An update on adjuvant interferon for melanoma

Background: Despite advances in the staging and surgical therapy of melanoma, patients with high-risk resected melanoma still have 5-year recurrence rates of 55% to 80% and 5-year survival rates as low as 25% to 70%. Effective adjuvant therapy is needed for this patient population. Methods: The authors review the literature regarding the use of interferon for the adjuvant therapy of resected melanoma. Results: Low-dose adjuvant interferon regimens have not affected overall survival and have had an inconsistent effect on disease-free survival across different stage groupings. High-dose adjuvant interferon improved disease-free and overall survival in the E1684 and Intergroup E1694 trials. High-dose interferon regimens cause significant morbidity, but quality-adjusted years of life are greater with this therapy. Conclusions: Adjuvant high-dose interferon should be considered standard therapy for all high-risk melanoma patients expected to be able to tolerate the interferon and treated off protocol. In addition, this regimen should serve as the active control in future trials of alternative adjuvant therapies for these patients.