Objective:

To analyze the efficacy and safety of tislelizumab plus bronchial arterial chemoembolization followed by tislelizumab and systemic chemotherapy in advanced NSCLC patients with bulky tumors (T ≥ 50 mm).

Approach:

• Study Design: Retrospective analysis of 68 patients with advanced NSCLC (IIIB-IVB) and bulky tumors, divided into two groups based on treatment received.
• Treatment Groups: Group A received tislelizumab plus BACE followed by tislelizumab and systemic chemotherapy; Group B received tislelizumab plus chemotherapy alone.
• Outcome Measures: Outcomes included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety.

Key Findings:

• Group A had a significantly higher ORR (79.41%) compared to Group B (44.12%), p = 0.006.
• Median PFS was significantly longer in Group A (12.47 months) than in Group B (7.73 months), HR: 0.55, 95% CI: 0.30-0.99, p = 0.024.
• No statistically significant difference in median OS between groups (20.73 months in Group A vs 19.63 months in Group B, p = 0.071).
• Multivariate analysis identified sequential treatment strategy and tumor diameter as independent favorable predictors of PFS.
• Most frequent grade 3 or higher treatment-related adverse events included neutropenia, anemia, and thrombocytopenia.

Interpretation:

Limitations:

• Retrospective design may introduce selection bias, affecting the reliability of the findings.
• Single-center study limits generalizability of findings.
• Non-randomized allocation of patients to treatment groups.

Conclusion:

The combination of tislelizumab, BACE, and systemic chemotherapy may provide a favorable treatment option for patients with advanced NSCLC and bulky tumors.