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Melanoma Vaccine May Enhance Interleukin-2 Efficacy

Improved clinical response and longer survival with interleukin-2 plus melanoma vaccine

WEDNESDAY, June 1 (HealthDay News) -- Patients with advanced melanoma who are treated with interleukin-2 and melanoma vaccine may have an improved clinical response and longer survival than those treated with interleukin-2 alone, according to a study published in the June 2 issue of the New England Journal of Medicine.

Douglas J. Schwartzentruber, M.D., from the Indiana University Health Goshen Center for Cancer Care, and colleagues investigated whether combining the melanoma vaccine with interleukin-2 could improve cancer outcomes in 185 patients with advanced melanoma. Participants had similar baseline characteristics, stage IV or locally advanced stage III cutaneous melanoma, were HLA-A0201-positive, without brain metastasis, and were eligible for high-dose interleukin-2 therapy. They were randomized to receive either interleukin-2 alone (at a dose of 720,000 IU per kilogram of body weight) or a gp100:209-217(210M) peptide vaccine plus incomplete Freund's adjuvant (Montanide ISA-51) once per cycle, followed by the same dose of interleukin-2. Clinical response, toxic effects, and progression-free survival were the outcomes studied.

The investigators found that both groups had toxic effects consistent with interleukin-2 therapy. The vaccine-interleukin-2 group had significantly improved centrally verified clinical responses (16 versus 6 percent) and significantly longer progression-free survival (2.2 versus 1.6 months), compared to the interleukin-2-only group. The vaccine-interleukin-2 group also had significantly longer median overall survival than the interleukin-2-only group (17.8 versus 11.1 months).

"A vaccine can enhance cytokine therapy in patients with melanoma, and highlights the potential of using rational combinations of immune agents in treating patients with metastatic cancer," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies. One author disclosed involvement with several patents related to the study topic.

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