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Fariba Navid, MD
High-dose interferon-alpha-2b (IFN-α-2b) for four weeks, followed by low-dose maintenance IFN-α-2b for 48 weeks has been shown to improve the disease-free survival of adult patients with the skin cancer melanoma that has spread to the nearby lymph nodes (stage III melanoma). However, this treatment has been associated with many side effects in adults.
The first prospective trial evaluating the side effects of this treatment regimen in children with stage III melanoma was conducted at St. Jude. Fifteen patients, 18 years old and younger, who have stage III melanoma were enrolled on the study from May 1999 through January 2004. The results demonstrated that IFN-α-2b was well tolerated in children and that the side effects were similar but appeared to be less severe than those reported in adults. All toxicities were reversible by stopping the drug temporarily or modifying the dose.
This trial also highlights some of the challenges in the treatment of melanoma in children, including the rare incidence, low index of suspicion and often initial misdiagnosis of melanoma in children.
A report on these findings appears in the February 15 issue of the journal Cancer. The first author is Fariba Navid, MD, Hematology-Oncology. Other authors include Wayne Furman, MD, Hematology-Oncology; Bhaskar Rao, MD, Surgery; Sandra Kovach, Hematology-Oncology; Catherine Billups, Biostatistics; Alvida Cain, Hematology-Oncology; Jesse Jenkins, MD, Pathology; and Martin Fleming, MD, and Rex Amonette, MD (University of Tennessee). Alberto Pappo, MD, of the Hospital for Sick Children in Toronto is the paper’s senior author.
Last update: April 2005