Dose-dependent treatment benefit in high-risk melanoma patients receiving adjuvant high-dose interferon alfa-2b.
This retrospective analysis of 150 consecutive high-risk melanoma patients treated with high-dose interferon alfa-2b at a single institution demonstrates similar relapse-free and overall survival data, as previously published from Eastern Cooperative Oncology Group (ECOG) and Intergroup trials. The data suggest at least a transient dose dependency of the treatment effect on relapse-free and overall survival with high-dose interferon in high-risk melanoma patients.


BACKGROUND
Adjuvant high-dose interferon seems to be the best adjuvant treatment option for patients with high-risk melanoma (AJCC-stage IIC, III) after definitive surgery.


METHODS
One-hundred fifty consecutive patients were treated at our institution during the period from September 1997 to March 2003 were retrospectively studied.


RESULTS
After a median follow-up of 35 months, 63% of patients had developed a melanoma relapse, and 37% were relapse- free. Fifty-five percent of patients are still alive, and 45% had died-all but 3 patients from melanoma. Patients with stage IIC disease demonstrated a similar unfavorable course of disease as patients with stage IIIC disease (2-year relapse-free survival 18% and 26%). We identified two groups of patients with different cumulative interferon dose-levels (> or =90% and <90% of the projected dose, according to the protocol), who demonstrated at least transient differences, both in terms of relapse-free and overall survival; the predictive impact was statistically independent upon the Cox regression analysis.


CONCLUSIONS
Our clinical data are consistent with the published ECOG and Intergroup data dealing with highdose interferon in high-risk melanoma patients. The data suggest a dose-dependency on the treatment effect and, therefore, support further prospective trials comparing different dose-distribution patterns in high-dose interferon.
Fluck
Michael
M
Department of Oncology, Fachklinik Hornheide at the University of Münster, Münster, Germany. micheal.fluck@fachklinik-hornheide.de
Kamanabrou
Darab
D
Lippold
Andrea
A
Reitz
Martina
M
Atzpodien
Jens
J
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007167:Immunotherapy; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D011379:Prognosis; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins