The interferons are a family of proteins produced by the body’s immune system. They serve a variety of purposes, including helping to defend against viruses, like influenza. There is good laboratory evidence, and some clinical evidence, that they also work to kill melanoma cells, both directly and also by stimulating the immune system to attack the cancer cells. The main interferon that works against melanoma is called interferon-alpha.

For over 10 years a vigorous debate has taken place between melanoma specialists as to whether or not interferon protects people from recurrence of melanoma, once they have had a melanoma removed.

Throughout the 1980’s and '90’s a series of clinical trials was performed in the USA and Europe to investigate the use of interferon-alpha in reducing the risk of recurrence after high-risk melanoma had been removed. Unfortunately, the results of those trials were very confusing due to different groups of patients tested, different dosage schedules chosen, and other factors.

There is now fairly good evidence that low dose and intermediate dose interferon have little effect, but a serious question mark remains over the use of high-dose interferon, or “HDI”. Three trials suggest that HDI significantly prolongs the time between the initial melanoma and any relapse that may occur. However, HDI involves giving the drug via a drip into the vein daily for a month as an outpatient. The side-effects of this treatment are considerable, and may include fevers, fatigue, muscle pains and mood disturbance. Many of these side-effects can be controlled and modified, but patients receiving the treatment require careful monitoring and special nursing care.

For this reason it is enormously important that further research is undertaken to find out whether this treatment protects against melanoma recurrence. If so, most patients would gladly tolerate a month of relative discomfort for the protection gained.

The MIA, including its three major clinics, at Royal Prince Alfred, Westmead, and Newcastle’s Mater Hospitals, have joined the large US Eastern Co-operative Oncology Group (ECOG) in a large clinical trial that will answer this vital question. Patients who have melanomas greater than 1.5 mm in thickness, including those with limited lymph node involvement, will be eligible to enter the trial and be randomly allocated to receive either one month of high dose interferon or our current standard treatment, which is careful observation. This trial is supported by the National Cancer Institute, USA, and Schering Plough, Australia.