Biochemotherapy Offers New Hope for Late-Stage Melanoma Patients

The most lethal form of skin cancer, late-stage metastatic melanoma, is becoming less so with a new treatment offered at St. Luke's Episcopal Hospital. Biochemotherapy, which uses chemotherapy and biotherapy together to maximize the benefits of each, has been shown to reduce the mortality rate of late-stage metastatic melanoma by 10 percent.

"Biochemotherapy is a very encouraging new treatment option for people with advanced metastatic melanoma," says Dr. Sewa Legha, an oncologist at St. Luke's who has been investigating biochemotherapy for 10 years. "It has prolonged people's lives, while current treatments have shown little impact on the five-year survival rate."

About 47,000 people will develop melanoma in 2000, and 7,700 will die from the disease. Those who are diagnosed in Stage I of the disease - before the cancer has spread to other parts of the body - have a survival rate of nearly 100 percent. Patients diagnosed at Stage II can be cured, but the success rate lags behind that of Stage I melanoma.

For patients who aren't diagnosed until Stage III and IV - after the cancer has spread to the lymph nodes or internal organs - the outlook can be bleak. At Stage III, when the cancer has spread only to the lymph nodes, melanoma can be treated through surgery; but 70 percent of patients with Stage III melanoma eventually develop Stage IV.

Stage IV melanoma spreads via the lymphatic system, bloodstream, or both, to other parts of the body. The lungs, brain and liver are the most common sites. Patients diagnosed with Stage IV melanoma face grim odds: the five-year survival rate is less than 5 percent and the typical life span for someone with Stage IV ranges from six to nine months.

One of the most common treatments for Stage III and IV melanoma is chemotherapy, the use of anticancer drugs to kill cancer cells. Unfortunately, only a handful of the available chemotherapies have shown any temporary benefit.

Another treatment option is biotherapy, which boosts the immune system with chemicals that already exist in the body. The two primary biotherapy drugs are interferon and interlukin-2 (IL-2). Melanoma has been only slightly responsive to these drugs.

But Dr. Legha and other researchers across the country have combined chemotherapy and biotherapy to yield hopeful results. "Used in concert, these drugs have maximized the benefits of each other," Dr. Legha says. "And this regimen has reduced the mortality rate by 10 percent for Stage IV patients."

The combined therapy has shown some side effects, which include flu-like symptoms (caused by interferon) and low blood pressure (caused by IL-2). Still, Dr. Legha believes the benefits outweigh the discomfort for most patients.

"Biochemotherapy shows great promise," he says, "and I would encourage any doctor to consider it as treatment for a Stage IV patient."

Dr. Legha adds that researchers are now studying the use of biochemotherapy in Stage III patients, with the hopes that the success rate will be even greater. "This will likely be the standard therapy for Stage III patients in five to 10 years," he says.

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©2006 Texas Medical Center

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