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Immunotherapy as an adjunct to surgery in the treatment of cancer

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Abstract

A review of results obtained from numerous clinical trials of immunotherapy for various histological types of cancer serves to emphasize the many discrepancies in the various protocols. Even so, adjuvant immunotherapy in both man and animals has been shown to be relatively nontoxic and to have systemic activity. Definitive results must await long-term follow-up of patients, although in general some therapeutic benefit has been obtained by patients with melanoma and by selected patients with carcinoma of the lung. Adjuvant immunotherapy trials for other types of cancer are still in the preliminary phases. Because therapeutic benefit has not been definitely established, this treatment must be considered highly experimental. Clearly, adjuvant immunotherapy in its present form is not a panacea, but when criteria for methodology, immunologic agents, route, and schedule of administration have been thoroughly identified, it may prove to be a most beneficial adjunctive treatment for selected patients with cancer.

Résumé

De nombreux essais cliniques ont étudié les effets de l'immunothérapie sur divers types histologiques de cancers. L'analyse de ces essais démontre surtout l'extraordinaire variabilité des protocoles. Cependant, ces études ont prouvé que l'immunothérapie est relativement peu toxique et qu'elle a des effets systémiques. Il faudra des follow-up à long terme pour connaÎtre les résultats définitifs; mais il apparait déjà que l'immunothérapie est bénéfique dans les mélanomes et dans certains cas de cancer pulmonaire. Pour les autres cancers, les essais n'en sont qu'aux phases préliminaires. Ces types de traitement doivent encore Être considérés comme purement expérimentaux, puisque nous n'avons pas de preuves certaines de leur efficacité thérapeutique. Au stade actuel, l'immunothérapie adjuvante ne doit pas Être considérée comme une panacée. Lorsque les critères de méthodologie, de substance active, de voies et de schémas d'utilisation auront été soigneusement définis, ce type de traitement sera peut-Être un adjuvant utile dans certains cancers, chez des malades bien sélectionnés.

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Authors and Affiliations

  1. Division of Oncology, Department of Surgery, University of California School of Medicine, Los Angeles, California

    Frederick R. Eilber M.D., E. Carmack Holmes M.D. & Donald L. Morion M.D.

  2. Surgical Services, Veterans Administration Hospital, Sepulveda, California, USA

    Frederick R. Eilber M.D., E. Carmack Holmes M.D. & Donald L. Morion M.D.

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  1. Frederick R. Eilber M.D.
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  2. E. Carmack Holmes M.D.
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  3. Donald L. Morion M.D.
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Supported by grant CA12582 from the National Cancer Institute (DHEW) and the Medical Research Service of the Veterans Administration.

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Eilber, F.R., Holmes, E.C. & Morion, D.L. Immunotherapy as an adjunct to surgery in the treatment of cancer. World J. Surg. 1, 547–553 (1977). https://doi.org/10.1007/BF01556179

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