There is strong circumstantial evidence that tumor progression in cancer pa
tients is controlled by the immune system. As will be detailed below, this
conclusion is based on observations that turner progression is often associ
ated with secretion of immune suppressive factors and/or downregulation of
MHC class I antigen presentation functions. The inference is that tumors mu
st have elaborated strategies to circumvent an apparently effective immune
response. Importantly, a tumor-specific immune response cannot be detected
in most individuals. While this failure is in part technical, it also sugge
sts that the magnitude of the immune responses to which tumors have to resp
ond is low. This raises the concern. which is the underlying theme of this
commentary, that a more robust immune response elicited by deliberate vacci
nation will exacerbate the rate of immune escape and nullify the potential
benefits of immune-based therapies.