IMMUNOTHERAPY OF METASTATIC MELANOMA WITH INTERFERON-ALPHA AMD INTERLEUKIN-2 - PATTERN OF PROGRESSION IN RESPONDERS AND PATIENTS WITH STABLE DISEASE WITH OR WITHOUT RESECTION OF RESIDUAL LESIONS

This evaluation was performed in melanoma patients after successful im munotherapy to describe the pattern of relapse. 63 patients received i nterferon (IFN)-alpha and high-dose interleukin (IL)-2, resulting in t hree complete responses (CR), 13 partial responses (PR), three mixed r esponses (MR) and 17 stable diseases (SD). Median duration of response was 7 months (range 3-28) without surgery. Most relapses occurred at pre-existing sites. Duration of CR was 14-37+ months. In 11 patients, residual tumour lesions were resected. Interestingly, histology reveal ed almost complete tumour regression in 6 patients, including 2 of 4 w ith SD. 5 of these 11 patients have relapsed so far, 6 patients are st ill free of disease with a median of 17 months (range 8-34). Following relapse, 4 of 6 patients responded to retreatment with the identical IFN alpha/IL-2 protocol. The authors conclude that initial disease pro gression is mostly at previous sites of disease. Resection of residual lesions may offer a chance for extended disease-free survival similar to patients with CR to immunotherapy. Retreatment of relapsing patien ts is favourable.