Question:
What are the best experimental protocols for treatment of metastatic
melanoma? What are the best treatment centers?
Answer:
The "IMHO" in the beginning of my posting indicates that I was merely
expressing a personal opinion or hypothesis, which is open for discussion,
which has now started. The statement itself is true, I do have that
opinion. With "best" in this connection I meant the most promising of the
therapies I have some information about. In retrospect I agree that I
could have chosen a better wording.
I wonder, if you possibly point me to some information sources about IL-2,
I don't have much data about the results of using IL-2 based treatment
against melanoma, it could be as promising or more promising than vaccine
based therapies. Perhaps one day somebody could even combine IL-2,
vaccine, and nutritional supplements into a single therapy. Dr. Tallberg
already combines the two last ones, and shows in the study, the summary of
which follows, that both have significant merits as separate therapies and
that the combined therapy works better that either of the separate
therapies:
"Effect of Bio-Therapy and Specific Active Immunotherapy on Malignant
Melanoma, and Certain Other Forms of Cancer
Th. Tallberg
(published in June 1993 in "Deutsche Zeitschrift fur Onkologie, Journal
of Onclogy")
Summary
-------
As cancer can be the expression of a longstanding metabolic deficiency,
the aim was primaly to try to correct this systemic deficiency, and
also to stimulate the defence system of the patient by means of active
specific immunotherapy using autologous polymerized tumour tissue.
Thirteen stage III-IV melanoma patients have been treated with the full
bioimmunotherapy schedule, entailing the oral administration of the
trace element salts of chromium, vanadium, selenium, wolfram, tin and
magnesium. Amino acids glucine and sodium glutamate together with
aspirin were given with physiological doses of the vitamins A,B,C,D,K,
and folic acid. Repeated vaccinations against influenza A and B strains
were also given, and we recommend a diet containing neurogenic lipids
which are supposed to be involved in the cell differentiational
control. The aim of these metabolic supportive measures was to prevent
further malignant cell transformation. Specific active immunotherapy
was given as repeated intradermal injections using autologous tumour
polymer particles. The mean followup time of these stage III-IV
patients is over 100 months. Only 5 of the have died. The mean survival
time for them was over 65 months.
103 patients stage I-II, were treated in a randomized study after the
primary melanoma tumour had been extirpated. This study was designed to
analyze the part effect of the treatment consisting of only the trace
element salts and regular influenza vaccinations on survival and
appearance of recurrent disease. A 5-year study showed significantly
(p=0.0015) improved clinical results with fewer patients with recurrent
disease and very much delayed recurrences.
Two ocular melanoma patients have also been treated with the full
supportive measures, but without active immunotherapy, because of the
lack of polymerized tumour material. Both have survived for a mean
follow-up time of over 45 months.
Comparison between melanoma patients with recurrent disease in full
bioimmunotherapy with survival of patients in the randomized study
given partial biotherapy after having suffered relapse is very highly
significant (p < 0.0001) in favour of the clinical result of our active
specific bioimmunotherapy. Patients, in bio-immunotherapy, suffering
from other forms of cancer have also shown encouraging clinical
results."
In Dr. Tallberg's later study "Biological Cancer Treatment Based on
Biomodulation and Active Specific Immunotherapy" published 1994 in the same
journal the one mentioned above, the abbreviated (I've left out the
patient's age, sex, site of primary melanoma and site of recurrences)
clinical data for the stage III-IV cutaneous melanoma patients, with all
the patients which were alive in the previous study still surviving and
cancer free, is presented.
patient no of recurrences stage survival time clinical condition
(months)
------- ----------------- ----- ------------- -------------------
1 three times IVA 262 good, no sign of recurrence
2 once III 252 good, no sign of recurrence
3 once III 156 good, no sign of recurrence
4 twice IVA 83 dead with melanoma
5 three times IVB 65 dead without autopsy
6 seven times IVB 78 dead without autopsy
7 four times IVB 58 dead without autopsy
8 three times IVB 110 good, no sign of recurrence
9 once III 100 good, no sign of recurrence
10 three times IVA 98 good, no sign of recurrence
11 three times IVA 72 good, no sign of recurrence
12 twice IVB 34 dead without autopsy
13 twice IVA 42 good, no sign of recurrence
Patients 9 and 13, as well as two patients who suffered from ocular
melanoma have successfully been treated according to the full schedule of
supportive measures alone, without backing of active specific
immunotherapy. The reason for this was that in these 4 cases there was not
sufficient melanoma tumour material to mahe the autologuous vaccine.
