IMMUNOLOGICAL GENE-THERAPY APPROACHES FOR MALIGNANT-MELANOMA .2. PRECLINICAL STUDIES AND CLINICAL STRATEGIES

Immune-gene therapy approaches for the treatment of malignant melanoma are categorized into two major subgroups according to an active or pa ssive immunological principle. Active immune-gene therapy is subdivide d into melanoma cell vaccines, DNA-based vaccinations and the treatmen t of pre-existing tumor tissue by cell-mediated or direct transfer of cytokine and/or cell surface signal genes, Passive immunogene therapy, employing an adoptive treatment with in vitro activated and expanded anti-tumor effector cells, involves two major application fields for g ene transfer techniques, first the genetic modification of the effecto r cells, and second the in vivo amplification of pre-effector cells by procedures also used in active immune-gene therapy, Corresponding pre clinical studies are reviewed. The clinical studies inaugurated during the last few years are mostly still ongoing and focus on treatment sa fety and tolerability rather than efficacy, A recent trend is emerging to explore recombinant adenovirus and vaccinia virus vectors particul arly with regard to in vivo gene transfer applications, Overall, immun e-gene therapy of melanoma is still in a highly experimental stage of development but may become a safe, efficacious and practical adjuvant treatment modality in the future.