Adjuvant systemic therapy for melanoma

Determining potential treatment benefits for melanoma patients receiving adjuvant interferon

This tool is intended for use by doctors. The results of the tool alone should never be used to determine a patient's medical treatment. This tool is a statistical model and is not a substitute for an individual treatment plan developed by a doctor with personal knowledge of a specific patient. Other important factors that must be considered include the patient's own medical history, the patient's family medical history and the experience, knowledge, and training of the doctor. Doctors should discuss these results in person with their patients as part of their overall treatment recommendations and should not advise patients to access the tool on their own. Please note that the potential benefits from adjuvant interferon are based on published data from the Eastern Cooperative Oncology Group.

This tool was created exclusively for physician use by Drs. Stephan D. Thomé, Charles L. Loprinzi and Michael P. Heldebrant. It was introduced in their manuscript, "Determination of potential adjuvant systemic therapy benefits for patients with resected cutaneous melanomas" published in the September 2002 issue of the Mayo Clinic Proceedings.

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Estimates for baseline prognosis and 5-year outcomes

Five-year baseline prognosis (chance of being alive without recurrent cancer if no adjuvant therapy is given) based on ulceration, number of nodes, tumor depth and nodal bulk.

Stage Value:

Five-year baseline prognosis with surgery alone:

55%

Five-year prognosis with adjuvant Interferon:

25%

Adjuvant interferon therapy was associated with a hazard ratio of 0.7 (i.e., a 30 percent overall reduction of the risk) for overall and disease-free survival based on a recent pooled analysis of trials with a high-dose interferon arm. This estimate was used for the calculations above.

*Based on estimated proportional benefits in patients with involved lymph nodes.

The rationale for development of, and details regarding, this tool are provided in the study "Improving the Understanding of Adjuvant Therapy Benefits for Colon Cancer: A Prognostic Tool Developed From a Pooled Analysis" presented at the 2003 annual session of the American Society of Clinical Oncology (ASCO).