Complete responses and survival after polychemotherapy plus interferon-alpha for patients with metastatic melanoma

One hundred and one patients with metastatic melanoma were treated with three different dacarbazine (DTIC)-based polychemotherapy plus recombinant interferon (IFN) alpha-2b regimens in multicentre phase II trials in Finland during 1986-1993. The regimens were DTIC, nimustine (ACNU) plus IFN and two different schedules of DTIC, vincristine, bleomycin, lomustine (CCNU) plus IFN. There were 14 patients with complete response (CR) and 12 patients with partial response, with estimated median survivals of 44 months and 13 months respectively. The median survival was 14 months for 22 patients with stable disease, and 6 months for the 53 patients who had progressive or non-evaluable disease. The median progression-free interval was 6 months and the median survival 9 months for the whole group. Thirty-nine percent of patients survived at least 1 year and 17% at least 2 years. Age, sex, primary tumour site, Clark's level, disease-free interval, prior therapy of recurrence and metastatic sites of patients who achieved CR were compared with those of other patients. In addition, the predictive value of these factors for survival was analysed. Prior therapy of recurrent disease (none, surgery or surgery plus radiotherapy) and metastatic profile (soft tissue or lung, one or two sites) were associated with CR in univariate analysis, while in multivariate analysis only prior therapy was found to be an independent prognostic factor. Prior surgery plus radiotherapy, soft tissue or lung metastases and response to present chemo-immunotherapy were significant predictors of favourable survival in univariate analysis. In multivariate analysis only response was an independent prognostic factor.