July 30, 2009

Pegylated Interferon Alfa-2b Reduces Quality of Life in Stage III Melanoma


Although it improves recurrence-free survival, adjuvant (post-surgery) treatment with pegylated interferon alfa-2b adversely affects quality of life among patients with Stage III melanoma. These results were published in the Journal of Clinical Oncology.

Skin cancer is the most common form of cancer in the United States, with more than one million new cases each year. Skin cancer is often divided into two broad categories: melanoma and non-melanoma. Non-melanoma skin cancer refers to several different types of skin cancer, but the most common types are basal cell carcinoma and squamous cell carcinoma.

Melanoma is less common than non-melanoma skin cancer, but tends to be much more aggressive. Of the more than one million new diagnoses of skin cancer each year, roughly 68,000 involve melanoma. More than 8,000 people die of melanoma each year in the United States. What makes melanoma so dangerous is that it is more likely than other types of skin cancer to spread (metastasize) to other parts of the body. Melanoma can occur anywhere on the body. The first signs of melanoma may be a mole that changes in appearance, bleeds, or has more than one color or an irregular shape.

Standard treatment for Stages II-III melanoma typically involves surgery to remove the cancer, with or without immunotherapy. Immunotherapy refers to treatment that stimulates the immune system to fight cancer. Interferon is a type of immunotherapy.

To evaluate the effects of adjuvant (post-surgery) treatment with a specific type of interferon known as pegylated interferon alfa-2b, researchers in Europe conducted a Phase III clinical trial. The study enrolled 1,256 patients with Stage II melanoma. After surgery, roughly half the patients were assigned to receive additional treatment with pegylated interferon alfa-2b and half were assigned to observation only. The intended total duration of treatment with pegylated interferon alfa-2b was five years.

At 3.8 years of follow-up, patients treated with pegylated interferon alfa-2b group had an 18% reduction in the risk of recurrence. Overall survival was 56.8% for the pegylated interferon alfa-2b group and 55.7% for the observation group. Compared with patients in the observation group, patients treated with pegylated interferon alfa-2b reported significantly worse quality of life. Some of the main side effects included appetite loss, fatigue, and breathing difficulties (dyspnea).

These results suggest that adjuvant pegylated interferon alfa-2b prolongs recurrence-free survival but adversely affects quality of life among patients with Stage III melanoma.

Reference: Bottomley A, Coens C, Suciu S et al. Adjuvant therapy with pegylated interferon alfa-2b versus observation in resected Stage III melanoma: A Phase II randomized controlled trial of health-related quality of life and symptoms by the European Organisation for Research and Treatment of Cancer Melanoma Group. Journal of Clinical Oncology. 2009;27:2916-2923.

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