This is a single center, phase 1 / 2 randomized safety and feasibility study in which 24 patients participate for 3 months.

Bronchoscopic transbronchial needle injection (TBNI) of Tremelimumab (n=16)/placebo(n=8) in mediastinal/hilar lymph node or primary lung tumor

• Safety and feasibility of intranodal and intratumoral TBNI
• Pharmacokinetics of therapeutic antibodies in plasma after TBNI

1. Pathologically confirmed, T1-2N0M0 NSCLC
2. Considered a surgical lung tumor resection candidate, as determined by the pulmonologist and lung surgeons at the multidisciplinary tumor meeting.
3. Above 18 years of age on day of signing informed consent

• Subjects with a condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of TBNI.
• Additional malignancy that is progressing or requires active systemic treatment.
• Active or prior documented autoimmune or inflammatory disorders
• Uncontrolled intercurrent illness that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent
• Active infection requiring systemic therapy.
• A history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
• Active infection including tuberculosis, hepatitis B, hepatitis C.
• Psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
• Has received prior therapy with an anti-PD-1, anti-PD-L1 including durvalumab, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways in the past year.
• Patient is pregnant or breastfeeding
• Patients with known oncogenic drivers such as activating EGFR or BRAF mutations or ALK or ROS1 gene rearrangements