Appraisal of anti-idiotypic antibodies in the treatment of solid tumors in humans.

Anti-idiotypic antibodies may be valuable in the induction of antitumor immunity in two ways--they can serve as a ready source of antigen when the appropriate TAA is difficult or impossible to purify. More importantly, regulatory anti-idiotypic antibodies can activate specific T-helper cells, bringing all the components of cellular immunity to bear on neoplastic process. Although the results in studies in animals have demonstrated resistance to tumor challenge after immunization with anti-idiotypic antibodies, studies of humans with advanced malignancies have failed to produce substantial clinical results. Nevertheless, immunization with anti-idiotypic antibodies has influenced some tumors. These studies represent important, initial steps toward understanding the immune network and modulating it in favor of the host, against human tumors. As a continued understanding of the immune network evolves and strategies for activating and suppressing specific immune responses are developed, it should be possible to design vaccines for specific uses. Although current anti-idiotypic vaccines do not seem promising for the treatment of established solid tumors in humans, we can look with anticipation to studies of polyvalent vaccines for the prevention of carcinoma in high risk groups.