On Some Curiosities of Tumor Immunotherapy

This article discusses unresolved questions and contradictions in modern tumor immunotherapy, focusing specifically on the state of the immune system, checkpoint inhibitors (CPIs), chemo-immunotherapy, and the significance of systemic immune system activation. The discussion begins with the observation that, despite significant progress, the clinical success of CPI therapies remains severely limited, and the individual baseline status of the immune system is rarely taken into account in oncological immunotherapy. Drawing on the authors' own clinical experience, it is argued that robust immune system activation via PAMP-based therapy—combined with low-dose chemotherapy and reduced CPI dosages—can lead to improved tumor control while simultaneously reducing toxicity. Particular attention is paid to the role of natural killer (NK) cells, which, in the authors' view, is underestimated in current immuno-oncology. Furthermore, the article explores the interrelationships between immune status, body temperature, the tumor microenvironment, tumor mutation rates, and therapeutic efficacy. The article advocates for an individualized immuno-oncological treatment approach that systematically evaluates and specifically modulates the functional state of the immune system, thereby enhancing the effectiveness of existing immunotherapies. Such a post-treatment strategy has the potential to improve relapse prevention, long-term survival, and cure rates in cancer patients.