What Is Cancer Immunotherapy?
Immunotherapy represents one of the most significant breakthroughs in cancer treatment in decades. Unlike chemotherapy, which directly attacks cancer cells (and healthy cells along with them), immunotherapy harnesses your body's own immune system to recognize and destroy cancer. This approach has transformed outcomes for many cancers that were previously considered untreatable, including advanced melanoma, lung cancer, and certain blood cancers.
The most widely used immunotherapy drugs — checkpoint inhibitors like pembrolizumab (Keytruda) and nivolumab (Opdivo) — work by removing the 'brakes' that cancer cells use to hide from the immune system. Once unmasked, the immune system can attack the cancer with remarkable precision. In the US, however, these drugs cost $12,000-$15,000 per infusion, with treatment continuing for 12-24 months.
Immunotherapy Cost Comparison
The cost disparity for immunotherapy between the US and international markets is staggering. The same FDA-approved Keytruda infusion that costs $12,000 in a US hospital may cost $3,000-$5,000 at an accredited Turkish hospital, using the identical drug manufactured by Merck. This price difference exists because many countries negotiate drug prices at the national level, resulting in dramatically lower costs passed on to patients.
Immunotherapy Cost Comparison 2025 (Per Year)
| Country | Keytruda/Opdivo | CAR-T Therapy | Savings vs USA |
|---|---|---|---|
| USA | $150,000 - $200,000 | $350,000 - $475,000 | — |
| Turkey | $40,000 - $70,000 | $80,000 - $150,000 | Up to 70% |
| India | $25,000 - $50,000 | $50,000 - $100,000 | Up to 80% |
| Germany | $80,000 - $120,000 | $180,000 - $280,000 | Up to 40% |
| South Korea | $50,000 - $80,000 | $100,000 - $180,000 | Up to 60% |
| Thailand | $45,000 - $75,000 | Limited availability | Up to 65% |
| Israel | $70,000 - $100,000 | $150,000 - $250,000 | Up to 50% |
| Spain | $55,000 - $85,000 | $160,000 - $240,000 | Up to 55% |
Prices for Keytruda/Opdivo reflect annual treatment costs. CAR-T therapy is a one-time treatment. Costs may vary based on indication and treatment duration.
CAR-T cell therapy, the most advanced form of immunotherapy, offers even more dramatic savings. In the US, the drug alone (Kymriah or Yescarta) costs $373,000-$475,000, plus hospital fees that can push the total past $1 million. In India and Turkey, hospitals such as Liv Hospital Istanbul offer the total cost including the manufacturing process and hospital stay ranging from $50,000-$150,000, using the same cell engineering technology.
Access life-saving immunotherapy at a fraction of US costs. Browse accredited cancer centers offering checkpoint inhibitors and CAR-T therapy.
Find Immunotherapy CentersTypes of Immunotherapy Available Abroad
International cancer centers offer all major immunotherapy modalities approved for clinical use worldwide. This includes checkpoint inhibitors (Keytruda, Opdivo, Yervoy, Tecentriq, Imfinzi), CAR-T cell therapy at select centers, therapeutic cancer vaccines, oncolytic virus therapy, and cytokine therapies. The availability depends on the specific hospital and country.
- Checkpoint Inhibitors: PD-1/PD-L1 inhibitors (Keytruda, Opdivo, Tecentriq) and CTLA-4 inhibitors (Yervoy) — widely available
- CAR-T Cell Therapy: Kymriah, Yescarta — available in Turkey, India, Germany, Israel, and South Korea
- Combination Immunotherapy: Opdivo + Yervoy and other dual checkpoint regimens — available at major oncology centers
- Bispecific Antibodies: Newer agents like Blincyto — available at advanced cancer centers
- Cancer Vaccines: Sipuleucel-T and clinical trial vaccines — available at research hospitals
- Oncolytic Virus Therapy: T-VEC and similar agents — available at select European and Asian centers
Best Countries for Immunotherapy
Turkey offers the best value proposition for immunotherapy, with JCI-accredited hospitals providing all major checkpoint inhibitors at 60-70% less than US prices. American Hospital Istanbul has established immunotherapy infusion centers with experienced nursing teams who monitor patients throughout treatment. Several Istanbul hospitals also offer CAR-T cell therapy, making Turkey a one-stop destination for advanced immunotherapy.
