advanced metastatic disease of solid tumors, dictates that each tumor
mass, indeed each individual metastasis, will have a unique antigen and
cytokine environment and hence unique response to immune modu- lation. A
differential response to immunotherapy is thus inevitable. 4. Many of
the human trials described are not randomized and report survival or
response against historical controls. Most tumors described are
immunogenic human tumors: renal cell cancer and melanoma are most
common. In order to avoid the well-described inter-patient vari- ation
and rare incidence of spontaneous response among patient samples as well
as selection bias and changes in practice over time, randomized trials
are required. 5. Immunological treatment is unlike conventional
chemotherapy in its endpoint. Most chemotherapeutic regimes require a
complete response or a good partial response for cure or good
palliation. There are now many cases where immunotherapy has provided
long-term palliation without massive tumor reduction. Immunity may be
stimulated to a degree which holds tumorigenicity in check and most
importantly, pro- vides good palliation for the patient in a manner that
differs essentially from chemotherapy.