Vaccines as treatment for melanoma: an update review.

Background: In past three decades, the development of therapeutic vaccines has been a major focus in melanoma research. This strategy seeks to prime the immune system to combat the cancer, ideally leading to the eradication of recurrent disease or a delay in its progression. To date, clinical trials have assessed multiple vaccine methodologies, but the evidence for a clear clinical impact remains ambiguous. Data sources: We retrieved relevant clinical trials published as of 1990 through electronic databases, including PubMed, the Cochrane library and ClinicalTrials.gov. The key search terms were "melanoma," "vaccine," and "clinical trials". Study selection: Publications that met the following criteria were included as follows: (i) melanoma patients included; (ii) clinical trial registered; (iii) described the patients' outcomes; (iv) were full-text articles published in English. Results: A total of sixteen distinct methodologies have been evaluated in randomized phase III clinical trials. Among these, Talimogene laherparevec (T-VEC) is the sole vaccine that has received approval from the U.S. Food and Drug Administration (FDA) for melanoma treatment. Most vaccine strategies demonstrated acceptable safety profiles and elicited immune responses, but they exhibited limited clinical efficacy. When integrated with other immunomodulatory agents, their therapeutic potential appears significantly enhanced. Conclusions: Within future therapeutic frameworks, melanoma vaccines are envisioned to play a key role by inducing and amplifying a targeted T-cell response against cancer. This approach is particularly suited for combination with other immunotherapies that neutralize the resistance mechanisms found in the tumor microenvironment.