Prognostic factors for response and survival in patients with metastatic melanoma receiving immunotherapy

Melanoma Res. 1996 Apr;6(2):173-8. doi: 10.1097/00008390-199604000-00013.

Abstract

Sixty-five patients with advanced melanoma treated in phase II trials with interferon-alpha and high dose interleukin-2 were analysed for pretreatment prognostic parameters. Three levels of response were used: objective remission [three complete response (CR)/14 partial response (PR)], stable disease and progression. Elevated lactate dehydrogenase (LDH), impaired performance status and high tumor load were associated with poor response. Multivariate analysis considering two levels of response [CR/PR vs stable disease (SD)/progressive disease (PD)] did not reveal any model with more than one significant factor. Considering survival, LDH was also a strong factor. Additional prognostic factors here were performance status, metastatic sites, alkaline phosphatase and tumor load. A Cox regression analysis revealed LDH, performance status and metastatic sites as independent factors. The prognostic values of these parameters will have to be confirmed in a larger patient cohort. Using the landmark method, it was estimated whether the response obtained after two cycles of treatment predicted survival. Patients with PD at this time had a median further survival of 6 months, SD of 27 months, and PR/CR of more than 31 months. This observation may help making decisions at this time.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II

MeSH terms

  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Immunotherapy / methods*
  • Interferon-alpha / therapeutic use*
  • Interleukin-2 / therapeutic use*
  • Male
  • Melanoma / secondary
  • Melanoma / therapy*
  • Middle Aged
  • Prognosis
  • Survival Analysis

Substances

  • Interferon-alpha
  • Interleukin-2