Annals of Surgical Oncology, 9(10):1023–1032
Mokenge P. Malafa, MD, Frida D. Fokum, PhD, LaKesha Smith, and Audreen Louis
Department of Surgery, Southern Illinois University
School of Medicine, Springfield, Illinois
Melanoma is the leading cause of death from cutaneous malignancies. Relapse after curative surgical treatment of melanoma remains a significant clinical challenge and accounts for most of the mortality from this disease. Since 1970, a number of approaches have been tried for postsurgical adjuvant therapy for melanoma. Except for the recent success of high-dose interferon alfa-2, no other treatment modality has demonstrated reproducible increases in relapse-free or overall survival in randomized, controlled trials. Despite the success of interferon alfa-2, problems remain with this agent. Prevention of relapse is not complete, and toxicity is significant. Therefore, new therapeutic strategies are needed.
Whereas the current strategy of adjuvant therapy aims at eliminating occult microscopic metastatic tumor cells, a novel treatment paradigm is chronic suppression of occult microscopic metastatic tumor cells so that they never become clinically relevant. This concept is termed the promotion of tumor dormancy because the microscopic tumor cells are maintained in a dormant state. Read full article