Patients with AJCC Stage IIB and III melanoma have a poor 5-year survi
val rate which has been the driving force behind attempts to find an e
ffective adjuvant therapy for this stage of disease that would effecti
vely reduce relapse and improve survival. Immunotherapy with bacillus
Calmette-Guerin (BCG), Corynebacterium parvum, and levamisole have not
been successful in achieving this goal, nor have trials with chemothe
rapy in the adjuvant setting, including high-dose chemotherapy with au
tologous bone marrow transplantation. The recent Eastern Cooperative O
ncology Group (ECOG) 1684 study showed significant improvement in rela
pse-free and overall survival with high doses of alpha interferon (IFN
alpha) given for 1 year. Lower dosages of IFN alpha have to date been
unsuccessful in impacting upon long-term survival. Recent data with v
accines have been encouraging, and the GM2-KLH vaccine is the focus of
ongoing intergroup study comparing this treatment with IFN alpha in r
esected Stage IIB and III melanoma. The various regimens are reviewed
in this article. (C) 1998 Wiley-Liss, Inc.