TABLE 1.
Comparative table between different studies for the treatment of melanoma
Therapy | Disease Stage | Goal | Trial | Results | Reference |
---|---|---|---|---|---|
IL-2 (1998) | IV or recurrent melanoma | Determine the short- and long-term efficacy and toxicity of high-dose IL-2 | n = 70 → 600,000 or 720,000 IU/kg (IV). Cycle repeated after 6-9 days | n = 43 / PFS 8.9 months | (19) |
n = 12 / PFS 12 months | |||||
The results are more lasting for the patients with good pulmonary, heart and kidney function | |||||
IV or recurrent melanoma, without previous treatment | Determine the antitumor efficacy of IL-2 | n = 24 → 30 mg/kg (IV) for 8 weeks | n = 9 / PFS 8 weeks | (21) | |
n = 2 / PFS 16 weeks | |||||
Response rate is lower and efficacy in terms of response rate is comparable to conventional therapies such as DTIC. | |||||
IFNa-2b (1995) ESTG-1684 | IIB, IIC or III (with or without lymph node involvement) or recurrent melanoma | Determine the anti-tumor efficacy of high-dose IFNa-2b | n = 143 → 20 million IU/m2, 5 days a week for 4 weeks, followed by 10 million IU/m2, three times a week for 48 weeks | The analysis of 7 years of study showed that on average 1-1.7 years to PFS and 2.8-3.8 years to OS | (24) |
First agent to show significant OS benefit (more pronounced benefit in patients with lymph node involvement). | |||||
IFN-PEGa-2b (2011) EORTC 18991 | IIB, IIC or III (with or without lymph node involvement) or recurrent melanoma | Determine the anti-tumor efficacy of higher doses of PEG-IFNa-2b | n = 1256 / n = 627 → 6 Hg/kg weekly for 8 weeks, followed by 3 Hg/kg weekly for 5 years | PEG-IFNa-2b → the risk of recurrence and death in 7% of patients at 4 years and 13% for patients with nodal disease. | (27) |
Determine the anti-tumor efficacy of low-dose PEG- IFNa-2b | n = 1388 → half received 10 million IU/m2, 5 days a week for 4 weeks, followed by 5 million IU/m2, three times a week for 2 years | During 2 years of analysis, the results of PFS were better with the use of high medication doses. | (28) | ||
Biochemother apy | III, IV or recurrent melanoma | Determine whether the combination of chemotherapy and immunotherapy might have better efficacy | Patients were randomized to receive cisplatin, vin- blastine, and DTIC (CVD) alone or simultaneously with IL-2 and IFNa-2b | Those who received IL-2 and IFN-2b showed the slightly higher response rate and PFS than the group that received CVD alone. | (30) |
There was no increase in OS or durable responses. | |||||
Ipilimumab (2011) | III, IV or recurrent melanoma | Evaluate the median OS of patients who received an ipilimumab-containing regimen as compared with a group that received the gp100 vaccine alone | n = 403 → ipilimumab 3 mg/kg + gp100 peptide vaccine | Median OS in ipilimumab + gp100 group = 10 months | (33) |
n = 137 → ipilimumab 3 mg/kg | Median OS with ipilimumab alone = 10.1 months | ||||
n = 136 → gp100 vaccine peptide | Median OS with gp100 alone = 6.4 months | ||||
Evaluate the average OS with different doses of ipilimumab | n = 73 → 10 mg/kg | OS was 11% at 10 mg/kg, 4.2% | (34) | ||
n = 72 → 3 mg/kg | |||||
n = 72 → 0.3 mg/kg | |||||
every 3 weeks for 4 months by IV infusion | at 3 mg/kg and 0% at 0.3 mg/kg. | ||||
Ipilimumab proved more effective at a dose of 10 mg/kg. | |||||
Vemurafenib (2011) | III, IV or recurrent melanoma, without | Evaluate average OS with vemurafenib | n = 337, 960 mg vemurafenib orally twice daily | After 6 months, OS was 84% for vemurafenib and 64% for DTIC | (36) |
treatment previous | n = 338 → 1,000 mg/nv* of DTIC, IV, once every 3 weeks | Vemurafenib showed a 63% relative reduction in the risk of death (OS) and 74% in the risk of progression (PFS) as compared with DTIC | |||
Dabrafenib | III or IV, without previous treatment | Evaluate the antitumor efficacy of dabrafenib, another BRAF inhibitor | Patients were randomized to receive dabrafenib (n = 187) or DTIC (n = 63) | Average PFS was 5.1 months with dabrafenib versus 2.7 months with DTIC. | (39) |
70% → in risk of progression or death compared with DTIC | |||||
Trametinib | III or IV | Cause a stronger response against the cancer and prevent resistance to treatment, as patients who use vemurafe-nib eventually develop resistance. | n = 125 → varying doses of dabrafenib / trameti-nib | Average PFS was 10.8 months in this group, and 15 of 24 patients (63%) achieved either CR or PR. This dosage (150/2 mg) is being assessed in a phase III randomized trial | (40) |
Most PFS was achieved in 24 patients receiving 150 mg dabrafenib twice daily and 2 mg trametinib once daily | |||||
Imatinib | III or IV | Ascertain the effectiveness of imatinib for melanoma with Kit gene mutation | n = 28 → 400 mg of imatinib twice daily | The durable overall response rate was 16%, with a median time to progression of 12 weeks, and mean OS 46.3 weeks. | (41) |
n = 43 → 400 mg daily until disease progression or unacceptable toxicity to a mean of 12 months | 41.9% (n=18) CR | (42) | |||
30.2% (n=13) SD | |||||
23.3% (n=10) PR |
PFS, progression-free survival; OS, overall survival; PR, partial response; CR, complete response; SD, stable disease; ↓, decrease