Host-tumor Antagonism Xv; The Apparently Beneficial Effects Of Acute Concurrent Infections Or Of Toxin Therapy On The Course Of Malignant Melanoma

Abstract

Among the cases of spontaneous regression of malignant disease accepted as valid by Everson and Cole and other investigators, there were several in which fever or infection, or both, were implicated. Although the prognosis in malignant melanoma is notoriously bad, a number of cases have been reported in the literature in which the result was better than might be expected. Perhaps if the medical profession adopted a less pessimistic attitude about these highly malignant tumors, better results might be attained by the judicious use of all the modalities at our disposal. One form of treatment that has not been given sufficient emphasis in recent years is bacterial toxin therapy, possibly because the data on the subject have been buried in the older medical literature or remain unpublished. We have reviewed all the histories of patients with malignant melanoma in whom concurrent infections developed or who were treated by toxin therapy (Coley toxins), and have found some spectacular results, not only immediate but of long standing. The most important factors influencing success or failure with toxin therapy include the stage of the disease when toxins are begun, the potency of the preparation used, the duration and intensity of toxin therapy, and the amount of radiation given before or during treatment with toxins. The findings in a series of patients who either had infections or were treated with toxins suggest that at the present time toxin therapy may be of real value in producing a larger percentage of permanent beneficial results in malignant melanoma if administered before and after surgical removal of the tumor in operable as well as in inoperable cases.