Lung cancer is classified into two primary subtypes: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), which differ in molecular profile, biological behavior, and sensitivity to systemic therapy.
Immunotherapy represents one of the key directions in the systemic treatment of lung cancer, particularly in the non-small cell variant, which is characterized by immunological and molecular features that may influence tumor sensitivity to immune-based interventions. The selection of a therapeutic strategy takes into account PD-L1 expression, tumor mutational burden (TMB), and the characteristics of the tumor microenvironment — factors relevant both in localized disease and in metastatic lung cancer.
Within the framework of an individualized protocol, alongside registered agents, additional immunotherapy methods aimed at activating and sustaining immune control over the tumor process may be considered in select cases.
Oncolytic Virus Therapy
Oncolytic virus therapy may be incorporated into an individualized lung cancer treatment protocol as one of the components of comprehensive immunotherapy.
Oncolytic viruses selectively target and replicate within tumor cells, using their intracellular mechanisms, a process may lead to the death of the infected cell. Released viral particles then enter neighboring tumor cells, sustaining localized anti-tumor activity within the tumor site.
Through this process, oncolytic virus therapy can directly damage and destroy tumor cells, trigger the release of tumor antigens, engage the immune system in recognizing cancer cells, and generate a local inflammatory response that enhances the effect of subsequent treatment stages.
Depending on clinical indications, the method may be combined with direct intratumoral virus injection or integrated with other therapeutic approaches within a comprehensive treatment plan.
Checkpoint Inhibitor Therapy
Tumor cells evade immune recognition in two ways: by reducing their own visibility to the immune system, or by actively suppressing the immune response through regulatory mechanisms known as immune checkpoints. Oncolytic virus therapy addresses the first of these mechanisms. Infected tumor cells acquire viral antigens that the immune system recognizes as foreign, making them visible targets for immune attack.
Checkpoint inhibitors target the second mechanism. Under normal conditions, immune checkpoints protect the body’s own tissues from autoimmune reactions; however, tumor cells exploit this same pathway to weaken the anti-tumor immune response. Checkpoint inhibitors block this suppression and help restore the ability of immune cells to attack the tumor.
Following completion of the oncolytic virus therapy course, checkpoint inhibitors are considered as the next stage of treatment. This sequence reflects the specifics of their immune action: activating the immune response too early, while the virus is still working, can reduce its effectiveness. In this two-stage approach, viral therapy makes the tumor visible to the immune system, while checkpoint inhibitors remove the suppressive protection that the tumor has established.
In cases of intolerance or unavailability of checkpoint inhibitors, cytokine-mediated immunotherapy may be considered as an alternative.
Anti-Cancer Vaccines for Lung Cancer
When cryopreserved tumor tissue is available, a personalized anti-cancer vaccine can be prepared based on the patient’s own tumor material. Unlike preventive vaccines against infectious diseases, these vaccines are designed to train the immune system to recognize and target tumor-specific antigens in a given patient with lung cancer.
The patient’s tumor material undergoes specialized laboratory processing and is then administered as an immunological stimulus. This approach may help enhance immune recognition of tumor cells that were previously less visible to the immune system.
Preparation of a personalized vaccine requires a tumor tissue sample obtained through biopsy or surgical intervention and preserved by cryopreservation.
Photodynamic Therapy for Lung Cancer
Photodynamic therapy (PDT) may be integrated into a comprehensive immunotherapeutic approach as a method of both direct tumor destruction and immune activation. PDT uses photosensitizers that selectively accumulate in tumor cells and are activated by light of a specific wavelength, generating reactive oxygen species that damage cancer cells.
The combined use of PDT may:
- contribute to localized destruction of tumor lesions;
- stimulate an anti-tumor immune response;
- potentiate the efficacy of other therapeutic components.
Photodynamic therapy for lung cancer is typically administered in combination with oncolytic virus therapy. This approach allows for the integration of the direct cytotoxic effect of PDT with viral oncolysis and subsequent immunotherapy, potentially enhancing the destruction of drug-resistant tumor cells and augmenting immune recognition of tumor-associated antigens.
ATACK: Donor Lymphocyte Therapy
ATACK (Allogeneic Targeted Activated Cancer Killer cells) is a method of cellular immunotherapy that uses specially prepared donor immune cells (such as T cells and NK cells), for targeted action against tumor cells. The key principle of the method is the use of donor cells that are intentionally different from the patient’s own cells. This difference allows them to recognize cancer cells as foreign and trigger a more pronounced immune elimination response.
To enhance targeting specificity, monoclonal antibodies directed against antigens expressed on the surface of tumor cells may be applied.
ATACK may be considered within an individualized treatment protocol, especially in the setting of minimal residual disease (MRD), when the primary tumor burden has been reduced and the therapeutic strategy is focused on controlling remaining tumor cells.
Who May Be Considered for Immunotherapy in Lung Cancer?
Immunotherapy for lung cancer, including metastatic forms of the disease, may be considered for patients who:
- have not achieved a clinically meaningful response to standard treatment approaches for lung cancer;
- are exploring additional therapeutic options after completion of standard therapy;
- have the ability to travel abroad to receive specialized treatment.
Depending on the individual characteristics of the lung cancer, specific immunotherapy methods may be considered in the presence of the following factors:
- specific molecular, genetic, and immunological tumor characteristics relevant to the selection of a personalized immunotherapy protocol.
- tumor material (fresh or cryopreserved) that, in selected cases, may be used for the development of a personalized anti-cancer vaccine.
How Each Case Is Evaluated
Prior to the development of an individualized immunotherapy protocol for lung cancer, a comprehensive clinical and diagnostic evaluation is performed, including:
- a detailed analysis of previously administered treatment methods and their outcomes;
- review of imaging data (MRI, CT, PET-CT) to assess the extent and localization of the disease;
- evaluation of molecular and genetic testing results or recommendations for additional testing when necessary.
How Treatment Is Conducted
Immunotherapy programs for lung cancer generally include the following stages:
- an individual online consultation with Professor Shimon Slavin;
- treatment planning and development of a personalized therapeutic protocol;
- delivery of lung cancer immunotherapy procedures in partner clinics in Germany or Kazakhstan, in line with local regulatory requirements;
- application of additional immunotherapy methods when medically indicated;
- in-person and remote patient follow-up and support.
Treatment involves coordination among several specialized medical centers to ensure a comprehensive and integrated approach.
International Patient Support
For patients traveling from other countries to receive treatment, the following support is provided:
- guidance and assistance throughout all stages of international treatment;
- support with medical travel arrangements;
- remote follow-up and support after returning home;
- coordination with local treating physicians for continued monitoring.
Next Steps
To determine whether immunotherapy for lung cancer may be considered in your case:
- complete the contact form on the website;
- submit medical records for preliminary review;
- schedule an individual consultation.
Each clinical case is reviewed on an individual basis. Immunotherapy programs for metastatic breast cancer may be of interest to patients who have already undergone standard treatment stages and are exploring additional therapeutic options.
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