ADJUVANT THERAPY OF MELANOMA

Patients with AJCC Stage IIB and III melanoma have a poor 5-year survi val rate which has been the driving force behind attempts to find an e ffective adjuvant therapy for this stage of disease that would effecti vely reduce relapse and improve survival. Immunotherapy with bacillus Calmette-Guerin (BCG), Corynebacterium parvum, and levamisole have not been successful in achieving this goal, nor have trials with chemothe rapy in the adjuvant setting, including high-dose chemotherapy with au tologous bone marrow transplantation. The recent Eastern Cooperative O ncology Group (ECOG) 1684 study showed significant improvement in rela pse-free and overall survival with high doses of alpha interferon (IFN alpha) given for 1 year. Lower dosages of IFN alpha have to date been unsuccessful in impacting upon long-term survival. Recent data with v accines have been encouraging, and the GM2-KLH vaccine is the focus of ongoing intergroup study comparing this treatment with IFN alpha in r esected Stage IIB and III melanoma. The various regimens are reviewed in this article. (C) 1998 Wiley-Liss, Inc.