Spontaneous regression: a hidden treasure buried in time

Spontaneous tumor regression is a phenomenon that has been observed for hundreds, if not thousands of years. Although the term spontaneous implies 'without apparent cause', a review of case reports over the last several hundred years demonstrates that regression generally coincides with acute infections. Observations of this non-specific effect led to the emergence of active cancer immunotherapies by the 1700s. By the 1890s, William Coley refined this approach with a bacterial vaccine which, when administered properly, could induce complete regression of extensive metastatic disease. Unfortunately, after Coley's death, his vaccine and technique fell into obscurity. Modern approaches to treatment have reduced the occurrence of spontaneous regressions. Aseptic techniques and antibiotics significantly reduce postoperative infections, while chemotherapy and radiation impair immune activation even when an infection does occur. More than a century after its inception, Coley's vaccine and aggressive approach to treatment may still be one of most effective immunotherapies for cancer.