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Adjuvant interferon in melanoma – a resurrection?

Authors
Journal
British Journal of Cancer
0007-0920
Publisher
Nature Publishing Group
Publication Date
Identifiers
DOI: 10.1054/bjoc.2001.1798
Keywords
  • Editorial
Disciplines
  • Biology
  • Medicine

Abstract

Editorial - Adjuvant interferon in melanoma – a resurrection? o U British Journal of Cancer (2001) 84(9), 1141–1142 © 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2001.1798, available online at http://www.idealibrary.com on http://www.bjcancer.com Results of the Eastern Co-operative Oncology Group (ECOG) 1684 trial of high-dose interferon (HDI) versus observation in resected stage IIB or III melanoma (primary tumour >4 mm in depth and/or lymph node involvement) were published in 1996 (Kirkwood et al, 1996). The study was the first to show a statisti- cally significant improvement in relapse-free and overall survival in these patients with a high risk of relapse. This was hailed as a breakthrough in the USA: here at last, after many negative studies, was an effective treatment. In Europe the response was more muted, with many oncologists unwilling to submit patients to such an arduous regimen without further supportive evidence. The results of the Intergroup E1690 study were therefore disap- pointing: although the improvement in relapse-free survival with high-dose treatment seen in the ECOG 1684 trial was confirmed there was no improvement in overall survival (Kirkwood et al, 2000a). The difference in these results is due to an improvement in the outcome of patients kept under observation in the later trial, there being an increase in median survival after relapse from 1.8 years in ECOG 1684 to 4.3 years in E1690. The reasons for this remain unclear: salvage therapy with interferon at relapse accounts for some of the increase and there were differences between the two study populations. Whatever the explanation, these conflicting reports on the efficacy of HDI have led to only limited uptake of the regimen in the UK to date. A number of studies of low-dose interferon (LDI) in this indica- tion have also been undertaken. The first major study, conducted under the auspices of the World Health Organization, showed no improvement in relapse-free or overall survival for patient

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