ABSTRACT
Advanced melanoma, a deadly disease with few nonsurgical treatment options, has been the malignancy most targeted for active immunotherapy. SA. Rosenberg et al. analyzed 440 patients with metastatic cancer, mainly melanoma, treated with 541 different vaccines over a nine-year period at the National Cancer Institute. The lack of clinical effectiveness of cancer vaccines thus far should not mean that vaccine approaches should be abandoned. Despite modest numbers of clinical responses in patients with advanced melanoma, vaccination with dendritic cells pulsed with peptides or whole tumor lysate remains a promising approach. Vaccine trials have included late-stage melanoma patients with large tumor burdens and metastatic disease. Clinical response rates to multiple different vaccine types have been exceedingly low in spite of often observed immunologic responses, but it is through these approaches that we have gained valuable insight and knowledge about tumor immunology.
