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Targeting Melanoma Sites in Vivo can Induce Complete Tumor Ablation and Prolong Patient Survival: An Exploratory Study

Abstract

E. George Elias and Bhuvnesh K Sharma

Dermal and subdermal metastases as well as primary invasive melanoma allow an excellent opportunity to study the effects of intralesional therapy. The therapy consisted of weekly intralesional administration of nontoxic doses of granulocyte-macrophage colony stimulating factor at 500 microgram, and in case of failure to establish complete tumor response at the injection sites in 4-6 weeks; weekly intralesional interleukin-2 at 18 million international units was substituted. The results revealed complete response in patients with multiple small in transit metastases ranging in size from few millimeters to one centimeter (n=4) for over 31-48 months, but not in any of the large sclerotic lesions of 2 centimeter or more (n=3). Complete responses were elicited for 6 months in one of two patients with distant metastases who had palpable subdermal tumors treated with granulacyte-macrophage colony stimulating factor. A patient with primary cutaneous melanoma with a satellite lesion and and a large regional lymph node metastasis received both cytokines in the skin sites, one week prior to surgery, had complete tumor necrosis, intense immune response at the injection sites and at the regional lymph nodes, with over 36 months disease free survival. This could be an affective new approach to tumor-specific adjuvant immunotherapy.