Results of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients.

2.50
Hdl Handle:
http://hdl.handle.net/10541/91885
Title:
Results of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients.
Authors:
Keilholz, Ulrich; Conradt, Christian; Legha, Sewa S; Khayat, David; Scheibenbogen, Carmen; Thatcher, Nick; Goey, Swan H; Gore, Martin; Dorval, Thierry; Hancock, Barry W; Punt, Cornelis J; Dummer, Reinhard; Avril, Marie-Francoise; Bröcker, Eva B; Benhammouda, A; Eggermont, Alexander M; Pritsch, Maria
Abstract:
PURPOSE: In patients with stage IV melanoma, durable responses have been reported with treatment regimens that involve high-dose interleukin-2 (IL-2). We analyze long-term results of 631 melanoma patients from 12 institutions who had received IL-2 alone, in combination with interferon alfa 2a or 2b (IFNalpha), or with cytotoxic drugs. METHODS: Case records that contained pretreatment parameters, response data, and updated survival information were collected. After univariate analysis, the multivariate evaluation of the impact of pretreatment parameters on response and survival was performed by logistic regression and Cox's regression, respectively. RESULTS: Patients were divided into four groups according to treatment: IL-2 alone (n=117), IL-2 and chemotherapy (n=49), IL-2 and IFNalpha (n=153), and IL-2, chemotherapy, and IFNalpha (n=312). The median survival of all patients was 10.5 months and the 2- and 5-year survival rates were 19.9% and 10.4%, respectively. Independent prognostic factors for response and survival were entirely different, treatment group being the only significant factor for response, and serum lactate dehydrogenase (LDH), metastatic site, and performance predicting survival. The addition of IFNalpha to IL-2 was associated with prolonged survival, but the effect of additional chemotherapy was less obvious. CONCLUSION: Serum LDH, metastatic site, and performance status are useful stratification factors for randomized trials in metastatic melanoma. The improved long-term survival rates observed in melanoma patients treated with IL-2/IFNalpha-containing regimens are notable in contrast to the reported 5-year survival rates of 2% to 6% achieved with chemotherapy, but because selection bias cannot be ruled out, the impact of IL-2, as well as all other components of the treatment regimens, on survival needs to be confirmed in prospective randomized trials.
Affiliation:
Department of Medicine III (Hematology/Oncology/Transfusion Medicine), University Hospital Benjamin Franklin, Free University Berlin, Germany. Keilholz@ukbf.fu-berlin.de
Citation:
Results of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients. 1998, 16 (9):2921-9 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
Sep-1998
URI:
http://hdl.handle.net/10541/91885
PubMed ID:
9738559
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
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Full metadata record

DC FieldValue Language
dc.contributor.authorKeilholz, Ulrichen
dc.contributor.authorConradt, Christianen
dc.contributor.authorLegha, Sewa Sen
dc.contributor.authorKhayat, Daviden
dc.contributor.authorScheibenbogen, Carmenen
dc.contributor.authorThatcher, Nicken
dc.contributor.authorGoey, Swan Hen
dc.contributor.authorGore, Martinen
dc.contributor.authorDorval, Thierryen
dc.contributor.authorHancock, Barry Wen
dc.contributor.authorPunt, Cornelis Jen
dc.contributor.authorDummer, Reinharden
dc.contributor.authorAvril, Marie-Francoiseen
dc.contributor.authorBröcker, Eva Ben
dc.contributor.authorBenhammouda, Aen
dc.contributor.authorEggermont, Alexander Men
dc.contributor.authorPritsch, Mariaen
dc.date.accessioned2010-02-11T16:29:18Z-
dc.date.available2010-02-11T16:29:18Z-
dc.date.issued1998-09-
dc.identifier.citationResults of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients. 1998, 16 (9):2921-9 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid9738559-
dc.identifier.urihttp://hdl.handle.net/10541/91885-
dc.description.abstractPURPOSE: In patients with stage IV melanoma, durable responses have been reported with treatment regimens that involve high-dose interleukin-2 (IL-2). We analyze long-term results of 631 melanoma patients from 12 institutions who had received IL-2 alone, in combination with interferon alfa 2a or 2b (IFNalpha), or with cytotoxic drugs. METHODS: Case records that contained pretreatment parameters, response data, and updated survival information were collected. After univariate analysis, the multivariate evaluation of the impact of pretreatment parameters on response and survival was performed by logistic regression and Cox's regression, respectively. RESULTS: Patients were divided into four groups according to treatment: IL-2 alone (n=117), IL-2 and chemotherapy (n=49), IL-2 and IFNalpha (n=153), and IL-2, chemotherapy, and IFNalpha (n=312). The median survival of all patients was 10.5 months and the 2- and 5-year survival rates were 19.9% and 10.4%, respectively. Independent prognostic factors for response and survival were entirely different, treatment group being the only significant factor for response, and serum lactate dehydrogenase (LDH), metastatic site, and performance predicting survival. The addition of IFNalpha to IL-2 was associated with prolonged survival, but the effect of additional chemotherapy was less obvious. CONCLUSION: Serum LDH, metastatic site, and performance status are useful stratification factors for randomized trials in metastatic melanoma. The improved long-term survival rates observed in melanoma patients treated with IL-2/IFNalpha-containing regimens are notable in contrast to the reported 5-year survival rates of 2% to 6% achieved with chemotherapy, but because selection bias cannot be ruled out, the impact of IL-2, as well as all other components of the treatment regimens, on survival needs to be confirmed in prospective randomized trials.en
dc.language.isoenen
dc.subjectCancer Stagingen
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshClinical Trials, Phase I as Topic-
dc.subject.meshClinical Trials, Phase II as Topic-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInterferon Alfa-2a-
dc.subject.meshInterferon Alfa-2b-
dc.subject.meshInterleukin-2-
dc.subject.meshL-Lactate Dehydrogenase-
dc.subject.meshMale-
dc.subject.meshMelanoma-
dc.subject.meshMiddle Aged-
dc.subject.meshMultivariate Analysis-
dc.subject.meshNeoplasm Staging-
dc.subject.meshPrognosis-
dc.subject.meshRegression Analysis-
dc.subject.meshSurvival Analysis-
dc.titleResults of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine III (Hematology/Oncology/Transfusion Medicine), University Hospital Benjamin Franklin, Free University Berlin, Germany. Keilholz@ukbf.fu-berlin.deen
dc.identifier.journalJournal of Clinical Oncologyen

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