High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: Analysis of 270 patients treated between 1985 and 1993

Purpose: To determine the short- and long-term efficacy and toxicity of the high-dose intravenous bolus interleukin 2 (IL-2) regimen in patients with metastatic melanoma, Patients and Methods: Two hundred seventy assessable patients were entered onto eight clinical trials conducted between 1985 and 1993. IL-2 (Proleukin [aldesleukin]; Chiron Corp, Emeryville, CA) 600,000 or 720,000 IU/kg was a dministered by 15-minute intravenous infusion every 8 hours for up to 14 co nsecutive doses over 5 days as clinically tolerated with maximum support, i ncluding pressors, A second identical treatment cycle was scheduled after 6 to 9 days of rest, and courses could be repeated every 6 to 12 weeks in st able or responding patients, Data were analyzed through fall 1996. Results: The overall objective response rate was 16% (95% confidence interv al, 12% to 21%); there were 17 complete responses (CRs) (6%) and 26 partial responses (PRs) (10%), Responses occurred with ail sites of disease and in patients with large tumor burdens. The median response duration for patien ts who achieved a CR has not been reached and was 5.9 months for those who achieved a PR, Twelve (28%) of the responding patients, including 10 (59%) of the patients who achieved a CR, remain progression-free. Disease did not progress in any patient responding for more than 30 months. Baseline perfo rmance status and whether patients had received prior systemic therapy were the only predictive prognostic factors for response to IL-2 therapy. Toxic ities, although severe, generally reversed rapidly after therapy was comple ted. Six patients (2%) died from adverse events, all related to sepsis, Conclusion: High-dose IL-2 treatment seems to benefit some patients with me tastatic melanoma by producing durable CRs or PRs and should be considered for appropriately selected melanoma patients. (C) 1999 by American Society of Clinical Oncology.