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Immunotherapy Does Not Prolong Life When Skin Cancer Spreads

ds of immunotherapy combined with chemotherapy, interferon and interleukin-2. Of the 11 studies that reported on side effects from chemoimmunotherapy, eight showed blood disorders and flu-like symptoms resulting from the combined treatment. In four studies that used interleukin-2 without interferon, patients had more blood side effects after treatment.

Jedd Wolchok, M.D., an oncologist at Memorial Sloan-Kettering Cancer Center, said that it is difficult to tease out which of the two immunotherapy agents might be responsible for the side effects to patients’ blood.

“Both immunotherapies have considerable side effects,” Wolchok said. “Interleukin-2 is likely more difficult since it can lower blood pressure and cause fluid to build up in the body. These side effects are a consequence of what these immune hormones were originally designed to do — for example, interferon is a natural antiviral agent, so the fact that it causes flu-like symptoms very commonly is not a surprise.”

Sasse said, “The interleukin is more toxic and needs hospitalization for its administration. It is also known to promote more systemic reactions than interferon. But the adverse effects of either drug are dose dependent.”

Wolchok said, “This area should definitely continue to be investigated. My hypothesis is that chemotherapy may be used to modulate and potentiate newer immunotherapy drugs.”

Sasse, however, said, “There are some controversies about the use of chemotherapy in advanced melanoma — the chemotherapy does not save lives and additionally, there is doubt that it prolongs the survival of these patients.”

“My opinion is that there are enough studies in this subject and therefore, no need of new trials,” Sasse added. “At the moment, the focus should be given to the development of new therapeutic approaches to melanoma.” He cited advances in molecular biology and the carcinogenesis of melanoma as possible avenues for ne
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