Immunotherapy in malignant melanomaa

Accumlated evidence suggests that human neoplasms contain antigens that elicit humoral and cellular immunity in the immunocompetent host. A recent summary report showed that Stage II melanoma patients with metastases to regional lymph nodes had a lowered incidence of recurrence and a higher incidence of survival following surgery and postoperative BCG immunotherapy. To verify these findings, clinical trials are now under way in which we radomized melanoma patients into groups to compare treatment by surgery alone with surgery and BCG only, or surgery and BCG in combination with allogeneic melanoma cell vaccine. Serum samples from each patient are monitored by in vitro techniques to define those methods which best correlate to clinical course. Hopefully, such correlations can be used to monitor response to immunotherapy before disease is clinically apparent. Although immunotherapy does not cause regression of far advanced disease, it undoubtedly will be beneficial against subclinical, microscopic tumor.