Purpose: Melanoma is a common and deadly tumor that upon metastasis to the central nervous system has a median survival duration of <6 months. Activation of the signal transducer and activator of transcription 3 (STAT3) has been identified as a key mediator that drives the fundamental components of melanoma malignancy, including immune suppression in melanoma patients. We hypothesized that WP1193, a novel inhibitor of STAT3 signaling, would enhance the antitumor activity of IFN-α against metastatic melanoma.Experimental Design: Combinational therapy of STAT3 blockade agents with IFN-α was investigated in a metastatic and an established syngeneic intracerebral murine tumor model of melanoma. The immunologic in vivo mechanisms of efficacy were investigated by T-cell and natural killer (NK) cell cytotoxic assays.Results: IFN-α immunotherapy was synergistic with WP1193 showing marked in vivo efficacy against metastatic and established intracerebral melanoma. At autopsy, it was noted that there was a decreased trend in mice with melanoma developing leptomeningeal disease treated with combinational therapy. The combinational approach enhanced both NK-mediated and T-cell-mediated antitumor cytotoxicity.Conclusions: The immune modulatory effects of STAT3 blockade can enhance the therapeutic efficacy of IFN-α immunotherapy by enhancing both innate and adaptive cytotoxic T-cell activities. This combination therapy has the potential in the treatment of metastatic melanoma that is typically refractory to this type of immune therapeutic approach. Clin Cancer Res; 16(9); 2550-61. ©2010 AACR.Patients with stage IV melanoma, especially upon metastasis to the brain, have a median survival duration of <6 months (1) despite multimodality therapy, and the prognosis is even more dire in patients who develop leptomeningeal disease (LMD), who have a median survival of <2 months. Several large, cooperative-group adjuvant trials have documented a 24% to 38% reduction in the relative relapse risk with the use of high-dose IFN-α for stages II and III melanoma with overall survival prolongation (2). In contrast, no large cooperative-group trials have shown significant prolongation of survival with IFN-α for inoperable stage IV melanoma and especially for those with central nervous system (CNS) melanoma and metastasis. IFN-α is known to have powerful effects on immune cells, including enhancing natural killer (NK) cell tumor cytotoxicity (3), dendritic cell maturation, Th1 skewing, enhancement of T-cell survival, inducing immunologic memory (4), and inhibiting the invasive ability of cancer cells (5). Therapeutic strategies using IFN-α in melanoma patients with LMD have included the direct intraventricular administration of IFN-α, which resulted in the clearance of malignant cells in the cerebrospinal fluid (6) but was confounded by significant and sustained neurotoxicity (7). Thus, there is a clear clinical need to identify treatment modalities that exert therapeutic effects in melanoma patients with CNS disease.A key transcription...