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There is no consistent evidence to suggest a benefit for hormonal therapy.

The immune system is important in metastatic MM, as evidenced by lymphoid infiltration into tumour and surrounding tissues, and well-reported spontaneous remissions.4,5,7,14 This has led to attempts to modulate the immunological environment of tumours, usually by the use of cytokines, particularly interferon alpha15 and interleukin-2,16 given directly or by gene therapy. This has improved outcomes in other tumours.17 Such therapy has single-agent response rates of 15-20% and it has been suggested that such therapy produces a higher rate of durable remissions.15

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