Melanoma and IFN alpha: Potential adjuvant therapy

Interferon alpha (IFN alpha) is the most used adjuvant treatment in clinical practice for melanoma (MEL) high-medium risk patients; however, the use of IFN alpha has yielded conflicting data on Overall Survival (OS) and disease free survival (DFS) rates. Starting from these considerations, we carried out an analysis on our MEL patients who received adjuvant IFN alpha therapy, in order to identify possible predictors for their outcome. A total of 140 patients were included in our analysis. Patients with Breslow thickness <= 2.00 mm presented a significantly longer mean DFS than patients with Breslow >= 2.01 mm (p = 0.01). Using non- parametric Spearman's Coefficient test we found association between DFS and Breslow thickness (p < 0.001) and between DFS and ulceration (p = 0.03). Performing Multiple Regression test, Breslow thickness (p < 0.001) remained the only statistically significant predictor. From the OS analysis we found that patients with lower Breslow values < 2.00 mm (p < 0.0001), and absence of ulceration (p < 0.004) showed a significantly better long-term survival. From the current analysis we found that the use of low dose IFN alpha is justified only for cutaneous melanoma <= 4.01 mm that was not ulcerated; patients with Breslow >= 4.01 mm, in our opinion, should not carry out adjuvant treatment with low dose IFN alpha, because its side effects could be higher than the its benefits.