RE: NCRP 136 / Immunology, DNA repair, cancer...

["Bjorn Cedervall" <bcradsafers@HOTMAIL.COM>]

>No antitumoral immununity effect has ever been shown. The only tumor that 

>may provide an exception (but it is not clear at all) is chronic myeloid 

>leukemia.

----

For the first sentence I should add: _In a clearcut way_ (as examples I 

include below two articles related to melanomas - I will take a closer look 

at the other examples given as a response to my writing). Once the tumor has 

become chaotic enough (on a DNA/protein level) it seems to be an 

irreversible process.



DNA Repair: Immunological reactions against DNA (as in SLE) is to my 

knowledge not related to an attack against DNA repair (enzymes or other 

repair associated proteins).



Bjorn Cedervall     bcradsafers@hotmail.com

------

Interleukin-2 not beneficial for patients with advanced metastatic melanoma



Last Updated: 2000-10-18 18:46:41 EDT (Reuters Health) - Preliminary results 

from the first-ever randomized phase III trial of immunotherapy in malignant 

melanoma, presented here at the 25th congress of the European Society of 

Medical Oncology, show no advantage for patients with metastatic melanoma 

whose disease is sufficiently advanced (ECOG performance status 1) to cause 

symptoms.



Dr. Ulrich Keilholz, from the Free University, Berlin, Germany, and 

colleagues from the EORTC (European Organization for Research and Treatment 

of Cancer) Trial have been looking at the survival effect of adding 

high-dose interleukin-2 (IL-2) to conventional chemotherapy in patients with 

advanced melanoma.



The trial, which took place from 1995 through 2000, involved 363 patients 

from nine centers in five countries. One group received 250 mg/square meter 

dacarbazine plus 30 mg/square meter cisplatin on days 1 through 3 days, and 

10 MU/square meter interferon-alpha-2b on days 1 through 5. The second group 

had the same treatment followed by decreasing dosages of intravenous IL-2 on 

days 4 through 9. In the absence of disease progression a maximum of 4 

cycles with 4-week intervals was given.



Overall, 43% of patients received all four cycles. Analysis of the data 

revealed a complete remission rate of 5.2% in patients receiving treatment 

with IL-2 versus 5.3% in patients not receiving IL-2. There was a partial 

response rate of 21.6% in group 1 and 18.9% in group 2.



Commenting on the results, Dr Keilholz indicated that in patients with 

impaired performance status, the IL-2-containing regimen should not be 

explored any further. However, although the addition of IL-2 using the 

decrescendo regimen used in group 2 had no significant impact on overall 

survival, Dr. Keilholz believes that "for those patients who had not yet 

developed symptoms from the spread of their disease [ECOG performance status 

0], treatment may [still] hold promise," and warrants further evaluation.



The current median follow-up of this study is 2.1 years. Results based on 

longer follow-up will be available after the next analysis of the data in 

2001.

----

(copy-pasted from Medline)

Lancet 2001 Sep 15;358(9285):866-9.



Effect of long-term adjuvant therapy with interferon alpha-2a in patients 

with regional node metastases from cutaneous melanoma: a randomised trial.



Cascinelli N, Belli F, MacKie RM, Santinami M, Bufalino R, Morabito A.



National Cancer Institute, Via G Venezian 1, 20133, Milan, Italy. 

who-melanoma@istitutotumori.mi.it



BACKGROUND: Less than half of patients with melanoma that has spread to 

local draining regional lymph nodes (stage III melanoma) live with no 

disease for 5 years or longer after surgery. We aimed to see whether 

interferon alpha-2a increased survival prospects in these patients. METHODS: 

444 patients from 23 centres in the WHO Melanoma Programme had complete 

lymphadenectomy for pathologically proven regional nodal spread of melanoma 

and were randomly assigned to receive either 3 MU subcutaneously of 

recombinant interferon alpha-2a three times a week for 3 years, or to 

observation alone after surgery. Patients were stratified by centre, nodes 

with macroscopic or microscopic melanoma, number of affected nodes, and 

nodal metastatic spread. Treatment was continued for 3 years or until first 

sign of relapse. FINDINGS: 424 patients entered the study. 5-year 

disease-free survival of those who had surgery plus interferon alpha-2a was 

27.5% (95% CI 21.7-33.6); for those who received surgery alone, survival was 

28.4% (22.5-34.6) (p=0.50). Neither Kaplan-Meier cumulative survival rates, 

nor multivariate analysis of survival, showed a difference between those who 

had surgery and interferon alpha-2a (35%, 95% CI 29-42) and those who had 

surgery alone (37%, 31-44). INTERPRETATION: Patients with melanoma that has 

spread to the local draining regional lymph nodes tolerate well 3 MU of 

interferon alpha-2a given subcutaneously three times a week for 3 years, but 

this treatment does not improve either disease-free or overall survival.





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