The use of interleukin-2 (IL-2) and interferon-alpha (IFN alpha) in combina
tion with chemotherapy for the treatment of advanced malignant melanoma has
generated considerable interest. In particular, the relatively high number
of durable complete responses has suggested this may be a significant adva
nce in the treatment of malignant melanoma. We report our experience at the
University of Colorado in 43 patients, Including many with poor prognostic
factors. Patients received cisplatin 20 mg/m(2) on days 1-4, vinblastine 1
.6 mg/m(2) on days 1-4, dacarbazine 800 mg/m(2) on day 1, IL-2 9 x 10(6) IU
/m(2) per day intravenously over 24 h on days 1-4 and IFN alpha 5 x 10(6) I
U/m(2) per day subcutaneously on days 1-5 every 3 weeks. The median follow-
up for all patients was 34 months. Responses were seen in 20 patients (47%,
95% confidence interval 31-62%) and comprised five complete responses (CRs
) (12%) and 15 partial responses (PRs) (35%). Two patients achieving a CR r
emain disease free at 45 and 47 months follow-up. In addition three patient
s who obtained a surgical CR and another with only minor residual changes o
n computed tomography scan have not progressed at 27, 30, 40 and 27 months,
respectively. Toxicity was manageable, but all patients had at least one g
rade 3 or 4 toxicity, predominantly hypotension and neutropenia. There were
no treatment-related deaths. In conclusion, the response rate and duration
is within the range previously reported for biochemotherapy. The results o
f ongoing randomized studies are awaited to better define the value of bioc
hemotherapy in the treatment of advanced melanoma. (C) 2000 Lippincott Will
iams & Wilkins.