Melanoma is an immunologic tumour as indicated by clinical regression, long
dormancy and the presence of class 1 dependent cytotoxic responses against
well defined tumour peptides. The poor prognosis and relative chemoresista
nce of patients with regional nodal or metastatic disease highlights the ur
gent need for an effective adjuvant therapy. A wide variety of different ag
ents have been assessed including high dose interferon which has been shown
to improve overall survival, although results of a subsequent study have n
ot confirmed these findings. Currently, a variety of different biotherapies
and biochemotherapy regimes are being assessed in phase II and III studies
and sentinel lymph node biopsy now provides an accurate method for staging
so that all patients can be stratified into well-designed randomised contr
olled trials.