India's top cancer centers, including Tata Memorial Hospital and Apollo Hospitals, offer the most affordable immunotherapy worldwide. India has also developed its own CAR-T manufacturing capabilities, further reducing costs. Germany and Israel are leaders in cutting-edge immunotherapy research, with access to the latest clinical trials and experimental treatments not yet available elsewhere.
Keytruda was my only option for advanced melanoma, but even with insurance my copay was $3,000 per infusion in the US. I found a JCI-accredited hospital in Turkey that provided the same Merck Keytruda for $4,500 total per cycle. Over a year of treatment, I saved over $100,000.
David L., melanoma patient treated in Turkey
The Treatment Process Abroad
Immunotherapy treatment abroad follows the same clinical protocols as in the US. You'll start with a comprehensive evaluation including biomarker testing, imaging studies, and a tumor board review. For checkpoint inhibitors, infusions are typically administered every 2-6 weeks. Many patients complete their first 2-3 cycles abroad, then arrange for continued treatment closer to home if preferred.
For CAR-T therapy, the process requires a longer stay of 3-4 weeks. Your T-cells are collected via leukapheresis, engineered in a laboratory, and then infused back after a brief lymphodepleting chemotherapy. You'll remain under close monitoring for 10-14 days after infusion due to the risk of cytokine release syndrome (CRS), which requires immediate management.
Safety & Monitoring Protocols
Immunotherapy can cause unique side effects called immune-related adverse events (irAEs), which occur when the activated immune system attacks normal tissues. International cancer centers, including Koç University Hospital, follow the same irAE management protocols recommended by ASCO, ESMO, and NCCN guidelines. These include regular blood work, liver function monitoring, thyroid panels, and immediate access to corticosteroids and other immunosuppressive agents.
Before starting treatment abroad, ensure the hospital has an ICU with immunotherapy-specific protocols, an endocrinology team for thyroid complications, and 24/7 oncology coverage. All JCI-accredited oncology centers meet these requirements, but it's always worth confirming during your initial consultation.
Don't let cost prevent you from accessing immunotherapy. Find accredited international centers offering the same FDA-approved treatments at affordable prices.
Compare Immunotherapy OptionsFrequently Asked Questions
Frequently Asked Questions
Is the immunotherapy drug the same as what I'd get in the US?
Yes. Accredited international hospitals use the same FDA-approved and EMA-approved drugs manufactured by the same pharmaceutical companies (Merck, Bristol-Myers Squibb, Roche, etc.). Keytruda is Keytruda whether administered in New York or Istanbul — the drug is identical.
Can I start immunotherapy abroad and continue at home?
Yes, this is a common approach. Many patients complete their initial cycles abroad, then transfer care to a local oncologist. The international hospital provides detailed treatment records, drug protocols, and scheduling recommendations to ensure seamless continuity.
How long does each immunotherapy infusion take?
Checkpoint inhibitor infusions typically take 30-60 minutes for Keytruda and Opdivo, with a 1-hour observation period afterward. Total time at the hospital is usually 2-3 hours per session. Frequency depends on the drug and indication, ranging from every 2 to 6 weeks.
Are immunotherapy side effects managed differently abroad?
No. International oncology centers follow the same ASCO/ESMO/NCCN guidelines for managing immune-related adverse events. All accredited hospitals have the necessary medications (corticosteroids, infliximab, mycophenolate) and specialist teams to manage any side effects.
Is CAR-T therapy available outside the US?
Yes, CAR-T cell therapy is now available in Turkey, India, Germany, Israel, South Korea, and several other countries. Some countries have developed their own CAR-T manufacturing capabilities, significantly reducing costs compared to the US.