A number of vaccine approaches involve the administration of whole melanoma cells with adjuvants, which serve to potentiate the immune response to an antigen. Genetic engineering of these cells (see below) can also induce them to express costimulatory molecules that increase their efficacy as antigen presenting cells (APCs) and/or cytokines which can activate effector cell populations.
Donald Morton and his colleagues have developed a polyvalent melanoma cell vaccine which includes three allogeneic melanoma cell lines, each of which express high concentrations of the six identified melanoma associated antigens (MAAs). Among these antigens are three gangliosides (glycolipids) and three proteins found on the surface of melanoma cells. The cells are irradiated and injected intradermally with BCG, a potent adjuvant. The immune response is then evaluated through ELISA analysis of antibody production. This vaccine has been found to enhance the survival in stage IIIA and IV melanoma by up to a factor of four, and is currently undergoing stage III trials.
M.G. Hanna has developed an autologous tumor vaccine that administers irradiated self tumor cells with BCG in an attempt to jump-start the immune system and evoke a response to distinct tumor antigens that are not usually challenged. An increase in the survival rate of patients suffering from colorectal cancer has been observed in the vaccine's clinical trials. David Berd also utilizes irradiated autologous tumor cells and BCG adjuvant in his whole melanoma cell vaccine. In addtion to the cells and BCG, Berd adds DNP hapten and cyclophosphamide, a cytotoxic drug which augments the cell-mediated immune responses. The vaccine has been observed to induce an inflammatory response as well as T cell infiltration at the site of injection, and has been found to increase survival in melanoma patients.