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 in 75 by the year 2000. Active specific immunotherapy with vaccines is evolving as a promising new modality in the treatment of malignant melanoma.

OBJECTIVE

To present a concise and understandable summary of the key molecular and clinical concepts of melanoma vaccines currently under investigation, the history that led to their development, and their anticipated clinical response.

METHODS

The recent advances in the field of melanoma immunobiology and the newest experiment vaccines are reviewed.

RESULTS

There is no effective melanoma vaccine that successfully treats or prevents melanoma. However, their use has been associated with regression or delayed disease progression in some cases. The minority of patients who do have a major clinical response to vaccine therapy experience an improvement in survival. Even in those patients in whom melanoma vaccines cannot improve survival, the paucity of severe 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 melanoma. The clinical effectiveness of melanoma vaccines is unclear and adequately controlled studies need yet to be performed. Current melanoma vaccines manipulate antigen presentation networks and combine the best cellular and antibody antitumor immune response effective in mediating tumor protective immunity; these combination vaccines hold the most promise. The ideal melanoma vaccine will ultimately prevent melanoma.