DIFFERENTIAL RESPONSES TO CHEMOIMMUNOTHERAPY IN PATIENTS WITH METASTATIC MALIGNANT-MELANOMA

An open, multicentre non-randomised study was performed to evaluate th e activity and toxicity of combination chemoimmunotherapy, consisting of cisplatin, interleukin-2 and interferon-alpha in metastatic maligna nt melanoma. Between March 1992 and September 1993, 28 patients with p athologically proven metastic malignant melanoma, bidimensionally meas urable disease and an Eastern Go-operative Oncology Group score less t han or equal to 1 were treated with the combination chemoimmunotherapy . The regimen consisted of cisplatin (100 mg/m(2) on day 0), interleuk in-2 (Proleukin, Chiron, Middlesex, U.K.) 18 x 10(6)IU/m(2)/d continuo us intravenous infusion on days 3-7 and 17-22, with interferon-alpha ( Roferon-A, Roche, Hertfordshire, U.K.) 9 x 10(6)U/d subcutaneously on days 3, 5, 7, 17, 19, 21 during the interleukin-2 infusions. The treat ment cycle lasted 28 days. Among 27 assessable patients, 5 patients ac hieved partial responses, for an overall response rate of 18% (95% Cl 6-37%). Median progression-free survival was 44 days (range 8-279) and median overall survival was 264 days (range 41-1432). Differential re sponses were noted in 41% of patients and responses were more frequent in non-visceral disease (skin, lymph node and soft tissue disease)(P = 0.04). These results indicate that differential responses to chemoim munotherapy are common in patients with metastatic melanoma. This may account for the broad range of response rates reported in the literatu re. (C) 1997 Elsevier Science Ltd.