Inclusion Criteria:

For both stage III and IV

• Histological proof of cutaneous melanoma
• Melanoma expressing both gp100 and tyrosinase, each in approximately 20% or more of cells by immunohistochemistry staining,
• HLA type A2 and/or A3, with known HLA-DR4 expression,
• WBC > 3.0 x 109/l, lymphocytes > 0.8 x 109/l, platelets > 100 x 109/l, serum creatinine < 150 μmol/l, serum bilirubin < 25 μmol/l.
• Expected adequacy of follow-up,
• Written informed consent.

For Stage III only

• Stage III melanoma according to the 2001 AJCC criteria.
• Start of treatment within 2 months of lymph node dissection for melanoma stage III

For stage IV only

• Stage IV melanoma according to the 2001 AJCC criteria. Limited tumor burden; LDH < 2x upper limit of normal

Exclusion Criteria:

For both stage III and IV

• No autoimmune disorders, no concomitant use of immunosuppressive drugs,
• no serious concomitant disease, no serious active infections, no other malignancy in the past 5 years with the exception of curatively treated carcinoma in-situ of the cervix/squamous cell carcinoma of the skin,
• No known allergy to shell fish (contains KLH) are excluded.
• No pregnancy or lactation,

For stage III only:

• No signs or symptoms of distant metastases as defined by normal history, physical examination, chest X-ray and serum LDH.
• No concomitant or previous systemic treatment for melanoma

For stage IV only:

• No clinical signs of CNS metastases, in patients with a clinical suspicion of CNS metastases, a CT scan of the brain should be performed to exclude this.
• No prior chemotherapy, immunotherapy, or radiotherapy within three months before planned vaccination is allowed.