Treatment of metastatic melanoma using interleukin-2 alone or in conjunction with vaccines

Clin Cancer Res. 2008 Sep 1;14(17):5610-8. doi: 10.1158/1078-0432.CCR-08-0116.

Abstract

Purpose: To identify prognostic factors associated with survival beyond 4 years and overall response in patients with metastatic melanoma treated with high-dose bolus i.v. interleukin-2 (IL-2) given either alone or in combination with a variety of melanoma vaccines.

Study design: 684 consecutive patients with metastatic melanoma received high-dose bolus i.v. IL-2 either alone or in conjunction with a variety of melanoma vaccines. Treatments occurred between August 1, 1985 and January 1, 2006.

Results: The overall objective response rate was 13% for patients receiving IL-2 alone and 16% for patients who received IL-2 with vaccine. In patients treated with IL-2 alone (n=305) and IL-2 with vaccine (n=379), having an objective response was associated with survival beyond 4 years (P<0.0001). No pretreatment factors could be identified that were strongly associated with increased rate of objective response or long-term survival in patients receiving IL-2 alone. In patients receiving IL-2 with vaccines, there were increased response rates in patients with s.c. or cutaneous disease only and lower response rates with visceral disease only. Patients who received the gp100:209-217(210M) peptide plus IL-2 showed a strong trend to increased objective responses compared with IL-2 alone (22% versus 12.8%; P=0.01) and also compared with patients who received a variety of vaccines that did not include this immunogenic peptide (13.8%; P=0.009).

Conclusion: IL-2 can produce a modest response rate in patients with metastatic melanoma including patients with durable complete responses. S.c. or cutaneous disease only and vaccination with gp100:209-217(210M) peptide was associated with significant increase in response rates.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, Neoplasm / immunology
  • Antigens, Neoplasm / therapeutic use
  • Cancer Vaccines / therapeutic use
  • Child
  • Combined Modality Therapy
  • Female
  • Humans
  • Interleukin-2 / administration & dosage*
  • Male
  • Melanoma / mortality
  • Melanoma / therapy*
  • Membrane Glycoproteins / immunology
  • Membrane Glycoproteins / therapeutic use*
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Skin Neoplasms / mortality
  • Skin Neoplasms / therapy*
  • Survival Analysis
  • Treatment Outcome
  • gp100 Melanoma Antigen

Substances

  • Antigens, Neoplasm
  • Cancer Vaccines
  • Interleukin-2
  • Membrane Glycoproteins
  • PMEL protein, human
  • gp100 Melanoma Antigen