Autoimmunity During Interferon Treatment for Melanoma Linked with Improved Survival
Melanoma - Skin Cancer
Among patients receiving immunotherapy for melanoma, those who showed evidence of autoimmunity (an immune response against the body's own tissues) survived significantly longer than those who did not. These results were published in the New England Journal of Medicine.
Melanoma is a type of skin cancer that typically begins in the form of a mole. Stage II and stage III melanoma refer to melanoma that has spread from its site of origin to deeper tissue layers or nearby lymph nodes, but not to distant sites in the body.
Standard treatment for stages II-III melanoma typically includes surgery to remove the cancer, with or without immunotherapy. Immunotherapy refers to treatment that stimulates the immune system to fight cancer. Melanoma appears particularly responsive to immunotherapy.
Interferon alfa-2b is a type of immunotherapy. Though treatment with this agent has been shown to improve survival in patients with melanoma, common side effects include fatigue, fever, joint pain, and liver problems. Furthermore, only a subset of patients appears to benefit from treatment. In order to provide more individualized melanoma treatment, researchers continue to explore ways to identify those patients most likely to respond to immunotherapy. Patients who are unlikely to respond could be spared the toxic effects of treatment.
Interferon alfa-2b induces autoimmunity in some patients. In autoimmune conditions, the immune system attacks the body's own tissues. In order to determine whether the development of autoimmunity following treatment with interferon alfa-2b is linked with response to treatment, researchers in Greececonducted a study among 200 patients with stage IIB, stage IIC, or stage III melanoma.
All patients were treated with interferon alfa-2b. Autoimmunity was defined as the subsequent development of antibodies against the body's own tissues, or signs of autoimmunity such as vitiligo (a skin disorder).
After a median follow-up of 46 months, 115 patients experienced a cancer recurrence and 82 patients died.
Signs of autoimmunity were identified in 52 patients (26%). Patients with evidence of autoimmunity experienced significantly better survival than patients without evidence of autoimmunity:
- Among the 148 patients without autoimmunity, 73% developed a cancer recurrence and 54% died.
- Among the 52 patients with autoimmunity, 13% developed a cancer recurrence and 4% died.
The researchers conclude that evidence of autoimmunity during treatment with interferon alfa-2b is linked with improved overall survival and improved survival without cancer recurrence in patients with melanoma.
Reference: Gogas H, Ioannovich J, Dafni U et al. Prognostic Significance of Autoimmunity During Treatment of Melanoma with Interferon. New EnglandJournal of Medicine . 2006;354:709-718.