High-Dose Interferon Alfa in Treating Patients With Stage II or StageIII Melanoma

This randomized phase III trial is studying high dose interferon alfa to see how well it works compared to observation only in treating patients with stage II or stage III melanoma that has been completely removed by surgery.

Interferon alfa may interfere with growth of cancer cells. It is not yet known whether treatment with interferon alfa is more effective than observation alone for stage II or stage III melanoma that has been completely removed surgically.

Inclusion Criteria: Histologically confirmed primary melanoma of cutaneous origin Stage II (T3 N0 M0 1.5-4.0mm Breslow depth Clinically negative regional lymph node pathologic status unkown OR Histologically negative regional lymph nodes Stage III (T4 N0 M0) Greater than 4.0mm Breslow depth OR Stage III (T1-4 N1) One lymph node positive microscopically Patients must meet at least 1 of the following criteria T2b N0 primary melanoma 1.01-2.0mm with ulceration, node negative T3a-b N0 primary melanoma 2.01-4.0mm with and without ulceration, node negative T4a-b N0 primary melanoma > 4.0mm with and without ulceration, node negative T1aN1a-2a (microscopic)-primary melanoma of any thickness with microscopically positive lymph node (any number) Note EORTC patients who are node negative T2 or T3 are ineligible Patients with positive sentinel node should undergo complete lymphadenectomy of the nodal basin prior to study Must complete all primary therapy (wide excision with or without lymphadenectomy) and be randomized in the study within 84 days of wide excision No clinical, radiological/laboratory, or pathological evidence of incompletely resected melanoma or any distant metastatic disease No clinically palpable lymphadenopathy Age: 18 and over Performance Status: ECOG 0-1 Life expectancy: Not specified Hematopoietic WBC at least 3,000/mm^3 Platelet count at least 125,000/mm^3 Hematocrit at least 30% Hepatic: Bilirubin no greater than 2 times the upper limit of normal (ULN) AST, LDH, and Alkaline phosphate no greater than 2 times ULN If lactate dehydrogenase or alkaline phosphate is above normal, a contrast enhanced CT scan or MRI of the liver is required to document the absence of tumor Renal: BUN no greater than 33mg/dl OR Creatinine no greater than 1.8mg/dl Cardiovascular: No history of active ischemic heart disease No cerebrovascular disease No congestive heart failure(New York Heart Association class III or IV heart disease) Exclusion Criteria: Biologic Therapy: No prior immunotherapy including tumor vaccines, interferon, interleukins,levamisole, or other biologic response modifers for melanoma Chemotherapy No prior or concurrent chemotherapy Endocrine Therapy No concurrent systemic corticosteriods including oral steriods (i.e., prednisone, dexamethasone), topical steroid creams or ointments, or any steriod-containing inhalers. Radiotherapy: No Prior or concurrent radiotherapy Surgery: See Disease characteristics Other: No other concurrent immunosuppressive medications No other history of invasive melanoma No autoimmune disorders or conditions of immunosuppression No other concurrent or prior malignancies within past 5 years Cancer in situ Lobular carcinoma in situ of breast Carcinoma in situ of the cervix Atypical melanocytic hyperplasia or Clark 1 melanoma in situ Basal or squamous cell skin cancer No evidence of organic brain syndrome or significant impairment of basal cognitive function or any psychiatric disorder that would preclude study participation No other significant medical or surgical condition, or any medication or treatment regimens, that would interfere with study participation. Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 6 months after study