Kirkwood needs to STOP!!! NO MORE INTERFERON!!! Geeze!!!!

If you have followed this blog for 10 minutes, you know that when faced with Stage 3b melanoma 16 years ago, my only options for treatment were interferon or watch and wait....'cherry picking' lesions as they developed, surgically!  Since, even then, we KNEW that interferon did very little to treat melanoma generally and provided NO statistically significant impact on overall survival, but DID make you sick as a dog ~ I watched and waited.  Here's how that decision went down when I met with my oncologist after learning I had a node positive for melanoma back in 2003: 

"Next stop, oncologist.  He was an incredibly sweet man who very sadly informed me that HE felt devastated whenever he had to take care of patients with renal cell carcinoma or melanoma.  (Years later, Dr. Weber also said: “Melanoma is the kind of tumor that gives cancer a bad name!”)  My local onc begged me to do a year of interferon.  When I noted the sad facts related to interferon’s lack of tangible success in prolonging life or preventing further disease, he replied with tears in his eyes, “But you’re so young, I just can’t stand it for you to do nothing.”  His dismay and horror at my condition were most disconcerting and uncomfortable, but in 2003, there really was nothing else to offer.  I decided to “watch and wait” as the rest of my body including my brain was clear on scans."

Here are zillions of posts/reports/abstracts on interferon that I've written since then:

More than you ever wanted to know about melanoma and interferon (and related reports!)

Now...there's this:

E3611- A Randomized Phase II Study of Ipilimumab at 3 or 10 mg/kg Alone or in Combination with High Dose Interferon-α2b in Advanced Melanoma. Tarhini, Lee, Li....Kirkwood.  Clin Cancer Res. 2018 Nov 12.

Interferon-α favors a Th1 shift in immunity and combining with ipilimumab (ipi) at 3 or 10 mg/kg may down regulate CTLA4-mediated suppressive effects leading to more durable antitumor immune responses. A study of tremelimumab and high-dose interferon-α (HDI) showed promising efficacy supporting this hypothesis.

E3611 followed a 2 by 2 factorial design (A: ipi10+HDI; B: ipi10; C: ipi3+HDI; D: ipi3) to evaluate (i) no HDI versus HDI (across ipi doses) and (ii) ipi3 versus ipi10 (across HDI status). We hypothesized that median progression free survival (PFS) would improve from 3 to 6 months with HDI versus no HDI and with ipi10 versus ipi3.

For eligible and treated patients (N=81) at a median follow-up time of 29.8 months, median PFS was 4.4 months when ipilimumab was used alone and 7.5 months when HDI was added. Median PFS was 3.8 months with 3mg/kg ipilimumab and 6.5 months with 10mg/kg. By study arm, median PFS was 8.0 months in arm A, 6.2 months in B, 5.7 months in C and 2.8 months in D. The differences in PFS and overall survival (OS) did not reach statistical significance. Adverse events were consistent with the known profiles of ipilimumab and HDI and significantly higher with HDI and ipi10.

While PFS was increased, the differences resulting from adding interferon-α or higher dose of ipilimumab did not reach statistical significance and do not outweigh the added toxicity risks.

I repeat THEIR words: "...the differences resulting from adding interferon-α or higher dose of ipilimumab did not reach statistical significance and do not outweigh the added toxicity risks."  Not to mention, the ipi/interferon combo results did not begin to approximate the results that can be gained by either anti-PD-1 product (Opdivo or Keytruda) alone!!!!  For the love of all that is holy and your Hippocratic oath - Kirkwood, I beg you!  STOP with the interferon!!!

For what it's worth.  Still yelling, for more than 16 years - with melanoma, but WITHOUT interferon.  Would really like to stop having to climb back on this soap box! - c