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To the Editor—In their article on immunotherapy, Drs Ballow and Nelson¹ omit an important clinical application of interferon therapy. Adjuvant interferon alfa-2b for melanoma is now a well-established standard of care among oncologists. The Eastern Cooperative Oncology Group trial EST 1684² demonstrated that, after resection, patients with lesions of Breslow depth more than 4 mm and any lesion associated with positive regional lymph nodes, either clinically or pathologically, experienced up to a 42% increase in disease-free survival with adjuvant interferon therapy. This also represents an overall benefit for patients with high-risk lesions.

Christopher Nauman, MD
Boston University School of Medicine
Boston, Mass

1. Ballow M, Nelson R. Immunopharmacology: immunomodulation and immunotherapy. JAMA. 1997;278:2008-2017. FREE FULL TEXT 2. Kirkwood JM, Strawderman MH, Ernstoff MS, Smith TJ, Borden EC, Blum RH. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: The Eastern Cooperative Oncology Group trial EST 1684. J Clin Oncol. 1996;14:7-17. ABSTRACT

In Reply.—Our article in the JAMA Primer on Allergic and Immunologic Diseases was not meant as an exhaustive review on the subject of immunotherapy. Many more therapeutic studies have been published on the various immunomodulators and biological-response modifiers than we were able to review in our . . . [Full Text of this Article]

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Immunopharmacology: Immunomodulation and Immunotherapy
Mark Ballow and Robert Nelson
JAMA. 1997;278(22):2008-2017.
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