[Adjuvant therapy of malignant melanoma]

Malignant melanoma is resected with curative intent in 80-85% of the patients. In case of tumor thickness according to Breslow of > 4 mm and metastatic regional lymph nodes a high relapse rate and mortality of 50-90% is observed. Single agent chemotherapy with DTIC is effective as combination regimen, however does not significantly improve the relapse-free interval respectively the overall survival or quality of life. Several attempts with other adjuvant treatment modalities (e.g. BCG immunotherapy) are not convincing as well. The best results of adjuvant treatment in high-risk resected melanoma were published in 1996 by Kirkwood, who used interferon-alfa 2b. He could demonstrate a prolonged relapse free and overall survival. It does represent the current standard adjuvant treatment. However, the costs and toxicities of IFN are barriers to its widespread use.