Practical guidelines for the management of interferon‐α‐2b side effects in patients receiving adjuvant treatment for melanoma

Abstract

Interferon-alpha-2b (IFNalpha2b) is the only effective adjuvant therapy for melanoma patients at high risk of recurrence that has been approved by regulatory authorities worldwide. However, IFN toxicities increase the risk of poor treatment compliance and impair the potential for benefit from this agent. A review of the literature demonstrated little recent attention to supportive care in the management of IFN toxicities. An international group of experts with extensive personal experience in the use of IFNs worked together to develop practical guidelines for the use of IFNs. Practical recommendations were developed for patient education on the use of IFN; initial patient assessment and monitoring, including contraindications to the use of IFN, monitoring and managing adverse events, and IFN dose modification and discontinuation; IFN injection procedures; treatment of elderly patients; and use during pregnancy and nursing. Successful adjuvant therapy of melanoma with high-dose IFN requires close compliance with the treatment regimen. Recommendations for the recognition and management of adverse events are designed to enable more patients to complete the full planned course of treatment.

miR-146a negatively regulates NK cell functions via STAT1 signaling

“…IFN-α is used for the treatment of cancers as well as HBV and HCV infections, 26,27 IL-12 treatment maybe highly beneficial in the context of therapies by enhancing NK cell functions in cancer patients. 28 To evaluate whether these cytokines could reverse miR-146a expression in NK cells from CHB and HCC patients, isolated NK cells were treated with IFN-α/β and IL-12.…”

Mental Health Services Use by Melanoma Patients Receiving Adjuvant Interferon: Association of Pre-treatment Mental Health Care with Early Discontinuation

“…Discontinuation of hd-ifn is recommended when dose adjustment is not sufficient to control side effects 16,17 . Significant mental health effects of ifn are a recognized reason for discontinuation 11,16,17 .…”

“…Discontinuation of hd-ifn is recommended when dose adjustment is not sufficient to control side effects 16,17 . Significant mental health effects of ifn are a recognized reason for discontinuation 11,16,17 . "Duration" was defined as time on IV ifn plus time on subcutaneous (sc) ifn based on the date of the last sc ifn prescription plus the median time interval between prescription dates.…”

The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma

“…Practical guidelines for clinical management of interferon-α2b-related adverse effects are available. 32 …”

“…[47][48][49][50][51][52][53][54][55][56][57][58] The development of autoimmunity might be associated with clinical response, as a report demonstrated an association between autoimmune thyroid dysfunction and improved relapse-free and overall survival in patients with melanoma who were treated with adjuvant interferon-α2b or IL-2. 58,59 Although the panel recognizes published guidelines for the treatment of patients with interferon-α2b, 32 IL-2 60 and ipilimumab, 10 four special-issue topics were identified where there are not significant level A or level B data to guide clinical recom mendations. These issues include the manage ment of interferon-related depression, frequency of clinical labora tory monitoring and imaging during treatment and how to determine when to stop therapy (Box 2).…”