Prognostic factors for response and survival in patients with metastatic melanoma receiving immunotherapy

Sixty-five patients with advanced melanoma treated in phase II trials with interferon-a and high dose interleukin-2 were analysed for pretreatment prognostic parameters, Three levels of response were used: objective remission [three complete response (CR)/14 partial response (PR)], stable disease and progression, Elevated lactate dehydrogenase (LDH), impaired performance status and high tumor load were associated with poor response, Multivariate analysis considering two levels of response [CR/PR vs stable disease (SD)/progressive disease (PD)] did not reveal any model with more than one significant factor. Considering survival, LDH was also a strong factor, Additional prognostic factors here were performance status, metastatic sites, alkaline phosphatase and tumor load, A Cox regression analysis revealed LDH, performance status and metastatic sites as independent factors. The prognostic values of these parameters will have to be confirmed in a larger patient cohort, Using the landmark method, it was estimated whether the response obtained after two cycles of treatment predicted survival, Patients with PD at this time had a median further survival of 6 months, SD of 27 months, and PR/CR of more than 31 months, This observation may help making decisions at this time.