Active immunotherapy for lung cancer
Lung cancer remains the most common cancer-related cause of death worldwide among men and women accounting for about 13% of all diagnosed new cancer cases. Surgery is the primary treatment strategy for patients in good general health with early-stage cancer. The primary purpose of cancer surgery is to remove completely lung tumor and draining lymph nodes, which is often technically difficult to perform (due to tumor size or awkward location) or contraindicated in some patients not fit for surgery. Radiochemotherapy of the advanced disease is considered to be of a palliative nature and has no significant influence on survival of patients. We believe that future advances in systemic treatment of lung cancer patients will be defined by developing immunotherapeutic technologies, such as XPV immunotherapeutic protocols.
Our extensive clinical experience suggests that cell vaccinations of patients with stage IV lung cancer can achieve various degrees of clinical responses (complete or partial response, disease stabilization) of more than 6 months’ duration in a significant proportion of vaccinees. Although our clinical results are encouraging, they must be interpreted with caution due to a small number of patients with very advanced disease treated in our study.
Case 1. A 50-year-old patient was diagnosed with central squamous carcinoma of the left low-lobar bronchus, metastatic lesions in the upper lobe of the right lung and in regional lymph nodes (T2 N3M1), and atelectasis of 6 segment on the right. The patient presented with dyspnea at rest, cough with blood-streaked sputum, general weakness and low back pain. ERS was 60 mm/h. Vaccination caused a short-term increase in body temperature to 38.5ºC. Patient’s condition remained stable over 7-month time, after which hemoptysis and weakness came gradually forward. Due to the pronounced weakness, the patient was bedridden. Symptomatic therapy was escalated, and in a month time life-threatening symptom disappeared and his condition stabilized. One year after the onset of vaccine therapy, ultrasonography showed a focal lesion (56×54 mm) in the right kidney (blood parameters were normal), and the patient developed intermittent macrohematuria. Three years later, X-ray examination showed rugged pneumofibrosis, and CT detected signs of focal lesion (49.5×56.4 mm.) in the right kidney and a focus (27.9×61.2×70 mm) of bone destruction was noted in the hucklebone. The right kidney was surgically removed, and a metastatic lesion was confirmed histologically. A final follow-up 4.5 years after vaccine therapy found the patient in good condition without any signs of disease progression.
Case 2. A 75-year-old patient was diagnosed with сentral squamous carcinoma of the right lung with X-ray signs of metastatic lesions in S3 segment on the left and in II intercostal space on the right. The patient presented with dyspnea at rest, cough with moderate quantity of phlegm and marked general weakness. Vaccine therapy was well tolerated. A final follow-up 3 years after vaccinotherapy showed a significant amelioration of disease symptoms and no signs of disease progression.