Other Treatments for Melanoma
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The primary treatment for melanoma is surgical. Although requiring further clinical trials, in some cases, biological therapy may be used in the treatment of melanoma.
Hundreds of combination therapies are currently in trials. Advanced melanoma patients should be considered for enrollment in a trial for their own benefit as well as for the advancement of melanoma treatment. Thus far, no single investigative approach stands out as highly effective; however, they all hold promise with rare patients showing durable responses. Most treatment protocols are evaluating combinations of adjuvant therapies, hoping to achieve a synergistic effect. Ongoing research into the biology of melanoma continues to suggest new drug targets that will block tumor progression or enhance host response.
Biological therapy involves using medications or substances made by the body to increase or restore the body's natural defenses against cancer. It is also called biological response modifier (BRM) therapy or immunotherapy. Examples include interferon, interleukin 2, and melanoma vaccines.
The drugs or vaccines stimulate the body to mount a defense against the cancer. Biological therapy may be started after surgery to prevent recurrences. Side effects include chills, fever, aches, depression, and fatigue and can be a significant barrier to successful treatment for some patients.
Low-dose interferon study
Interferon therapy's effectiveness in treating melanoma patients still leaves many questions unanswered for patients and doctors. High-dosage interferon can be toxic, while low-doses may be ineffective. To test the effectiveness of low-dose interferon, a recent significant British study, published in the Journal of Clinical Oncology (January 2004), followed 674 informed, high-risk malignant melanoma patients.
Some of the patients were randomly assigned a course of low-dose, long-term interferon alfa-2a, while the comparison group was given nothing. During the two year clinical trial and longer follow-up period, there were as many deaths in the low-dose interferon group as in the untreated patient group. An editorial accompanying the study calls for further clinical studies to determine how best to use interferon. In the meantime, the editorial notes that interferon may still be an "appropriate option" for certain patients.
Clinical responses to melanoma vaccines are still poor and currently there is no melanoma vaccine with a proven efficacy. Vaccine therapy still remains an experimental therapy in patients with metastatic melanoma. Further research is required.
American Cancer Society website. Available at: http://www.cancer.org/docroot/home/index.asp .
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Hancock BW, Wheatley K, Harris S, Ives, et al. Adjuvant interferon in high-risk melanoma: the AIM HIGH Study—United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon Alfa-2a in high-risk resected malignant melanoma. J Clin Oncol . 2004;22(1):11-4;7-10.
Hancock BW, Wheatley K, Harris S, Ives, et al. Low-dose interferon doesn't help high-risk melanoma patients [summary]. American Cancer Society website. http://www.cancer.org/docroot/NWS/content/NWS 1_1_1x_Low-Dose_Interferon_Doesnt_Help_High-Risk_Melanoma_Patients.asp. Accessed: November 18, 2004.
Lens M. The role of vaccine therapy in the treatment of melanoma. Expert Opin Biol Ther . 2008 Mar;8(3):315-23. Review.
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Stein JA, Brownell I. Treatment approaches for advanced cutaneous melanoma. J Drugs Dermatol. 2008 Feb;7(2):175-9. Review.
Last reviewed July 2008 by ]]>Ross Zeltser, MD, FAAD]]>
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