Stage IV Lung Squamous Cell Carcinoma Treated With or Without Bronchial Artery Chemoembolization After First-line Chemotherapy and Immunotherapy

This study aimed to evaluate the differences in efficacy (e.g., progression-free survival, overall survival, objective response rate, and incidence of adverse events) and safety (e.g., incidence of adverse events) between tislelizumab therapy combined with 1-3 cycles of bronchial artery chemoembolization (with gemcitabine) and tislelizumab monotherapy in patients with stage IV squamous cell lung cancer who achieved partial remission or disease stabilization after standard first-line treatment (carboplatin + paclitaxel chemotherapy + tislelizumab immunotherapy, 4-6 cycles). The goal was to explore ways to optimize first-line treatment strategies and further improve the overall efficacy of first-line treatment for patients with advanced squamous cell lung cancer.

Inclusion criteria

• Squamous cell carcinoma of the lung confirmed by histology or cytology;
• According to the TNM staging system of the 9th edition of American Cancer Association, it was assessed as stage IV.
• Has received standard first-line chemotherapy immunotherapy for 4~6 cycles, and achieved partial remission or disease stability according to the efficacy evaluation of RECIST1.1;
• The patient is 18-80 years old;
• ECOG PS score is 0-1;
• The main organ functions meet the following criteria: (1) Blood routine examination: hemoglobin (HB) ≥ 90g/L; Leukocyte (ANC) ≥ 3.0× 109/L; Neutrophils ≥ 1.5× 109/L; Platelet (PLT) ≥ 75× 109/L; (2) Biochemical examination: albumin (ALB)≥29g/L; Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2uln; Total bilirubin (TBIL) ≤ 1.5 ULN; Creatinine ≤ 1.5 ULN;
• Patients and/or their families agree to participate in clinical trials and sign informed consent forms;
• No history of other malignant tumors;
• No active infection;
• Be able to cooperate with research follow-up;
• At least one measurable lesion (according to RECIST 1.1);
• The expected survival time is more than 3 months.

Exclusion criteria

• There is epidermal growth factor receptor (EGFR) sensitive mutation or anaplasticlymphomakinase (ALK) gene translocation;
• Have a history of allergy to contrast agents or chemotherapy drugs;
• Received other anti-tumor treatments other than standard first-line chemotherapy immunotherapy;
• Arrhythmia with myocardial ischemia or myocardial infarction above grade II and poor control (including QTc interval ≥450ms for men and ≥ 470 ms for women);
• Coagulation function is seriously abnormal and cannot be corrected;
• Hypertension patients still have poor blood pressure control (systolic blood pressure > >160mmHg, diastolic blood pressure > 100 mmhg) after antihypertensive drugs treatment;
• Pregnant or lactating female patients;
• Have a history of mental illness or psychotropic drug abuse;
• Patients with symptomatic brain metastasis;
• Patients with autoimmune diseases;