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March 1997

Treating Patients With Melanoma With Interferon-Reply

Author Affiliations

Department of Medicine University of Pittsburgh School of Medicine 200 Lothrop St Pittsburgh, PA 15213-2582

La Jolla, Calif

Arch Dermatol. 1997;133(3):387-389. doi:10.1001/archderm.1997.03890390131023

We are writing to respond to comments by Cook and Zitelli concerning interferon therapy for patients with melanoma. While they mainly express their personal views, a few points concerning data generated in the Eastern Co-operative Oncology Group (ECOG) trial E1684,1 which examined the effects of adjuvant therapy with interferon alfa-2b in patients with high-risk melanoma, should be clarified. First, the dose of interferon alfa-2b selected for ECOG trial E1684 (20 mIU/m2 once daily intravenously 5 days per week for 4 weeks, then 10 mIU/m2 subcutaneously 3 times per week for 48 weeks) was intended to be near the maximum tolerable dose. The rationale for selecting this dosage was based on the knowledge that interferon alfa-2b has direct antiproliferative and immunomodulatory actions on melanoma and that these effects would potentially be maximized by use of the highest tolerable dose. Additional rationale came from clinical trials that showed that high doses of interferon