Purpose: To evaluate the quality-of-life effects of adjuvant high-dose interferon alfa-2b (IFNα2b) treatment of high-risk melanoma. Patients and Methods: A quality-of-life-adjusted survival analysis (Quality-Adjusted Time Without Symptoms, and Toxicity [Q-TWiST]) was applied to the Eastern Cooperative Oncology Group Trial E1684, which compared high-dose IFNα2b treatment for 1 year versus observation in 280 high-risk patients. IFNα2b was administered at a dosage of 20 mU/m2 intravenously daily for 5 days per week for 4 weeks, and then three times weekly at 10 mU/m2 subcutaneously for 48 weeks. Results: After 84 months of median follow-up time, the IFNα2b group gained a mean of 8.9 months without disease relapse (P = .03) and 7.0 months of overall survival (P = .07) as compared with the observation group, but had severe treatment-related toxicity for 5.8 months, on average. The IFNα2b group had more quality-of-life-adjusted time than the observation group regardless of the relative valuations placed on time with toxicity (Tox) and time with relapse (Rel). This gain was significant (P <.05) for patients who consider Tox to have a high relative value and Rel to have a low relative value. In contrast, for patients who value Tox about the same as Rel, the quality-adjusted gain for IFNα2b was not statistically significant. An analysis stratified according to tumor burden indicated that the benefit of IFNα2b was greatest in the node-positive strata. Conclusion: For patients with high-risk melanoma, the clinical benefits of high-dose IFNα2b can offset the toxic effects. The optimal treatment for an individual patient depends on the patient's tumor burden and preferences regarding toxicity and disease relapse.
|Number of pages||8|
|Journal||Journal of Clinical Oncology|
|Publication status||Published - 1996|
ASJC Scopus subject areas
- Cancer Research