Unprecedented Results Achieved with Melanoma Treatment

Intralesional interleukin-2 shows promise in cutaneous melanoma metastases.

While physicians have not adopted the treatment of cutaneous melanoma metastases with intralesional interleukin (IL)-2, a recent study has highlighted its effectiveness and reports a 100% response rate among study participants.

Eleven study participants were selected who either had stage III or stage IV cutaneous melanoma metastases. All patients had one or more chronic medical conditions as well, with 64% of participants having cardiovascular disease.

Patients were treated for 4 to 6 weeks depending on tolerance with IL-2 solution and a daily topical imiquimod and retinoid cream. Patients 1, 7, and 8 initially had tumors limited to the extremities and overnight occlusive wraps were placed on them to increase cutaneous absorption of the topical medications.

For lesions that ulcerated during treatment, topical therapies were temporarily lifted or were reduced in frequency. After therapy was completed with intralesional IL-2, topical medications were applied once daily for 7 days out of the month for 1 year as maintenance therapy.

There was a 100% response rate among patients who received this treatment and the 2-year survival rate was 82%. Seven of the 11 patients studied are still living without recurrence of melanoma. Of the 5 deaths that did occur, 3 were due to central nervous system metastasis, 1 was due to complications with MDS, and 1 was due to natural causes at the age of 94.

Side effects of the treatment were either mild or non-existent in patients participating in the study, with rigors reported in 6 of the 11, which only lasted 15 to 30 minutes and dissipated on its own. One patient reported nausea and a worsening of baseline depression. Patient 2 developed asymptomatic hypotension and his antihypertensive medications were held on subsequent treatment days.

While the study shows much promise in the treatment of cutaneous melanoma metastases with a 100% response rate among patients, study authors note the limitations in only studying 11 patients. Additionally, the lack of a comparison group also limits these findings.

Nevertheless, treatment of cutaneous melanoma metastases with intralesional IL-2 could offer an optimal treatment choice for patients with this condition. Further studies need to be conducted in order to confirm these findings to make the treatment a part of the guidelines for melanoma therapy.