Cytotoxic chemotherapy is associated with modest survival advantage as initial treatment of advanced lung cancer. However, toxicity and minimal benefit to use second line treatment justifies exploration of alternative approaches. Recent understanding of mechanisms by which tumor antigen recognition can be enhanced has justified development of a recent flurry of vaccine trials in lung cancer. Preliminary results suggest a remarkably high safety profile and significant activity with respect to improvement in time to progression and survival in comparison to historical controls or lower dose treated cohorts, particularly in non small cell lung cancer. This review summarizes current results of vaccine trial development in non small cell and small cell lung cancer.