Immunotherapy can be an important modality in the therapy of patients with malignant melanoma. melanoma. Development of novel therapeutic approaches, along with optimization of existing therapies, continues to hold a great promise in the field of melanoma therapy research. Use of anti-CTLA4 and anti-PD1 antibodies, realization of the importance of co-stimulatory signals, which translated into the use of agonist CD40 monoclonal antibodies, as well as activation of innate immunity through enhanced expression of co-stimulatory molecules on the surface of dendritic cells by TLR agonists are only a few items on the list of recent advances in the treatment of melanoma. The need to engineer better immune interactions and to boost positive feedback loops appear crucial for the future of melanoma therapy, which ultimately resides in our understanding of the complexity of immune responses in this disease. Keywords: malignant melanoma, immunotherapy, vaccines, cytokines, immunomodulation, dendritic cells FUNDAMENTAL DISCOVERIES AND PERSPECTIVES IN ANTI-TUMOR IMMUNOTHERAPY Most of the discoveries in human cancer immunology originate from studies of melanoma, a cancer shown to be among the most immunogenic of all tumors. In the past thirty years, much has been learned about the immunobiology of melanoma. As this knowledge continues to expand, so does the potential therapeutic role of immunotherapy in augmenting the antitumor immune Mouse monoclonal antibody to BiP/GRP78. The 78 kDa glucose regulated protein/BiP (GRP78) belongs to the family of ~70 kDa heat shockproteins (HSP 70). GRP78 is a resident protein of the endoplasmic reticulum (ER) and mayassociate transiently with a variety of newly synthesized secretory and membrane proteins orpermanently with mutant or defective proteins that are incorrectly folded, thus preventing theirexport from the ER lumen. GRP78 is a highly conserved protein that is essential for cell viability.The highly conserved sequence Lys-Asp-Glu-Leu (KDEL) is present at the C terminus of GRP78and other resident ER proteins including glucose regulated protein 94 (GRP 94) and proteindisulfide isomerase (PDI). The presence of carboxy terminal KDEL appears to be necessary forretention and appears to be sufficient to reduce the secretion of proteins from the ER. Thisretention is reported to be mediated by a KDEL receptor. responses against melanoma. A schematic representation of P529 the antitumor immune responses generated in melanoma is presented in Figure 1. FIGURE 1 Role of Dendritic Cells (DCs) and Mechanisms of Tumor-Mediated Immunosuppression (schematic). The activation of immature dendritic cells (iDCs) is followed by migration to lymphatic nodes, sites of transformation to mature dendritic cells. The uptake … Melanoma was the first tumor model to reveal CD4 and CD8 cellular specificity to the tumor differentiation antigens gp100 and tyrosinase.1,2 The subsequent efforts to identify specific P529 genes encoding tumor antigens and their corresponding epitopes yielded major progress in further understanding of the antitumoral immune responses. It became clear that genetic changes in cancer cells can lead to the build-up of new specific antigens, which are MHC-restricted and recognized by the CD4+ lymphocytes. MAGE-1 represented the first tumor antigen specifically recognized by the cytotoxic CD8+ lymphocytes. 3 Initial studies on MAGE-1 supported the idea that the human immune system could respond to the tumor antigens, thus sparking a great deal of interest in identifying potential therapeutic P529 targets and biomarkers predicting response to immunotherapy. These advances have contributed to the development of vaccines, natural real estate agents such as for example interferons and inter-leukins, cellular therapies, and antibodies used to take care of melanoma currently. These therapies continue being tested, either by itself or in mixture, to be able to improve the generally unsatisfactory tumor response prices (RRs) ranging just 5% to 10%. The actual fact that effective preclinical research do not often result in clinically significant objective RRs in sufferers with melanoma is a common theme. Although such remedies as vaccines have the ability to induce tumor antigen-specific T-cells considerably, they have just translated into marginal scientific responses, and at the expense of severe or life-threatening autoimmune toxicities often. The actual fact that particular cytotoxic T-cells aren’t capable of effective tumor lysis resulted in the idea of tumor tolerance.4 It really is now clear that various immunosuppressive components in the tumor microenvironment limit the anti-tumor activity of induced anti-suppressor T-cells and other effector cells. Latest advances in the treating melanoma concentrate on concentrating on systems of tumor immunosuppression, including cytotoxic T lymphocyte-associated antigen 4 (CTLA4) and designed loss of life-1 receptor (PD1). This review summarizes fundamental concepts and recent improvements in our understanding and treatment of melanoma. Ongoing development of novel therapeutic methods concurrent with optimization of existing therapies and identification of effective combination treatment regimens continue to hold much promise in the field of melanoma research. CYTOKINES A number of cytokines, including Interleukin-2 (IL-2), Interferon-a (IFN-), alone or in combinations with IL-2, IL-12 as well as others have been P529 tried with various degrees of success in the therapy of melanoma (Table 1). TABLE 1 Clinical Use of Cytokines in Melanoma Interleukin-2 (IL-2) The biological effects P529 of IL-2 are complex. Relevant for malignancy therapy is the enhancement of CTL and NK-cell lysis. In response to IL-2 activation, a mixture of NK and CD8+ cells acquire cytolytic properties, which lead.