title: Differential responses to chemoimmunotherapy in patients with metastatic malignant melanoma.
abstract: An open, multicentre non-randomised study was performed to evaluate the activity and toxicity of combination chemoimmunotherapy, consisting of cisplatin, interleukin-2 and interferon-alpha, in metastatic malignant melanoma. Between March 1992 and September 1993, 28 patients with pathologically proven metastatic malignant melanoma, bidimensionally measurable disease and an Eastern Co-operative Oncology Group score < or = 1 were treated with the combination chemoimmunotherapy. The regimen consisted of cisplatin (100 mg/m2 on day 0), interleukin-2 (Proleukin, Chiron, Middlesex, U.K.) 18 x 10(6)IU/m2/d continuous intravenous infusion on days 3-7 and 17-22, with interferon-alpha (Roferon-A, Roche, Hertfordshire, U.K.) 9 x 10(6) U/d subcutaneously on days 3, 5, 7, 17, 19, 21 during the interleukin-2 infusions. The treatment cycle lasted 28 days. Among 27 assessable patients, 5 patients achieved partial responses, for an overall response rate of 18% (95% CI 6-37%). Median progression-free survival was 44 days (range 8-279) and median overall survival was 264 days (range 41-1432). Differential responses were noted in 41% of patients and responses were more frequent in non-visceral disease (skin, lymph node and soft tissue disease) (P = 0.04). These results indicate that differential responses to chemoimmunotherapy are common in patients with metastatic melanoma. This may account for the broad range of response rates reported in the literature.
authors.affiliation: Melanoma Unit, Royal Marsden NHS Trust, London.
authors.forename: P N
authors.initials: PN
authors.lastname: Mainwaring
authors.forename: H
authors.initials: H
authors.lastname: Atkinson
authors.forename: J
authors.initials: J
authors.lastname: Chang
authors.forename: J
authors.initials: J
authors.lastname: Moore
authors.forename: B W
authors.initials: BW
authors.lastname: Hancock
authors.forename: P J
authors.initials: PJ
authors.lastname: Guillou
authors.forename: R
authors.initials: R
authors.lastname: Oskam
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016207:Cytokines / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007167:Immunotherapy; D007370:Interferon Type I / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D016207:Cytokines; D007370:Interferon Type I; D007376:Interleukin-2; D011994:Recombinant Proteins; D002945:Cisplatin