Tumour necrosis factor: clinical relevance.

The anticancer effect of tumour necrosis factor (TNF) in murine tumours and in vitro has stimulated great enthusiasm for investigating its possible therapeutic role in humans. Results have now indicated that 400-800 micrograms ng/m2 of TNF may be given to patients and further dose increases are limited by hypotension and hepatic damage. At this dose, no consistent anticancer effects have yet been seen and measurement of TNF serum concentrations suggests that these effects are less than those required to induce regression of mouse tumours. TNF as a single agent is unlikely to have a major role in the treatment of cancer in humans and further studies will explore combination with other agents. During the investigation of the clinical role of TNF, observations have clarified its biological role as a mediator of inflammation and shock, cachexia and organ dysfunction.