An update on pegylated IFN-α2b for the adjuvant treatment of melanoma

For patients with localized melanoma, excision of the primary tumor, including lymphadenectomy for nodal metastases, is standard treatment. However, patients with large primary tumors (stage IIB and IIC) or stage III melanoma have a relatively poor prognosis owing to the high risk of recurrence. High-dose IFN-alpha 2b and pegylated IFN-alpha 2b (PEG-IFN-alpha 2b) are the only approved options for adjuvant therapy of stage III melanoma, but the lack of comparative data has led to considerable confusion in choosing between these options. In this article, current evidence regarding the pharmacokinetics, efficacy, safety and tolerability of adjuvant PEG-IFN-alpha 2b in patients with melanoma is reviewed, with frequent reference to and comparisons with data using IFN-alpha 2b. Particular focus is given to the pharmacokinetic differences between IFN-alpha 2b and PEG-IFN-alpha 2b and their implications for the treatment of high-risk patients. In addition, emerging evidence suggests that PEG-IFN-alpha 2b therapy may provide clinically significant overall survival benefit for selected high-risk patients.