ABSTRACT
Cytokines such as interferon, interleukin and tumor necrosis factor are natural body defense proteins which have been used individually in recent years to produce a few complete responses of some tumors in a few patients but their overall effect has been limited. The hypotheses is that a biologic stimulus such as endotoxin will stimulate the immune system in a more natural way and hence will be more likely to have an effect especially in the presence of a naturally produced fever than treatment from just one lymphokine. One of the side effects of current lymphokine studies has been fever usually spiking in nature but there has been no obvious effort to relate the extent of the fever to any tumor responses. Clinical experience has shown that increased temperature can enhance the results of radiotherapy and chemotherapy in some situations. Therefore it is logical to put this hypothesis to a test clinically. It is surprising that the combined effect of fever and lymphokine stimulation has not been reported aside from Coley's work, and it is only in retrospect that fever has been suggested to be essential to the tumor control noted. Most of the literature, animal and human, has focused on the destructive effect of temperature on tumor cells and not as part of an immune response to control tumor growth. Endotoxin is the pyrogen on which most current information is available. More effective and more available pyrogens may be developed later.
