Adjuvant therapy in melanoma

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.