| Abstract: | Passive, active and adoptive immunotherapy of human cancers and leukemias raise a renewed interest strengthened by the availability of purified biological substances such as IL2, interferon, thymic hormones and by some recent favourable therapeutic results which have demonstrated the possibility of obtaining objective tumor regressions by immunotherapy. Analysis of results of chemotherapy shows that only 8 human cancers and malignant hemopathies are curable at an advanced diffuse stage of disease. These cancers are characterized by the rarity or absence of late metastases (more than 3-4 years after initial diagnosis). Cure may be considered as complete with a high probability if disease free status is maintained for 3 years. This finding suggests the absence of tumor stem cells capable to produce late metastases. Other cancers are not chemocurable at an advanced systemic stage. In most of them late metastases (greater than 4 years after diagnosis) are observed. A model of organization of malignant tumors based on the distinction between primitive tumor stem cells which are rarely or exceptionally in cycle and protected by a specific microenvironment and committed tumor stem cells is proposed. According to this model, only cancers and/or metastases and malignant hemopathies containing but committed tumor stem cells would be chemocurable. Analysis of a trial of adjuvant therapy of breast cancer with poly A: poly U shows the possibility of immunotherapy to prevent the development of late metastases, independently of hormonal status in contrast with standard adjuvant chemotherapy which is only active on early micrometastases in premenopausal women.(ABSTRACT TRUNCATED AT 250 WORDS) |
