An update on adjuvant interferon for melanoma.
BACKGROUND
Despite advances in the staging and surgical therapy of melanoma, patients with high-risk resected melanoma still have 5-year recurrence rates of 55% to 80% and 5-year survival rates as low as 25% to 70%. Effective adjuvant therapy is needed for this patient population.


METHODS
The authors review the literature regarding the use of interferon for the adjuvant therapy of resected melanoma.


RESULTS
Low-dose adjuvant interferon regimens have not affected overall survival and have had an inconsistent effect on disease-free survival across different stage groupings. High-dose adjuvant interferon improved disease- free and overall survival in the E1684 and Intergroup E1694 trials. High-dose interferon regimens cause significant morbidity, but quality-adjusted years of life are greater with this therapy.


CONCLUSIONS
Adjuvant high-dose interferon should be considered standard therapy for all high-risk melanoma patients expected to be able to tolerate the interferon and treated off protocol. In addition, this regimen should serve as the active control in future trials of alternative adjuvant therapies for these patients.
Gray
Richard J
RJ
Division of General Surgery, Mayo Clinic, Arizona, USA. gray.richard@mayo.edu
Pockaj
Barbara A
BA
Kirkwood
John M
JM
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D020360:Neoadjuvant Therapy / Q000379:methods; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
D000276:Adjuvants, Immunologic; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins