BCG immunotherapy in patients with malignant melanoma

Twenty-one patients with malignant melanoma received immunotherapy with BCG. Thirteen patients had adjuvant immunotherapy on a monthly schedule. Of these, eight with regional lymph node metastases (stage III) had been treated by lymphadenectomy. Two of the stage III patients had tumor recurrences within one year, while six are alive and free of melanoma at a median interval of 22 months. The remaining five patients (stage I or II) had level 4 or 5 (Clark classification) primary lesions. Their average tumor-free survival has been 18 months, but there was one regional recurrence in six months. Eight patients received intralesional treatment with BCG. The extent of local response correlated inversely to the stage of their disease. Higher doses of BCG or multiple simultaneous injections into the same lesion did not produce complete resolution of nodules in patients with far-advanced melanoma. In none was the course altered by intralesional therapy.