The Effect of Combined Cryotherapy and Immunotherapy on Systemic T Cell Changes and Clinical Outcomes in Metastatic Non-small Cell Lung Cancer

Inclusion Criteria: * Patients with Eastern Cooperative Oncology Group (ECOG) performance score 0 - 1; * Patients with histologically confirmed metastatic non-small cell lung cancer and PD-L1 expression on tumor cells was evaluated; * CT examination shows measurable tumor formations according to the RECIST 1.1 criteria; * Primary lung tumor or metastasis accessible to flexible bronchoscopy; * Patients may have received surgery, adjuvant or neoadjuvant chemotherapy prior to the study if it was completed at least 12 months before relapse; * Patients informed about the purpose and course of the study and provided a written consent to participate. Exclusion Criteria: * Patients who refused to participate in the clinical trial and did not sign the informed consent form; * Men and women under the age of 18, pregnant women; * Patients belonging to a vulnerable social group; * High risk of general anesthesia, defined as American Society of Anesthesiologists (ASA) class 4 - 6; * Documented allergy to medications used during general and local anesthesia, systemic cancer treatment; * Patients previously treated with immune checkpoint inhibitors; * EGFR mutations or ALK translocations have been identified in patients; * Patients with previously diagnosed autoimmune diseases, active viral hepatitis, uncontrolled human immunodeficiency virus (HIV) infection or untreated tuberculosis; * Patients treated with immunosuppressive drugs, systemic corticosteroids, with equivalent doses of prednisolone exceeding 10 mg/day; * Patients with an increased risk of bleeding during an interventional procedure; * Acute untreated conditions that would make it impossible to perform an interventional lung procedure.