ADJUVANT IMMUNOTHERAPY FOR PATIENTS WITH MELANOMA - ARE PATIENTS WITHMELANOMA OF THE HEAD AND NECK CANDIDATES FOR THIS THERAPY

Background. Although a wealth of information is available on adjuvant immunotherapy for melanoma, little is known about adjuvant immunothera py for head and neck melanoma. Interestingly, a few immunotherapy clin ical trials report the observation of clinical responses in a subset o f patients with head and neck melanoma. Method. An up-to-date literatu re search was performed to identify the current information on adjuvan t immunotherapy for patients with melanoma, including head and neck me lanoma, Moreover, a retrospective analysis of a subset of primary head and neck melanoma was performed using data from a phase III, randomiz ed, double-blind, multi-institutinal, vaccinia melanoma oncolysate adj uvant immunotherapy trial that was performed in our laboratory for pat ients with stage III (AJCC) melanoma. Results, In a passive immunother apy trial with an antibody to melanoma ganglioside antigen GM2, a comp lete regression was observed in one patient with lesions of the right cheek. In three active specific immunotherapy trials, including our ph ase III trial, a subset of patients with head and neck primary melanom a showed a longer disease-free and overall survival with immunotherapy . Moreover, these clinical responses were correlated to the induction of immune response, delayed-type hypersensitivity response and melanom a-specific antibody response. Conclusions. The above results therefore suggest that patients with head and neck melanoma clinically respond to immunotherapy. However, these results need to be confirmed in a pro spectively randomized trial for patients with head and neck melanoma. (C) 1997 John Wiley & Sons, Inc.