CURRENT STATUS OF MELANOMA VACCINES

BACKGROUND. Malignant melanoma is increasing worldwide faster than any other cancer and the American lifetime risk is estimated to reach 1 i n 75 by the year 2000. Active specific immunotherapy with vaccines is evolving as a promising new modality in the treatment of malignant mel anoma. OBJECTIVE. TO present a concise and understandable summary of t he key molecular and clinical concepts of melanoma vaccines currently under investigation, the history that led to their development, and th eir anticipated clinical response. METHODS. The recent advances in the field of melanoma immunobiology and the newest experiment vaccines ar e reviewed. RESULTS. There is no effective melanoma vaccine that succe ssfully treats or prevents melanoma. However, their use has been assoc iated with regression or delayed disease progression in some cases. Th e minority of patients who do have a major clinical response to vaccin e therapy experience an improvement in survival. Even in those patient s in whom melanoma vaccines cannot improve survival, the paucity of se vere side effects has provided a quality of life superior to standard multiagent chemotherapy. CONCLUSION. Melanoma vaccines are relatively safe immunotherapeutic modalities for the management of malignant mela noma. The clinical effectiveness of melanoma vaccines is unclear and a dequately controlled studies need yet to be performed. Current melanom a vaccines manipulate antigen presentation networks and combine the be st cellular and antibody antitumor immune response effective in mediat ing tumor protective immunity; these combination vaccines hold the mos t promise. The ideal melanoma vaccine will ultimately prevent melanoma . (C) 1997 by the American Society for Dermatologic Surgery, Inc.