New trends in the use of biological response modifiers for treatment of malignant neoplasm

Biological response modifiers are critical controllers of cell division and hence tissue, growth, migration development and differentiation. The family of biological response modifiers includes interferons, tumor necrosis factor, interleukins, colony stimulating factors and hematopoietic growth factors as well as tumor vaccines and monoclonal antibodies. Biological response modifiers have important roles in cancer development and progression, control of cell replication and apoptosis and modulation of immune reactions such as sensitization. This article reviews the biology, pharmacology and clinical application of biological response modifiers in oncology. The antitumor activity of biological response modifiers may be augmented immune response including activation of natural killer lymphocytes and enhanced expression of cell surface antigens (MHC I and II). Combination of biological therapy with chemotherapy improves the response of those tumors refractory to conventional therapies. Colony stimulating factors are used for manipulating immune system to fight against cancer and to prevent chemotherapy-induced neutropenia. Recent advances in tumor immunology, most notably the identification of genes encoding for cancer regression antigens, have paved the way for the development of a variety of novel and specific vaccines and monoclonal antibody approaches. These approaches are discussed from a therapeutic perspective. (author)