In contrast to biotherapy with interleukin 2, more recent strategies have focused on using dendritic cells (DCs) as vaccines to enhance antigen-specific immunity. Dendritic cells are theoretically advantageous in a vaccination paradigm since they combine specificity and potency in the activation of antitumor cytolytic T lymphocytes. Although there is general agreement as to the potential benefits of DC therapy, there is a lack of consensus regarding the best vaccination protocols. Several DC trials for metastatic melanoma have been recently published. Nestle et al8 observed objective responses in 5 of 16 patients (2 complete and 3 partial responses) when DCs were loaded with peptides derived from tyrosinase, MART-1, gp100, MAGE-1, and MAGE-3 and injected directly into the lymph nodes (MART indicates melanoma antigen recognized by T cells; MAGE, melanoma-associated antigen). Using a similar panel of peptides but intravenous vaccination, Mackensen et al9 reported a partial clinical response in 1 of 14 patients. Finally, when Thurner et al10 loaded DCs with a single MAGE-3A1 peptide and vaccinated patients by intradermal and intravenous routes,10 they observed partial regression in 6 of 11 patients. In terms of cutaneous immunologic responses, Nestle et al8 observed regression of a single melanocytic nevus in 1 patient, and Mackensen et al9 reported the development of generalized vitiligo in 1 patient of 14. In both cases, the patients' disease progressed despite their having undergone the vaccination.