William Coley Treated Cancer in the 1890s by Injecting His Patients With Bacteria

William Coley was a young surgeon at New York Hospital in 1890 when he watched a patient die of an inoperable sarcoma and went looking through old hospital records for cases of similar tumors that had spontaneously remitted. He found one. A house painter named Fred Stein had been admitted in 1885 with an enormous neck sarcoma. Two surgeries had failed. Stein had then contracted erysipelas — a Streptococcus skin infection — in the surgical wound, run a high fever for several days, and emerged from the infection with a tumor that had simply melted away. Coley tracked Stein down and confirmed he was alive and apparently cured seven years later.

The inference Coley drew was that something about the immune response to acute infection had attacked the cancer. He started injecting cancer patients with live, then killed, Streptococcus pyogenes and Serratia marcescens, calibrated to produce a high fever for several days. His first treated patient, an Italian immigrant named Zola with a tumor pressing on his jaw, saw the mass shrink within two weeks of the induced erysipelas; he survived eight years.

The results across hundreds of patients were inconsistent — some dramatic remissions, some no effect, some sepsis — but Coley's bacterial preparations were standardized by the pharmaceutical company Parke-Davis and sold continuously from 1893 to 1962. The 1962 Kefauver Harris Amendment to the Food, Drug, and Cosmetic Act required FDA proof of efficacy for any drug; Coley's toxins had no clean trials and were quietly discontinued. Coley is now usually remembered as the father of cancer immunotherapy, a field that essentially restarted in the 2010s with checkpoint inhibitors. His daughter Helen Coley Nauts founded the Cancer Research Institute in 1953 to keep his line of work going through the lean decades.