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Postgraduate Medical Journal 2003;79:672-680
© 2003 Fellowship of Postgraduate Medicine


REVIEW

Dr William Coley and tumour regression: a place in history or in the future

S A Hoption Cann 1, J P van Netten 2, C van Netten 1

1 Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada
2 Special Development Laboratory, Royal Jubilee Hospital and Department of Biology, University of Victoria, Victoria, British Columbia, Canada

Correspondence to:
Correspondence to:
Dr S A Hoption Cann
Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3; stephen.hoption.cann{at}ubc.ca

Spontaneous tumour regression has followed bacterial, fungal, viral, and protozoal infections. This phenomenon inspired the development of numerous rudimentary cancer immunotherapies, with a history spanning thousands of years. Coley took advantage of this natural phenomenon, developing a killed bacterial vaccine for cancer in the late 1800s. He observed that inducing a fever was crucial for tumour regression. Unfortunately, at the present time little credence is given to the febrile response in fighting infections—no less cancer.

Rapidly growing tumours contain large numbers of leucocytes. These cells play a part in both defence and repair; however, reparative functions can also support tumour growth. Intratumoural infections may reactivate defensive functions, causing tumour regression.

Can it be a coincidence that this method of immunotherapy has been "rediscovered" repeatedly throughout the centuries? Clearly, Coley’s approach to cancer treatment has a place in the past, present, and future. It offers a rare opportunity for the development of a broadly applicable, relatively inexpensive, yet effective treatment for cancer. Even in cases beyond the reach of conventional therapy, there is hope.


Keywords: Dr William Coley; tumour regression; fever; immunosuppression; immunotherapy; macrophages; neoplasms

Abbreviations: BCG, bacillus Calmette-Guerin; IL, interleukin; TNF, tumour necrosis factor




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