Mathé G
Service des Maladies Sanguines et Tumorales and ICIG (Univ. Paris-Sud, CNRS UA 04-1163, Villejuif, France.
Cancer Detect Prev Suppl. 1987;1:279-90.
The results today of passive immunotherapy with monoclonal antibodies (MAb) are still very limited, even via its indirect methods (in vitro tumor cell clearance of bone marrow before autologous retransplantation, transport of cytostatic chemicals, and radiation). Tumor cell heterogeneity requires the use of several MAb. Adoptive immunotherapy in the form of the graft vs leukemia (GVL) reaction associated with the graft vs host (GVH) reaction, after an allogeneic bone marrow transplantation, first demonstrated in animals in 1962, has been confirmed in man. The material and operational development of tumor immunology, immunopharmacology, and clinical trial methodology should improve active immunotherapy results and help to convert into a cure what is often a significant but only marginal increase: 1) of disease-free survival or 2) of survival or 3) of survival after relapse. The general ineffective management and use of adjuvant chemotherapy for all tumors except breast carcinoma before menopause will, on the other hand, contribute to necessary new concepts of how to manage the postremission, residual, minimal disease.
如今，单克隆抗体（MAb）被动免疫疗法的效果仍然非常有限，即便采用间接方法（如自体再移植前对骨髓进行体外肿瘤细胞清除、细胞毒性化学物质转运以及放疗）亦是如此。肿瘤细胞的异质性需要使用多种单克隆抗体。1962年首先在动物身上得到证实的、与移植物抗宿主（GVH）反应相关的移植物抗白血病（GVL）反应形式的过继性免疫疗法，已在人体得到确认。肿瘤免疫学、免疫药理学和临床试验方法学在材料和操作方面的发展，应能改善主动免疫疗法的效果，并有助于将通常虽显著但仅为微小提升的以下方面转化为治愈：1）无病生存期；2）生存期；3）复发后的生存期。另一方面，对于绝经前除乳腺癌之外的所有肿瘤，辅助化疗普遍管理不善且使用不当，这将促使人们形成关于如何处理缓解后残留微小疾病的必要新观念。
