How to find immunomodulators--a look backward and forward.

Abstract

The history of specific and unspecific immunomodulation is shortly discussed. While repository adjuvants are already established drugs for specific immunomodulation, no unspecific immunomodulator has successfully passed clinical trials in tumor patients yet. As this is in striking contrast to the effects seen with unspecific immunomodulators in experimental immunological and tumor test systems, the value of those screening models to predict clinical success may be asked for. To improve the success rate, it is recommended to test compounds for their immunomodulatory effects as broad as possible in ex vivo and in vivo test systems. Subsequently, the prophylactic as well as therapeutic potency of selected immunomodulating drugs should be evaluated in various models of aptitude, such as chronic infection, autoimmune diseases and chronic inflammatory reactions. Those diseases are at least to a certain extent influenced by the immune system, in contrast to the uncertainty in case of tumour diseases. Screening of immunomodulating compounds in tumor models should be done with special consideration of minimal residual diseases and formation of metastases.