A promising interferon plus four-drug chemotherapy regimen for metastatic melanoma.

Pyrhönen, Seppo; Hahka‐Kemppinen, Marjo; Muhonen, Timo

doi:10.1200/jco.1992.10.12.1919

Cited by 99 publications

(45 citation statements)

References 26 publications

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“…We observed an overall objective response in 34.3% of patients treated with the combined chemoimmunotherapy which is comparable with earlier trials achieving response rates between 23% to 64% (Atkins et al, 1994;Atzpodien et al, 1995;Feun et al, 1995;Hoffmann et al, 1998;Johnston et al, 1998;Legha, 1998;Middleton et al, 2000;Pyrhonen et al, 1992;Rosenberg et al, 1999;Thompson et al, 1997). Whereas in previous clinical trials, introducing cytokines in chemotherapeutic regimens yielded an enhanced efficacy (Atkins et al, 1994;Legha et al, 1996), our results raise doubts concerning the potential benefits of the presently used dosages of IL-2 and INF-a for therapy of metastatic melanoma since objective response rates of patients treated with chemotherapy alone were similar (29.9%) to sequential chemoimmunotherapy (34.3%).…”

Section: Discussionsupporting

confidence: 90%

Combination chemotherapy with or without s.c. IL-2 and IFN-α: results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemoimmunotherapy Group (ACIMM)

et al. 2002

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The purpose of this randomized trial was to evaluate the efficacy of combination chemoimmunotherapy compared with chemotherapy alone. A total of 124 patients were randomized to receive intravenous cisplatin (35 mg m 72 , days 1 -3), carmustine (150 mg m 72 , day 1, cycles 1 and 3 only), dacarbacine (220 mg m 72 , days 1 -3) and oral tamoxifen (20 mg m 72 , daily) in combination with (n=64) or without (n=60) sequential subcutaneous IL-2 and IFN-a. In those patients who received sequential immunotherapy, each cycle of chemotherapy was followed by outpatient s.c. IL-2 (10610 6 IU m 72 , days 3 -5, week 4; 5610 6 IU m 72 , days 1, 3, 5, week 5) and s.c. IFN-a (5610 6 IU m 72 , day 1, week 4; days 1, 3, 5, week 5). The overall response rate of patients treated with the combination of chemotherapy and IL-2/IFN-a was 34.3% with seven complete responses (10.9%) and 15 partial responses (23.4%). In patients treated with chemotherapy, only, the overall response rate was 29.9% with eight complete responses (13.3%) and 10 partial responses (16.6%). There was no significant difference in median progression free survival (0 months vs 4 months) and in median overall survival (12 months vs 13 months) for combined chemoimmunotherapy and for chemotherapy, respectively.

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Section: Discussionsupporting

confidence: 90%

Combination chemotherapy with or without s.c. IL-2 and IFN-α: results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemoimmunotherapy Group (ACIMM)

et al. 2002

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“…This is in contrast to stage IV patients with nonvisceral and visceral metastases, who may have a 1-year-survival rate of 46% and 18% respectively and median survival times of 8 and 3 months respectively . Furthermore, 71% of our patients had a WHO performance status of < 1, whereas this was the case for 92% of patients in the study by Pyrhonen et al (1992). Another aspect associated with poor prognosis was the median number of three metastatic sites in patients from our study, and in a previous review no patients with this characteristic survived for more than 1 year .…”

Section: Discussioncontrasting

confidence: 52%

“…Second, there are important differences between the patient populations of the two studies. In the study of Pyrhonen et al, (1992), 22 of the 48 patients (46%) had stage III disease, whereas all our patients had stage IV disease. For stage III melanoma patients with regional lymph node metastases, surgery with regional radical lymphadenectomy is the treatment of choice, and for patients with intransit metastases of an extremity isolated limb perfusion is preferred.…”

Section: Discussionmentioning

confidence: 62%

“…Another aspect associated with poor prognosis was the median number of three metastatic sites in patients from our study, and in a previous review no patients with this characteristic survived for more than 1 year . It can therefore be concluded that our patient population consisted of a group with a worse prognosis than those in the study by Pyrhonen et al (1992). In that study, 10% of patients had brain metastases and several patients had been systemically pretreated.…”

