A retrospective analysis of tolerance and outcomes of cutaneous malignant melanoma in patients receiving adjuvant interferonalpha 2B: A community oncology perspective
Muhammad Zubair Afzal, Vani Pinnamaneni, KC Birendra, Alan T. Davis, Tracy J. Koehler and Nehal Lakhani
Introduction: Interferon alpha 2B (IFN-α) therapy in malignant melanoma has improved relapse free survival and overall survival but is considerably toxic and lowers the overall quality of life (QoL) substantially. A significant number of patients do not complete the full duration (one year) of therapy.
Objective: The aim of this study was to evaluate patients’ ability to tolerate IFN-α therapy and to compare our results to reported data in the literature.
Methods: We conducted a retrospective review of patients diagnosed with cutaneous malignant melanoma who received IFN therapy after surgical resection. Patients were divided into two groups: patient who completed therapy (CIT) and those who did not (incomplete therapy, IIT). Duration of therapy was calculated. Reason for discontinuation and experienced side effects were reported. Statistical significance was determined at p < 0.05.
Results: A total of 64 patients were included in the review. There were 16 (25%) patients were able to complete therapy. The most common reasons for discontinuing IFN-α therapy was fatigue (81.3%), fever (40.6%), depression (28.1%) and nausea (18.8%). Patients in the CIT group were younger than those in the IIT group (47.4 ± 14.2 vs 57.8 ± 11.9 years, mean ± SD; p = 0.011). There also seemed to be an association that those with the presence of advanced disease may have been more likely to complete therapy (node positive disease at the time of diagnosis, p = 0.07).
Limitations: It is a retrospective study and has to rely on physician notes for the subjective data. For the survival analyses, the median follow-up times for both of the groups were less than 3.5 years.
Conclusions: Younger patients were more likely to complete therapy. There was a trend towards an association between more advanced disease and the completion of therapy. Most common causes of discontinuation of therapy were fatigue, fever, depression, and nausea.
Keywords: Malignant melanoma, INF-α, Side effects, Quality of life, Survival, Recurrence