Alfred E. Chang, MD

Haigh et al provide thoughtful, detailed summary of 3 decades of intensive work aimed at developing active, specific immuno-therapies (vaccines) for patients with melanoma. However, as the 20th century draws to a close, the key question is: Can any vaccine be considered an effective therapy for patients with melanoma? To rephrase the question: What constitutes proof of efficacy for a melanoma vaccine, and have any vaccines met those criteria? In a word, the answer to the first question is “no.” The answer to the second question, however, requires more elaboration.

Very little has changed in the management of advanced renal cell carcinoma since the approval of interleukin-2 (IL-2, aldesleukin [Proleukin]) in 1992 by the FDA for the systemic treatment of this disease. Dr. Bukowski succinctly reviews the