1336P - Clinical outcomes, toxic effect, and changes of immune microenvironment of drug-eluting beads bronchial artery chemoembolization (DEB-BACE) combined with immunotherapy in the treatment of elder patients with non-small cell lung cancer

Background

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide and the elderly patients with lung cancer is increasing. DEB-BACE has been investigated as one of the methods for patients with advanced lung cancer. The application of DEB-BACE in patients aged 70 years or older has been reported in the past, but the effect, safety and immune microenvironment of DEB-BACE combined with immunotherapy in the elder has not been demonstrated.

Methods

From October 2019 to January 2022, elderly patients with pathologically diagnosed stage IIIB to IV NSCLC with negative driver gene mutations who received DEB-BACE combined with immunotherapy as first-line treatment were enrolled in this retrospective study. They were all aged ≥70 years and cannot tolerate intravenous chemotherapy. The response was assessed according to the RECIST v1.1 criteria. The progression-free survival (PFS), overall survival (OS) and adverse events were collected. Neutrophil/lymphocyte ratio (NLR), and CD4/CD8 levels were also collected before and after treatment.

Results

A total of 122 patients were included in the final analysis,85 male and 37 female included. The median age of the cohort was 74.6 years, and 70% patients had a performance status ≥1. After a median follow-up of 24 months (95% CI:17.3-25.1), the median PFS and median OS were 9.6 months and 21.2 months.The common adverse events were nausea (36.1%,44/122), vomiting (27.8%,34/122), anemia (13.9%,17/122), decreased appetite (24.5%,30/122), decreased neutrophil count (11.4%,14/122), increased serum creatinine (8.3%,10/122), decreased platelet count (5.7%,7/122). 5 patients (4.1%) occurred grade 3 or higher immune-related adverse events. No patients occurred treatment-related deaths or unexpected embolization. The initial NLR and CD4/CD8 levels before treatment were 3.62±0.30 and 4.16±0.10, while the NLR and CD4/CD8 levels after treatment were 7.84±0.20 and 0.72±0.16.

Conclusions

DEB-BACE combined with immunotherapy has promising efficacy and well tolerated in patients aged 70 years and older advanced NSCLC and it might be an optimal option.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.