Treatment of malignant melanoma by active specific immunotherapy in combination with biological response modifiers

In this report we have briefly covered the approaches we have used for active specific immunotherapy in treatment of malignant melanoma. Our investigations and trials in recent years have been focused on using biological response modifiers in conjunction with active specific immunotherapy. It has been well-documented that tumors are heterogenous in many properties. We have found that melanomas are also heterogenous in expression of tumor-associated antigens that are immunogenic in the host. In vitro immune analysis has shown that the humoral responses of individual patients are heterogenous to defined melanoma antigens, as well as heterogeneity being present in the expression of these antigens on tumor cells. Therefore, when evaluating the response of groups of patients, in various treatment studies it may be difficult to interpret the data and its relevance. Clearly, from our studies the effect of biological response modifiers such as CYP affect individual patients' immune systems differently. This type of response is what one should expect when treating patients whose individual immune systems are heterogenous. Thus the presence of heterogeneity of tumors and immune responses makes immunotherapy treatment programs using active specific immunotherapy very difficult to interpret. Future emphasis should be placed on analyzing individual patients' responses to biological response modifiers in more detail and not collectively. The age of 'tailor-made' immunotherapy may be within reach of current technology. To determine which patient may benefit from one drug over another will help in treatment planning and may increase survival.