Clinical Study

Interleukin-2-Based Biochemotherapy for Patients with Stage IV Melanoma: Long-Term Survivors Outside a Clinical Trial Setting
Viviane Hess^a, Richard Herrmann^a, Hendrik Veelken^b, Michael Schwabe<sup>b

a</sup>Department of Medical Oncology, University Hospital Basel, Basel, Switzerland;
^bDepartment of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany

Address of Corresponding Author

Oncology 2007;73:33-40 (DOI: 10.1159/000120029)

  Key Words

• Biochemotherapy
• Interleukin-2
• Survival, long-term disease-free
• Melanoma
• Survival, overall

  Abstract

Background: The role of Interleukin-2 (IL-2)-based biochemotherapy (BCT) for patients with metastatic melanoma remains controversial and few data of patients treated outside a specialized trial setting are available. Methods: Sixty-six consecutive patients treated with BCT for stage IV melanoma were analyzed retrospectively. All patients received BCT consisting of dacarbazine, cisplatin and vinblastine (CVD), interferon alfa-2a (IFN), and IL-2. IL-2 was administered at two different dose levels: 3 × 10⁶ U/m²/day (BCT-3) and 9 × 10⁶ U/m²/day (BCT-9), each intravenously on 4 consecutive days (days 5-8, 17-20, 26-29). Results: Nine of 66 patients achieved a complete (CR) and 11 patients a partial response (PR), resulting in an overall response rate of 30%. Five responses (2 CR and 3 PR) were observed in the 29 patients treated according to the BCT-3 protocol, 15 responses (7 CR and 8 PR) in the 37 patients treated according to the more IL-2 dose-intense BCT-9 protocol (17 vs. 41%; p = 0.033). Median overall survival (OS) for all 66 patients was 10 (range 3-119+) months. Responders had a superior OS than nonresponders (14 vs. 7 months, p < 0.001). After a median follow-up of 70 months, 5 patients are alive. Among them, 4 are in stable CR at 30+, 48+, 79+ and 119+ months, respectively, amounting to a disease-free survival rate of 6% (4/66). Conclusions: Long-term disease-free survival for patients with stage IV melanoma can be achieved with BCT outside a highly specialized clinical trial setting. Better selection criteria are needed in order to avoid the unnecessary toxic treatment of the majority of patients.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Prof. Dr. Hendrik Veelken
Department of Hematology and Oncology, University of Freiburg Medical Center
Hugstetterstrasse 55, DE-79106 Freiburg (Germany)
Tel. +49 761 270 7176, Fax +49 761 270 7175
E-Mail hendrik.veelken@uniklinik-freiburg.de

  Article Information

Received: January 18, 2007
Accepted after revision: August 23, 2007
Published online: March 10, 2008
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 5, Number of References : 23