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Volume 15
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10.3390/diagnostics15020201
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Article

Early Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study

by
Gediminas Vasiliauskas
1,*,
Evelina Žemaitė
2,
Erika Skrodenienė
2,
Lina Poškienė
3,
Gertrūda Maziliauskienė
4,
Aurimas Mačionis
4,
Skaidrius Miliauskas
1,
Donatas Vajauskas
4 and
Marius Žemaitis
1
1
Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
2
Department of Laboratory Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
3
Department of Pathology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
4
Department of Radiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(2), 201; https://doi.org/10.3390/diagnostics15020201
Submission received: 4 December 2024 / Revised: 8 January 2025 / Accepted: 15 January 2025 / Published: 17 January 2025
(This article belongs to the Special Issue Lung Cancer: Screening, Diagnosis and Management)
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Abstract

Background/Objectives: Cryotherapy is used for local tissue destruction through rapid freeze–thaw cycles. It induces cancer cell necrosis followed by inflammation in the treated tumor microenvironment, and it stimulates systemic adaptive immunity. Combining cryotherapy with immunotherapy may provide a sustained immune response by preventing T cell exhaustion. Methods: Fifty-five patients with metastatic non-small cell lung cancer who had received no prior treatment were randomized into two groups in a 1:1 ratio: the bronchoscopic cryotherapy group or the control group. Patients received up to four cycles of pembrolizumab as monotherapy or in combination with platinum-based chemotherapy. Immune-related adverse events (irAEs), complications, tumor size changes, overall response rate (ORR), and disease control rate (DCR) were evaluated. Results: Lung tumors, treated with cryotherapy, demonstrated continuous reduction from the baseline (22.4 cm2 vs. 14.4 cm2 vs. 10.2 cm2, p < 0.001). Similar changes were observed in pulmonary tumors in the control group (19.0 cm2 vs. 10.0 cm2, p < 0.001). The median change in pulmonary tumors between two groups was not significant (−42.9% vs. −27.7%, p = 0.175). No significant differences were observed in the ORR (28.6% vs. 23.1%, p = 0.461) or target lesion decrease (−24.0% vs. −23.4%, p = 0.296) between the groups. However, the DCR was significantly higher in the cryotherapy group (95.2% vs. 73.1%, p = 0.049). No cases of serious bleeding during cryotherapy or pneumothorax were observed. Six patients (25.0%) in the cryotherapy group and eight (26.7%) in the control group experienced irAEs. Conclusions: Our study demonstrated that combined bronchoscopic cryotherapy and immunotherapy with or without chemotherapy may reduce the rate of progressive disease in metastatic non-small cell lung cancer patients while maintaining a satisfactory safety profile.
Keywords: lung cancer; cryotherapy; immunotherapy lung cancer; cryotherapy; immunotherapy

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MDPI and ACS Style

Vasiliauskas, G.; Žemaitė, E.; Skrodenienė, E.; Poškienė, L.; Maziliauskienė, G.; Mačionis, A.; Miliauskas, S.; Vajauskas, D.; Žemaitis, M. Early Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study. Diagnostics 2025, 15, 201. https://doi.org/10.3390/diagnostics15020201

AMA Style

Vasiliauskas G, Žemaitė E, Skrodenienė E, Poškienė L, Maziliauskienė G, Mačionis A, Miliauskas S, Vajauskas D, Žemaitis M. Early Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study. Diagnostics. 2025; 15(2):201. https://doi.org/10.3390/diagnostics15020201

Chicago/Turabian Style

Vasiliauskas, Gediminas, Evelina Žemaitė, Erika Skrodenienė, Lina Poškienė, Gertrūda Maziliauskienė, Aurimas Mačionis, Skaidrius Miliauskas, Donatas Vajauskas, and Marius Žemaitis. 2025. "Early Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study" Diagnostics 15, no. 2: 201. https://doi.org/10.3390/diagnostics15020201

APA Style

Vasiliauskas, G., Žemaitė, E., Skrodenienė, E., Poškienė, L., Maziliauskienė, G., Mačionis, A., Miliauskas, S., Vajauskas, D., & Žemaitis, M. (2025). Early Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study. Diagnostics, 15(2), 201. https://doi.org/10.3390/diagnostics15020201

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