Active immunotherapy is a promising systemic treatment for lung cancer, including advanced forms of the disease.
Lung cancer is the most common form of tumor in men and the leading cause of cancer death worldwide. It is divided into non-small cell and small cell types, and central or peripheral localizations.
Surgery remains the only radical method in the early stages. Radiochemotherapy for advanced forms primarily resolves palliative tasks and does not significantly affect survival rates.
So in advanced forms systemic immunotherapy is discussed. In our practice a clinical effect lasting at least 6 months has been seen in some of the vaccinated patients with stage IV disease.
Before immunotherapy can be discussed, the tumour has to be identified. Non-small cell and small cell lung cancer behave and are treated differently: small cell responds quickly to chemotherapy and relapses just as quickly, non-small cell responds less well but offers more systemic options. Within non-small cell disease the driver mutations matter: with EGFR, ALK, ROS1 and several others, targeted therapy comes first, and that is not up for discussion.
The second factor is general condition. In lung cancer it is often limited by breathlessness and respiratory failure, and it is condition rather than stage that determines what a patient can tolerate. So at the consultation the doctor looks both at the scans and at how you handle exertion, what your oxygen saturation is and whether you also have COPD.
Lung cancer is one of the most heavily mutated tumours, and that is also its weak point: the more changes in the cell, the more targets the immune system has.
Lung tumours, particularly smoking-related ones, accumulate many mutations. Each mutation is a potentially foreign protein by which the cell can be told apart from a healthy one. The method aims to make those differences visible to the immune system.
Lung tumours, particularly smoking-related ones, accumulate many mutations. Each mutation is a potentially foreign protein by which the cell can be told apart from a healthy one. The method aims to make those differences visible to the immune system.
Immune cells are isolated from the patient's blood, activated outside the body and directed against tumour antigens. The product is individual and made for a particular patient.
Immune cells are isolated from the patient's blood, activated outside the body and directed against tumour antigens. The product is individual and made for a particular patient.
The procedure is outpatient. In the first 24 hours a temperature up to 38 °C and a flu-like state are possible; in patients with marked breathlessness the doctor separately assesses how such a reaction will be tolerated.
The procedure is outpatient. In the first 24 hours a temperature up to 38 °C and a flu-like state are possible; in patients with marked breathlessness the doctor separately assesses how such a reaction will be tolerated.
In advanced lung cancer the realistic goal is not disappearance of the tumour but stabilisation and preserved quality of life: less breathlessness, less weakness, better exercise tolerance. Monitoring is by CT and by how you feel, every few months.
In advanced lung cancer the realistic goal is not disappearance of the tumour but stabilisation and preserved quality of life: less breathlessness, less weakness, better exercise tolerance. Monitoring is by CT and by how you feel, every few months.
Below are clinical cases in which the condition was held stable for a long time in disseminated lung cancer.
Patient E., 75 years old
Central squamous cell carcinoma of the right lung (T3N1Mx)
Baseline
Complaints of cough, shortness of breath at rest, weakness; Karnofsky index 70%. Tolerated treatment well: on vaccination days — subfebrile temperature and local redness, disappearing within hours.
Dynamics
3 years after starting immunotherapy, the patient noted improved well-being, reduced shortness of breath, and increased performance. Exams every 4 months showed no signs of progression.
Observation period
4.5 years after starting vaccine therapy, the condition is stable, and no disease progression has been observed.
Stable — observed for 4.5 years
Patient D., 50 years old
Central squamous cell carcinoma with metastases (T2N3M1)
Baseline
Started treatment in moderate condition: shortness of breath, weakness, cough, periodic hemoptysis, ESR 60 mm/h. In response to the first vaccination — fever up to 38.5°C.
Stabilization
Over 2 months, the condition stabilized, and symptoms eased. A year later, blood parameters normalized, and X-rays showed no negative dynamics.
Condition stabilization during observation
The decision depends on the type of tumour, the driver mutations and the patient's general condition.
Advanced disease where radiochemotherapy serves mainly palliative aims; the period after radical surgery with a high risk of recurrence; progression on standard treatment. The method applies to both non-small cell and small cell types.
The morphological type, driver mutation status (EGFR, ALK, ROS1) and PD-L1 level if they were tested. With a driver mutation or high PD-L1, the standard lines come first — the centre's immunotherapy does not replace them.
Acute infections and pneumonia, decompensated respiratory or cardiac failure, pregnancy, conditions with deliberate immunosuppression. With severe respiratory failure a febrile reaction to administration may be poorly tolerated — this is decided case by case.
Quitting is not a formal condition of treatment, but it affects tolerance and lung function noticeably. This is the rare case where what the patient does gives an effect comparable to the treatment itself.
Treatment is outpatient. The induction stage runs over several months, after which the schedule follows the response. For patients from other regions, visits are planned so that travel does not worsen their condition.
The immunorehabilitation course for tumour diseases costs from 285 000 ₽ and can be paid in stages. A consultation with the professor costs 10 000 ₽, with the oncologist 7 000 ₽.
In advanced forms the method offers a systemic option where chemoradiotherapy only addresses palliative goals.
The method is applicable to both non-small cell and small cell lung cancer.
Treatment is not accompanied by a heavy toxic burden and does not limit the patient's daily activity.
Yes. Active immunotherapy is regarded as a promising systemic option; there are clinical examples of long stabilisation in stage IV disease.
Yes. Immunotherapy brings in the resource of the patient's own immune system for a targeted attack on the tumour and combines with other treatment methods.
The method acts selectively and does not damage healthy cells, so it is tolerated considerably better than aggressive therapy.
Yes. The centre is next to Moscow (Khimki, Skhodnya) and accepts patients from other regions; the first consultation can be done remotely from your documents.
The histology or cytology report, mutation and PD-L1 status if available, recent chest CT with a written report, summaries of the treatment already given and current blood tests.
Yes, the method does not cancel prescribed regimens. Intervals are matched to the chemotherapy cycles and blood counts: during deep cytopenia a procedure is postponed.
The course costs from 285 000 ₽ and can be paid in stages. The centre issues the contract, receipts and a certificate of payment for medical services for a tax deduction.
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