Analysis favors single-agent chemotherapy in melanoma tx

London - Results of a British meta-analysis suggest that there is no evidence to support the concept that clinicians should use a combination of biological therapies and chemotherapy instead of the commonly used single-agent chemotherapy regimen for patients with metastatic melanoma, news source MedicalNewsToday.com reports.

The meta-analysis results, published recently in the Journal of Clinical Oncology, says that for may years, single-agent dacarbazine has been the standard therapy for treating patients with metastatic melanoma - with results in median survival times of 6.4 to 7.8 months, according to studies.

In order to improve survival rates in patients whose disease has spread, several biological treatments have also been tested. For example, interferon-alpha (IFN) and interleukin-2 (IL-2) have been tested in both low and high doses combined or with chemotherapy in various studies.

Although the results of clinical trials have been inconsistent, results suggest that while combining biological therapies with chemotherapy is associated with an increased response rate, this therapy has the disadvantage of increased toxicity.

With a goal of obtaining a reliable assessment of the true benefit of biochemotherapy in metastatic melanoma, the British researchers undertook a meta-analysis of all randomized trials comparing biochemotherapy and chemotherapy published between 1966 and 2006. The results of each trial were combined to estimate an overall effect for biochemotherapy versus chemotherapy-treated patients.

The researcher’s analysis identified 18 trials involving more than 2,600 patients. Eleven of the trials compared chemotherapy plus IFN, and seven tested chemotherapy, IFN and IL-2.

The analysis of these trials showed a clear benefit for biochemotherapy in terms of partial, complete and overall responses. For overall response, the benefits were significant for whether IFN was administered alone or with IL-2.

The researchers conclude that comparison of the two immunotherapy regimens suggests that the addition of low-dose IL-2 to IFN results in no advantage to the patient, and that the similarity of overall response rates between the two biochemotherapy regimens further suggests that “it is unnecessary to subject patients to combination chemotherapy regimens that yield similar response results, but have greater toxicity, to that of single-agent chemotherapy.”