According to a recent article published in The Lancet, intermediate doses of interferon administered over a short interval do not appear to improve survival over no treatment in patients with stages IIB or III melanoma. However, longer durations of therapy with interferon do appear to improve outcomes.
Melanoma is a type of skin cancer that typically begins in the form of a mole. It is considered an aggressive type of cancer. Once melanoma has spread from its site of origin, cure rates fall dramatically. Stages IIB and III melanoma refer to melanoma that has spread from its site of origin to deeper tissue layers or nearby lymph nodes, but not to distant sites in the body. The majority of patients with this stage of disease experience a cancer recurrence and ultimately succumb to their disease. Researchers continue to evaluate novel treatment regimens to reduce the recurrence risk in this group of patients.
Standard treatment for stages II-III melanoma typically includes surgery to remove the cancer, with or without immunotherapy. Immunotherapy refers to treatment that stimulates the immune system to fight cancer. Melanoma appears particularly responsive to immunotherapy.
Interferon and interleukin-2 are considered immunotherapy agents. These agents, however, are associated with significant reductions in quality of life. In order to improve all aspects of treatment, optimal doses and duration of treatment for early melanoma are still being evaluated and refined.
Researchers affiliated with the European Organization of Research and Treatment for Cancer (EORTC) recently conducted a clinical trial to directly compared surgery plus intermediate doses of interferon to surgery alone in patients with stages IIB-III melanoma. This trial included 1,388 patients who initially underwent surgical removal of their cancer. Patients were then divided into three groups: those treated with interferon for 13 months following surgery; those treated with interferon for 25 months following surgery; and those receiving no further treatment (observation).
Overall, there were no significant differences in outcomes between the three treatment schedules:
The researchers concluded that the addition of intermediate doses of interferon does not appear to significantly increase survival compared to surgery alone in stages IIB-III melanoma. However, patients treated for a longer duration with interferon did improve; an additional trial will evaluate interferon for 5 years following surgery in this group of patients. Patients with stages II-III melanoma may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial evaluating novel treatment approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Eggermont A, Suciu S, MacKie R, et al. Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): a randomized controlled trial. The Lancet. 2005; 366:1189-1196.
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