Locoregional immunotherapy for nonresectable malignant hepatic disease

Systemic and regional chemotherapy in the treatment of hepatic metastases of colorectal origin has been extensively investigated over the past decade. In spite of the considerable response rates that have been observed in some regional chemotherapy protocols, it has been very hard to show any survival benefit as a result of this approach. It is fair to say that overall the results have been disappointing. In the search for new agents it is a logical development that the locoregional application of recombinant cytokines, in particular interleukin-2, has been investigated in the treatment of irresectable liver tumors. In spite of encouraging experimental data demonstrating the advantage of delivering high doses of various cytokines or effector cells at the tumor site, our clinical results and those of other groups have been rather poor so far. Here we discuss the problems encountered in the present situation and the opportunities that may lie ahead.