A recent report published in the Journal of Clinical Oncology has found that 9 weeks of multiagent biochemotherapy can significantly improve relapse-free survival in patients with high-risk melanoma, when compared to the commonly used 1-year course of high-dose interferon.
“This [phase III] randomized trial is the first to compare a multiagent regimen against high-dose interferon … and the first to demonstrate a statistically significant relapse-free survival benefit for any treatment regimen over high-dose interferon,” Dr. Lawrence E. Flaherty of Wayne State University and the Karmanos Cancer Institute, Detroit, said in a Skin & Allergy News release.
The research team analyzed a group of patients aged 10-74 years who had received wide excision of a cutaneous primary melanoma and a complete regional lymphadenectomy.
Importantly, all participants in this study did not present any evidence of metastatic disease and had never received radiation therapy treatment, chemotherapy, or immunotherapy for any form of cancer.
Subjects received either high-dose intravenous interferon for 52 weeks, or three cycles of cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon every 21 days.
The team followed all participants for a median of 7.2 years, after which time the median relapse-free survival was registered as 4.0 years for biochemotherapy versus 1.9 years for high-dose interferon alone.
Additionally, biochemotherapy was associated with a 5-year relapse-free survival rate of 48%, compared to 39% for high-dose interferon alone.
However, when researchers looked at overall survival, no improvement was observed for biochemotherapy, with both groups showing a 5-year overall survival of 56%. Nonetheless, median overall survival was still higher for biochemotherapy (9.9 years) when compared with only 6.7 years for the high-dose interferon group.
“Toxicities for biochemotherapy and high-dose interferon are different but comparable in magnitude, particularly when discontinuation for toxicity is considered,” the authors wrote in their study “Sequential Biochemotherapy Versus Chemotherapy for Metastatic Melanoma: Results From a Phase III Randomized Trial”.
In fact, even though biochemotherapy was associated with an increase in grade 4 toxicity, most of these deleterious effects were hematologic and of short duration.
Overall, these results show that biochemotherapy may become an alternative adjuvant treatment for high-risk melanoma. As Dr. Flaherty and colleagues explained “in appropriately selected patients by physicians at centers experienced in the use of this regimen”.
