New concepts in the immunotherapy of neoplasms

Elucidation of immunobiologic mechanisms, both in general and particularly as they relate to tumors, is a relatively new endeavor. Clinical application of immunotherapeutic principles has followed tentatively behind the leading edge of research information. Evaluation of this type of therapy is on-going, and results are quite variable. Certainly the major application of immunotherapy must be as an adjuvant, for it is ineffective, both in research and clinical settings, where there is discernible tumor burden. To be properly utilized, immunotherapy must be properly sequenced and not used with other modalities of therapy in such a way as to render it useless. It must be applied with the realization that its effects might be supportive of tumor growth; therefore, frequent assays of tis effects must be carried out both during and after treatment. At the present time, active nonspecific immunotherapy using BCG and active specific therapy using altered autochthonous cells are most in vogue. This is, however, a rapidly changing field and one can anticipate frequent new directions in therapy.