Immunological gene therapy approaches for malignant melanoma. 1. Tumor-immunological background.

Gene therapy approaches pursuing immunological strategies for the treatment of malignant melanoma play major roles in the current efforts to explore the potential benefits of gene transfer technologies for medicine. This may be explained by the nearly complete resistance of advanced metastatic melanoma towards conventional non-surgical treatment modalities, and the particular immunogenicity of melanoma in connection with a presumed immuno-gene therapeutic 'field effect'. The latter relates to the potency of the immune system to amplify gene transfer effects that are limited due to the imperfection of the currently available gene delivery systems. The ongoing clinical trials focus predominantly on treatment safety and tolerability rather than efficacy. The corresponding tumor-immunological background is reviewed, focusing on a treatment concept centred on tumor-reactive, cytotoxic CD8+ T effector cells.