title: The role of interleukin-2 in the management of stage IV melanoma: the EORTC melanoma cooperative group program.
abstract: OBJECTIVE
  To review the current information available from the European Organization for Research and Treatment of Cancer (EORTC) programs on the use of interleukin (IL)-2 in stage IV melanoma patients.
  
  
  METHODS
  A database from 631 patients treated within 27 trials with high-dose IL-2-based regimens was compiled to develop hypotheses and valid stratification factors for randomized trials. Subsequently, 126 patients were enrolled in a trial evaluating interferon alfa (IFN-alpha) and IL-2 with or without cisplatin, and 325 patients were enrolled in an ongoing EORTC trial (18951) to evaluate dacarbazine, cisplatin, and IFN-alpha, with or without IL-2.
  
  
  RESULTS
  The database suggests long-term survival rates of 23% and a 5-year survival rate of 13% for patients receiving a combination of IFN-alpha and IL-2 with or without chemotherapy. The addition of chemotherapy improved response rate but not survival. The first randomized trial testing the role of cisplatin in a chemoimmunotherapy regimen for advanced melanoma revealed a palliative effect for cisplatin but no survival benefit. The current trial (EORTC 18951), which is testing the impact of IL-2 on survival, is still immature. In the translational research program, we have evidence that patients in continuous complete remission after IL-2-based treatment have evidence of residual disease by polymerase chain reaction assay and, at the same time, melanoma-reactive T cells are present in the peripheral blood.
  
  
  CONCLUSIONS
  Mature results defining the role and, to some extent, the mechanism of IL-2 in advanced melanoma are emerging.
authors.affiliation: Department of Medicine III (Hematology, Oncology and Transfusion Medicine), University Hospital Benjamin Franklin, Free University of Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Keilholz
authors.forename: A M
authors.initials: AM
authors.lastname: Eggermont
mesh_terms: D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003606:Dacarbazine / Q000627:therapeutic use; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use*; D008545:Melanoma / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D016898:Interferon-alpha; D007376:Interleukin-2; D003606:Dacarbazine; D002945:Cisplatin