NEWER APPROACHES TO REGIONAL CANCER THERAPY THROUGH TUMOUR IMMUNOLOGY: IS THERE A ‘BREAKTHROUGH’?

Eagerly awaited ‘breakthroughs’ in immunological treatment have in the past been disappointingly unsuccessful in changing the outlook for most patients with otherwise incurable cancers. Many hopeful agents have been studied in therapeutic trials but each in turn has proven to be largely disappointing. One of the latest products of immunological research, tumour necrosis factor (TNF) was found to be too toxic for systemic use but has been found to be highly effective in improving the results of treatment of melanoma when used in a closed‐circuit perfusion system in combination with another chemotherapeutic agent. In the past the use of closed‐circuit perfusion has been confined to limbs, but techniques have recently been developed to apply closed‐circuit perfusion to liver, pelvic organs, and some abdominal regions including pancreas. The potential for studies of TNF in combination with chemotherapy in closed‐circuit perfusion treatment of otherwise resistant cancers in these organs and tissue regions has been greatly expanded. In many cancer treatment centres in the past there has been a reluctance to use and to acknowledge the benefits of regional delivery of anti‐cancer chemotherapy. The need for these techniques in the safe and effective use of TNF has further confirmed the importance of these methods in comprehensive cancer treatment centres, and the need for further studies and better understanding of the use of regional and closed‐circuit perfusion methods.