The biologic basis for combined modality treatment of cancer

Strategies related to cancer should be aimed at optimization of local and regional treatment. Delineation of subsets of patients with high risk for recurrence would have a significant impact, upon which such adjunctive systems of therapeutic management should be evaluated. In disseminated disease, or where the probability of dissemination is high, evaluation of any realistic potential combination of treatment for tumor control should be pursued. It is necessary to delineate optimal palliative therapy where tumor control is not possible, but also to test new drugs, immunotherapeutic tools and combination regimens in all such situations where the disseminated compartment of the disease is of high probability. Only under such circumstances will the most practical and important optimization of treatment programs be achieved. The development of the above basic attributes for each tumor type needs to be studied so that protocols can be developed with a clear understanding of the nature of the disease, condition to be studied, and the general therapeutic strategies to be followed.