title: Immunotherapy of metastatic melanoma with interferon-alpha and interleukin-2: pattern of progression in responders and patients with stable disease with or without resection of residual lesions.
abstract: This evaluation was performed in melanoma patients after successful immunotherapy to describe the pattern of relapse. 63 patients received interferon (IFN)-alpha and high-dose interleukin (IL)-2, resulting in three complete responses (CR), 13 partial responses (PR), three mixed responses (MR) and 17 stable diseases (SD). Median duration of response was 7 months (range 3-28) without surgery. Most relapses occurred at pre-existing sites. Duration of CR was 14-37+ months. In 11 patients, residual tumour lesions were resected. Interestingly, histology revealed almost complete tumour regression in 6 patients, including 2 of 4 with SD. 5 of these 11 patients have relapsed so far, 6 patients are still free of disease with a median of 17 months (range 8-34). Following relapse, 4 of 6 patients responded to retreatment with the identical IFN alpha/IL-2 protocol. The authors conclude that initial disease progression is mostly at previous sites of disease. Resection of residual lesions may offer a chance for extended disease-free survival similar to patients with CR to immunotherapy. Retreatment of relapsing patients is favourable.
authors.affiliation: Department of Hematology/Oncology, Medizinische Klinik V, University of Heidelberg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Keilholz
authors.forename: C
authors.initials: C
authors.lastname: Scheibenbogen
authors.forename: E
authors.initials: E
authors.lastname: Stoelben
authors.forename: H D
authors.initials: HD
authors.lastname: Saeger
authors.forename: W
authors.initials: W
authors.lastname: Hunstein
mesh_terms: D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy; D016898:Interferon-alpha / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000627:therapeutic use*; D008545:Melanoma / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D009364:Neoplasm Recurrence, Local
chemical_list: D016898:Interferon-alpha; D007376:Interleukin-2