ABSTRACT
The dawn of modern immunology probably started with William Coley, a New York surgeon at the turn of the 19th-20th century, who noticed that patients with residual postoperative disease who developed severe septicemia sometimes became disease-free and long-term survivors. He tried to mimic the immune response to the bacteria by making cell wall preparations, which became known as Coley’s toxins. He reported a large number of long-term responses to this therapy, although the tumor types were limited to melanoma and a few others. Attempts by others to reproduce his work were often unsuccessful, and details of the approach were clearly critical. Further evidence that the immune response can contain cancer comes from the infrequent but persistent reports of spontaneous remissions, which are usually limited to melanoma and renal cell cancer. Complete remissions of superficial melanomas are common following intratumoral administration of bacille Calmette-Guerin (BCG), which has little effect on non-injected lesions, although BCG combined with cell lines would appear to be able to induce systemic responses as well as increasing long-term survival in stage IV melanoma1.