Section: Discussionmentioning

confidence: 68%

“…The median duration of response and survival in these studies was reported to be up to 9 months and 14 months respectively. Pyrhonen et al, ( 1992) reported a 62% response rate (95% confidence limit 48-77%) with 13% complete responses in 45 patients upon combination treatment consisting of BOLD plus IFN-ax. Two patients with stable disease and two with progressive disease responded when the administration of IFN-ax was changed from a weekly to an intermittent schedule.…”

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confidence: 99%

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Chemoimmunotherapy with bleomycin, vincristine, lomustine, dacarbazine (BOLD) plus interferon α for metastatic melanoma: a multicentre phase II study

Punt

Herpen²,

Jansen³

et al. 1997

Br J Cancer

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Summary High response rates in patients with metastatic melanoma have been achieved with combination chemoimmunotherapy. A response rate of 62% in 45 patients has been reported for treatment with dacarbazine, bleomycin, vincristine, lomustine (BOLD) plus interferon ax (IFN-ax). We conducted a multicentre phase 11 study to confirm these results. Melanoma patients with distant metastases were treated as outpatients with dacarbazine 200 mg m-2 on days 1-5, vincristine 1 mg m-2 on days 1 and 4, bleomycin 15 mg on days 2 and 5 i.v. and lomustine 80 mg orally on day 1, repeated every 4 weeks. IFN-a-2b was initiated s.c. on day 8 at 3 MU daily for 6 weeks, and 6 MU t.i.w. thereafter. Forty-three patients entered the study. The median number of metastatic sites was three (range 1-5), and 81% of patients had visceral metastases. Nine patients had brain metastases, and seven patients were systemically pretreated. Among the 41 patients that were evaluable for response, the response rate was 27% (95% Cl 14-43%), with one complete and ten partial remissions. The response rate in 25 previously untreated patients without brain metastases was 40% (95% Cl 21-61%). Median duration of response was 6 (range 2-14+) months; median overall survival was 5 (1-26) months. The main toxicity was malaise/fatigue. We confirm that BOLD plus IFN-aX has activity in metastatic melanoma. The lower response rate in our study compared with the previous report is probably related to patient selection, as in the previous study 46% of patients had stage IlIl disease, whereas all our patients had stage IV disease, which is associated with a worse prognosis.

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Hepatic Abnormalities Identified on Abdominal Computed Tomography at Diagnosis of Uveal Melanoma

Feinstein

Marr²,

Winston³

et al. 2010

Arch Ophthalmol

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To determine the prevalence of hepatic abnormalities identified during abdominal computed tomography (CT) performed within 1 month of the diagnosis of primary uveal melanoma.Methods: Retrospective review of CT reports generated within 1 month following diagnosis of uveal melanoma in 91 patients at Memorial Sloan-Kettering Cancer Center, New York, New York, from 2004 to 2009.Results: Of 198 patients reviewed, 91 (46%) had a CT scan within 1 month of uveal melanoma diagnosis; 1 or more hepatic abnormalities were identified in 50 of these patients (55%). Abnormalities included 38 focal (13 solitary, 25 multiple) and 15 diffuse (11 partial, 4 complete) lesions. Six patients had hepatic lesions suspected to be metastatic melanoma, but this was confirmed in only 3. Lesions suspected to be metastases were more

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A promising interferon plus four-drug chemotherapy regimen for metastatic melanoma.

Abstract: Results demonstrate a remarkably high response rate in combining IFN-alpha and four chemotherapeutic agents. The apparent schedule-dependency of responses must be further explored in a controlled phase III study.

Cited by 99 publications

References 26 publications

Combination chemotherapy with or without s.c. IL-2 and IFN-α: results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemoimmunotherapy Group (ACIMM)

Combination chemotherapy with or without s.c. IL-2 and IFN-α: results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemoimmunotherapy Group (ACIMM)

Chemoimmunotherapy with bleomycin, vincristine, lomustine, dacarbazine (BOLD) plus interferon α for metastatic melanoma: a multicentre phase II study

Hepatic Abnormalities Identified on Abdominal Computed Tomography at Diagnosis of Uveal Melanoma

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