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The treatment of metastatic malignant melanoma that has spread to the lung often requires surgery, chemotherapy, and/or radiation therapy to enhance the quality of life and prolong the survival time of persons with this disease. Now, researchers report that a chemotherapy drug combined with a biologic therapy called interleukin-2, may be an effective new treatment option.

Malignant melanoma is a serious form of cancer that originates in the skin. Treatment options for melanoma depend on the

stage of disease (extent of cancer at diagnosis), and may include surgery, chemotherapy, radiation therapy, and/or biologic therapy.

Metastatic melanoma (stage IV) is cancer that began in the skin and has spread to other parts of the body. Treatment for this stage of disease may include surgery to remove lymph nodes or cancer from areas of metastasis. In addition, radiation therapy, chemotherapy, and/or biologic therapy may be used to relieve the symptoms of disease and prolong survival time. In 30 to 50% of persons with stage IV melanoma, the cancer will spread to the lung. There are several treatment strategies used currently to help control cancer in the lung; however, more effective options are needed. Researchers continue to develop and study new drugs and drug combinations, including biologic therapies to treat persons with melanoma that has spread to the lung.

One type of biologic therapy that has shown promise against this type of cancer is

interleukin-2, sometimes referred to as IL-2. Interleukin-2 is a

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cytokine, a substance that is naturally produced by the body’s immune system. In some cases, the use of interleukin-2 as a therapy can help stimulate the immune system and fight the cancer. In the case of metastatic melanoma, intravenous interleukin-2 has produced response rates of 15 to 20%; however, the side effects of this treatment often limit its use. Efforts to minimize these side effects by developing innovative new ways to deliver interleukin-2 (lower doses, administration under the skin rather than intravenously, and use in combination with other drugs) are ongoing.

Researchers in Germany evaluated the treatment of 27 persons who had metastatic melanoma that had spread to the lung. All patients had experienced a progression of their disease, despite receiving chemotherapy previously. All patients then received chemotherapy with dacarbazine, combined with a high dose of interleukin-2 (36 million units/day), administered by inhalation through the nose. Five patients (27%) had a complete remission of the lung cancer, a remission that still endured 1 year after therapy. In addition, 8 patients had a partial remission and 5 patients had stabilization of their disease (no further growth). These 13 persons experienced progression of their disease when the interleukin-2 was discontinued. The side effects of treatment were minimal.

The researchers concluded that the use of high-dose interleukin-2, taken by inhalation, is an effective treatment for some persons with metastatic melanoma that has spread to the lung. They indicated that interleukin-2 therapy should be continued in persons who have a partial remission or stabilization of disease for as long as the cancer does not show progression. Persons who have metastatic melanoma that has spread to the lung may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which an interleukin-2 (combined with other drugs) or another promising new treatment is being studied. Two sources of information on ongoing clinical trials include clinical trials listing services provided by the National Cancer Institute

( and also performs personalized clinical trial searches on behalf of patients. (

Cancer, Vol 88, No 9, pp 2042-2046, 2000)

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