Tolerability of Adjuvant High-dose Interferon Alfa-2b: 1 Month Versus 1 Year-A Hellenic Cooperative Oncology Group Study

Abstract

Background: High-dose interferon alfa-2b (IFN-α2b) as adjuvant therapy for melanoma is associated with substantial dose-limiting toxicity. It has been suggested that the 1-month intravenous (i.v.) induction regimen may be sufficient to reduce the risk of relapse and death. Patients and Methods: The Hellenic Cooperative Oncology Group is conducting a multicenter, randomized trial of 1-month i.v. induction versus 1 year of adjuvant IFN-α2b therapy in patients with stage IIB/III melanoma. Adverse events reported by the first 200 patients to complete therapy are described. Results: Both induction and maintenance regimens were well tolerated. The most common toxicities were flu-like and gastrointestinal symptoms, neutropenia, liver toxicity, and neurologic toxicity. The incidence of grade 3/4 toxicity was low and occurred mainly during the induction phase in both arms. Dose was reduced in 31% of patients during induction. Only 2% of patients discontinued. Dose was reduced in 8% of patients during maintenance and only 5% of patients discontinued. Conclusion: Intravenous induction with 15 MIU/m²/day IFN-α2b is well tolerated. Efficacy results from this trial are eagerly anticipated.