Objective 
1 . 0 
To determine the toxicity of immunization of Stage IV melanoma patients with 
an IL-2-secreting, X-irradiated melanoma cell-line expressing defined 
allogeneic MHC-specif ied determinants. The following will be evaluated: 
1.1 Toxicity of immunization. 
1.2 Evidence for induction of humoral and cellular immunity to autologous 
melanoma . 
1.3 Evidence for induction of humoral and cellular immunity to the 
allogeneic melanoma cell-line. 
1.4 Evidence for anti melanoma immunity in the immunized patients. 
2 . 0 Background 
Two hundred years after human melanoma was first described, the incidence of 
melanoma is rising more rapidly than any other malignancy excepting lung 
cancer in women. Once extra regional metastasis has occurred, the two year 
survival rate is less than 5 percent (1) . Our understanding of the management 
of advanced melanoma is insufficient and new treatment options are required. 
Such studies will help in the development of new strategies that are capable 
of defining new forms of therapy. 
2.1 Surgical Therapy: Surgical excision is recommended for primary cutaneous 
melanoma. The extent of excision usually depends on the measured thickness 
(depth) of the cutaneous lesion. In general, smaller lesions (<0.76 mm) have 
an excellent prognosis; however, the chance of cure diminishes as the 
thickness increases. In deep-level melanoma (>3.0 mm), even in the absence of 
obvious spread, the incidence of metastatic disease in the regional nodes is 
high, resulting in a lower cure rate and shorter periods of disease-free 
survival. Despite the progress that has been made in implementing strategies 
for disease control based on the recognition of early primary melanomas, the 
mortality rates have risen because of melanoma's burgeoning incidence. This 
increase will translate to 6,700 deaths in the United States this year. The 
main reason for this increase in the death rate is the fact that the prognosis 
is grave after melanoma metastasizes extra regionally. 
2.2 Chemotherapy: Treatment of advanced melanoma with chemotherapy is largely 
based on the use of dacarbazine — still the drug of choice, with a response 
rate of about 15 to 18% (2) . Studies have produced conflicting results 
regarding potentially superior combinations of chemotherapy (3) . Ahmann et al 
(4) recently argued that the survival rate beyond five years of 2% (in 593 
patients with metastatic melanoma who were treated with systemic chemotherapy) 
was not clearly linked to objective responses; they reasoned that it was 
related temporally but not causally to the institution of treatment. Thus, 
current chemotherapy regimens used to treat metastatic melanoma are at best 
palliative and even then are only temporary and actually palliative for a 
small percentage of patients (5) . 
Recombinant DNA Research, Volume 18 
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