Journal Article10.1200/JCO.2001.19.9.2370
High-Dose Interferon Alfa-2b Significantly Prolongs Relapse-Free and Overall Survival Compared With the GM2-KLH/QS-21 Vaccine in Patients With Resected Stage IIB-III Melanoma: Results of Intergroup Trial E1694/S9512/C509801
John M. Kirkwood,Joseph Ibrahim,Jeffrey A. Sosman,Vernon K. Sondak,Sanjiv S. Agarwala,Marc S. Ernstoff,Uma Rao +6 more
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TL;DR: A significant treatment benefit of HDI versus GMK in terms of RFS and OS in melanoma patients at high risk of recurrence is demonstrated in this prospective, randomized, intergroup trial.
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Abstract: PURPOSE: Vaccine alternatives to high-dose interferon alfa-2b therapy (HDI), the current standard adjuvant therapy for high-risk melanoma, are of interest because of toxicity associated with HDI. The GM2 ganglioside is a well-defined melanoma antigen, and anti-GM2 antibodies have been associated with improved prognosis. We conducted a prospective, randomized, intergroup trial to evaluate the efficacy of HDI for 1 year versus vaccination with GM2 conjugated to keyhole limpet hemocyanin and administered with QS-21 (GMK) for 96 weeks (weekly × 4 then every 12 weeks × 8). PATIENTS AND METHODS: Eligible patients had resected stage IIB/III melanoma. Patients were stratified by sex and number of positive nodes. Primary end points were relapse-free survival (RFS) and overall survival (OS). RESULTS: Eight hundred eighty patients were randomized (440 per treatment group); 774 patients were eligible for efficacy analysis. The trial was closed after interim analysis indicated inferiority of GMK compared with HDI. For...
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Citations
Malignant melanoma: current state of primary and adjuvant treatment.
TL;DR: Based on the available data, interferon-alpha2b remains the adjuvant therapy of choice for high-risk patients treated outside clinical trials, and the appropriate control arm for clinical trials evaluating new or modified adjUvant regimens.
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Cancer vaccines targeting carbohydrate antigens.
TL;DR: A series of carbohydrate cancer cell-surface differentiation antigens have been identified and synthesized and can be induced in the majority of vaccinated patients using KLH conjugate vaccines with a potent saponin immunological adjuvant.
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Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma metastatic to a lymph node: an assertion based on comprehensive, critical analysis: part II.
TL;DR: No surgeon, pathologist, or oncologist is a seer, diviner, or prophet when it comes to predicting accurately the outcome for a patient with metastatic melanoma; it is woefully substandard because it is without benefit.
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TL;DR: IFN alpha-2b is the first agent to show a significant benefit in relapse-free and overall survival of high-risk melanoma patients in a randomized controlled trial.
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TL;DR: A synthetic peptide, designed to increase binding to HLA-A2 molecules, was used as a cancer vaccine to treat patients with metastatic melanoma and, on the basis of immunologic assays, 91% of patients could be successfully immunized with this peptide.
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Charles M. Balch,Antonio C. Buzaid,Michael B. Atkins,Natale Cascinelli,Daniel G. Coit,Irvin D. Fleming,Alan N. Houghton,John M. Kirkwood,Martin F. Mihm,Donald L. Morton,Douglas S. Reintgen,Merrick I. Ross,Arthur J. Sober,Seng-Jaw Soong,John A. Thompson,John F. Thompson,Jeffrey E. Gershenwald,Kelly M. McMasters +17 more
TL;DR: The Melanoma Staging Committee of the AJCC has proposed major revisions of the melanoma TNM and stage grouping criteria to better reflects independent prognostic factors that are used in clinical trials and in reporting the outcomes of various melanoma treatment modalities.
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Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684.
J. M. Kirkwood,M. H. Strawderman,Marc S. Ernstoff,T. J. Smith,E. C. Borden,R. H. Blum +5 more
TL;DR: IFN alpha-2b is the first agent to show a significant benefit in relapse-free and overall survival of high-risk melanoma patients in a randomized controlled trial.
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Identification of Ny-Eso-1 Epitopes Presented by Human Histocompatibility Antigen (Hla)-Drb4*0101–0103 and Recognized by Cd4+T Lymphocytes of Patients with Ny-Eso-1–Expressing Melanoma
Elke Jäger,Dirk Jäger,Julia Karbach,Yao-Tseng Chen,Yao-Tseng Chen,Gerd Ritter,Yasuhiro Nagata,Sacha Gnjatic,Elisabeth Stockert,Michael Arand,Lloyd J. Old,Alexander Knuth +11 more
TL;DR: The characterization of HLA class II–restricted epitopes will be useful for the assessment of spontaneous and vaccine-induced immune responses of cancer patients against defined tumor antigens and the therapeutic efficacy of active immunization using antigenic HLA Class I–restricted peptides may be improved by adding HLAclass II–presented epitopes.
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