The interaction of host immunocompetence and tumor aggressiveness in superficial bladder carcinoma

The results of our studies suggest that in the natural history of bladder cancer intrinsic tumor aggressiveness as measured by loss of normal antigenic activity may be more relevant than intact host defenses as measured by an intact cell-mediated immune response. Our contention that tumor aggressiveness may be the more important variable fits in with the occasional success in cancer patients treated with chemotherapeutic agents that act by altering the genetic material of rapidly dividing tumor cells. Our data suggest that therapy directed at bolstering the host's immune system may not be as effective as therapy directed against molecular events within the cancer cells themselves. Unfortunately, presently available non-surgical modalities do not discriminate between aggressor (tumor) and defender (lymphocyte) cells.