Coley toxins immunotherapy: A retrospective review

Objective. Coley toxins are administered to cancer patients world-wide, tho ugh clinical studies assessing efficacy either alone or in combination with conventional cancer therapy are limited This article provides an overview of Coley toxins immunotherapy and compares the survival experience of cance r patients who received Coley toxins for renal, ovarian, breast cancer, or soft-tissue sarcomas with patients who received conventional treatment othe r than radiation. Data Sources Cases were compiled from 5 of 18 monographs by Helen Coley Nau ts. Study Selection Using a retrospective cohort design with external controls, 128 Coley cases treated in New York from 1890 to 1960 were compared with 1 675 controls from the Surveillance Epidemiology End Result (SEER) populatio n-based cancer registry who received a cancer diagnosis in 1983. Data Extraction Groups were matched on age, sex ethnicity, site, stage, and treatment status (ie, no radiotherapy). Data Synthesis The Cox proportional hazards model controlled for stage and menopausal status (when applicable) and the hazard ratio and 95% CI defined the odds of site-specific survival from date of diagnosis to last follow-u p. Compared to the SEER population, risk of death within 10 years was not s ignificantly different in Coley patients treated fur renal, ovarian, breast cancer or soft-tissue sarcomas. Conclusions This study suggests that patients treated with surgery and Cole y toxins between 1890 and 1960 experienced survival rates comparable to tho se of patients diagnosed in 1983 and treated with nonradiotherapeutic conve ntional approaches. The study is limited by small sample sizes, possibly in accurate technology,for staging during Coley time, and potential selection bias with Coley patients.