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dc.contributor.authorKeilholz, Ulrich
dc.contributor.authorConradt, Christian
dc.contributor.authorLegha, Sewa S
dc.contributor.authorKhayat, David
dc.contributor.authorScheibenbogen, Carmen
dc.contributor.authorThatcher, Nick
dc.contributor.authorGoey, Swan H
dc.contributor.authorGore, Martin
dc.contributor.authorDorval, Thierry
dc.contributor.authorHancock, Barry W
dc.contributor.authorPunt, Cornelis J
dc.contributor.authorDummer, Reinhard
dc.contributor.authorAvril, Marie-Francoise
dc.contributor.authorBröcker, Eva B
dc.contributor.authorBenhammouda, A
dc.contributor.authorEggermont, Alexander M
dc.contributor.authorPritsch, Maria
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.
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
html.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.


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