[Clinical trial of anti-idiotypic monoclonal antibodies in advanced melanoma].

In this study, first the background of idiotype network and characterization of high molecular weight-melanoma associated antigen (HMW-MAA) was reviewed. Second, the development and characterization of syngeneic anti-idiotypic monoclonal antibodies (anti-Id mAb) against anti-HMW-MAA mAb was described. Among them, anti-Id mAb MK2-23 and TK7-371 were shown to have the internal image of HMW-MAA, since they induced anti-anti Id antibody that reacts with HMW-MAA and also delayed type hypersensitivity to melanoma cells. Third, the results of clinical trial with anti-Id mAb in patients with advanced melanoma was described. Among 60 patients, 7 showed clinical response (CR 1, PR 3, MR 3). The survival of patients who developed anti-HMW-MAA Ab was significantly longer than in patients without detectable anti-HMW-MAA Ab. Moreover, anti-Id mAb immunized the patients after removal of metastatic lesions. The disease-free interval of patients who developed high titer of anti-anti Id Ab was significantly longer than that of those with low titer of the Ab. These results suggest that the anti-Id mAb may be a useful reagent for active specific immunotherapy of melanoma.