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. 2014 Mar-Apr;89(2):301–310. doi: 10.1590/abd1806-4841.20142540

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

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