEB-BACE/BAI, compared with 8 months for those patients treated with multiple cycles. PFS, progression-free survival; NSCLC, non-small cell lung cancer; DEB-BACE, drug-eluting beads bronchial artery chemoembolization; BAI, bronchial artery infusion chemotherapy.

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  Figure 5. Kaplan-Meier analyses of OS in advanced NSCLC treated with DEB-BACE/BAI. (A) The estimated median OS was 27 months for patients treated with immunotherapy, compared with 8 months for those patients without. (B) The estimated median OS was 3 months for patients with extrapulmonary metastases, compared with 13 months for those patients without. (C) The estimated median OS was 17 months for patients with tumor diameter <6 cm, compared with 7 months for patients with tumor diameter ≥6 cm. (D) The estimated median OS was 3 months for patients treated with a single cycle of DEB-BACE/BAI, compared with 15 months for those patients treated with multiple cycles. OS, overall survival; NSCLC, non-small cell lung cancer; DEB-BACE, drug-eluting beads bronchial artery chemoembolization; BAI, bronchial artery infusion chemotherapy.