William Coley

William Bradley Coley (January 12, 1862 – April 16, 1936) was an American bone surgeon and cancer researcher best known for his early contributions to the study of cancer immunotherapy, specifically causing infection as a way to fight cancer, a practice used as far back as 1550 BC. Coley is recognized as the Father of Cancer Immunotherapy for his contributions to the science.

Early sarcoma patients In 1890, Coley began his first year of private practice at New York Hospital and met Elizabeth (Bessie) Dashiell, a 17-year-old patient who would later go on to inspire Coley to search for better methods of treating sarcoma. Dashiell visited Coley after suffering from a hand injury which he soon discovered to be an aggressive bone tumor. Treatment for sarcoma at the time was scarce; the most widely accepted form of treatment was a complete amputation of the affected limb. Despite receiving such a critical surgery as forearm amputation, Bessie died just ten weeks later due to widespread metastasis of the original cancer. Bessie's death had a profound effect on Coley's approach to practicing medicine. Coley was distressed that even modern medicine's customary procedure still could not save the life of one of his first patients. Coley then decided to take the search for new possible treatments into his own hands, soon becoming one of the medical community's model clinician-scientists. Curious to discover the reason for the man's remission, Coley decided to search for the hospital's discharged patient, whom he eventually found in Manhattan with no trace of cancer left in his body. In 1891, he began his experiments on a patient named Zola, an Italian immigrant and drug-addict with a life-threatening tumor which he described as "the size of a small hen's egg" in Zola's right tonsil. Hoping to spawn a similar case of remission that he had been studying for the past year, Coley attempted to induce a response by Zola's immune system by injecting Streptococcus, a bacterium known to induce erysipelas attacks, directly into his tumor. Five months and several trials of injection later, Zola finally developed full-blown erysipelas infection. The tumor once thought to be irreversible then began to dissolve, disappearing within two weeks. Zola recovered and lived another eight years, before eventually succumbing to a recurrence of the tumour

Two years after Zola's initial treatment, Coley treated ten more of his own patients with the same live Streptococcus bacteria. Because of the unpredictable nature of infection, which killed patients of his on two separate occasions, Coley changed the bacterial ingredients of what would be coined Coley's toxins from the live Streptococcus bacteria, to two dead bacteria, Streptococcus pyogenes and Serratia marcescens. The formula change to the use of dead bacteria drastically reduced the risk of death in patients; however, Coley's toxins still remained controversial in the medical community. The passing of the 1962 Kefauver Harris Amendment, however, required Coley's toxins to be labeled as a "new drug" by the Food and Drug Administration. It was this final blow to Coley's life work that drastically reduced the use of the concoction for cancer treatment. Since its changed status under the FDA, it has only been able to be prescribed through experimental clinical trials, which have continuously produced mixed results.

Effectiveness

There is no good evidence that Coley's toxins have any benefit in cancer treatment, and their use as an adjunct or replacement for established treatment risks serious harm. According to Cancer Research UK's current statement regarding Coley's toxins, people with cancer who participate in the Coley's immunotherapy alongside conventional cancer treatments, or who use it as a substitute for those treatments, risk seriously harming their health.

Creation of the Cancer Research Institute Coley's daughter, Helen Coley Nauts (1907–2001), established the nonprofit Cancer Research Institute in 1953 to study her father's work in efforts to "advocate for a cancer research path that investigates harnessing the body’s immune system rather than one that seeks chemicals and radiation to attack the disease." The organization has since become a leader in funding research in immunology and tumor immunology at universities and hospitals worldwide.

Cancer Immunotherapy While Coley's own efforts to stimulate the immune system to fight cancer showed marginal results, the field of cancer immunotherapy is now a burgeoning field within medicine. Multiple approaches exist, including reprogramming T-cells to specifically attack cancerous cells and blocking checkpoints so the immune system can more effectively attack cancerous cells. Coley is regarded as a key early influence in this field.

Death

William Coley died on April 16, 1936, at the age of 74 in the Hospital for the Ruptured and Crippled (now called the Hospital for Special Surgery) in New York City. He was survived by his wife and two children who continuously worked after his death to preserve Coley's legacy in the field of cancer research.