Ives NJ et al. (2007) Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol 25: 5426–5434

For patients with metastatic melanoma, chemotherapy is the standard of care. Interferon (IFN) and interleukin 2 (IL-2) immunotherapy is active in malignant melanoma, and clinical trial data suggest that combined chemotherapy and immunotherapy (i.e. biochemotherapy) increases response rates; however, the results of these trials have not been consistent. A recent meta-analysis has assessed the effect of biochemotherapy in metastatic melanoma.

The meta-analysis included 18 trials (11 trials of chemotherapy ± IFN and 7 trials of chemotherapy ± IFN and IL-2) involving 2,621 patients. Overall, 2,039 deaths and 555 responses were reported. Biochemotherapy clearly improved partial response (odds ratio [OR] 0.66; P = 0.0001), complete response (OR 0.50; P = 0.0003), and overall response (OR 0.59; P <0.00001) rates. Overall response was increased significantly in both IFN (OR 0.60; P = 0.0002) and IFN plus IL-2 (OR 0.58; P = 0.0001) immunotherapy subgroups. Data from seven trials showed that biochemotherapy delayed the time to disease progression (OR 0.80; P = 0.0001), and there was no evidence of heterogeneity between the groups treated with the different types of immunotherapy (P = 0.5) or between different trials (P = 0.4). By contrast, biochemotherapy did not increase overall survival (OR 0.99; P = 0.9). There was, however, heterogeneity in the treatment effect between the different trials (P = 0.006), but not between the two immunotherapy subgroups (P = 1.0).

These data show that biochemotherapy improves responses rates, but not overall survival, in patients with metastatic melanoma.