BACKGROUND: Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis and a paucity of effective treatment options. We assessed the safety and efficacy of intrathecal interleukin-2 (IT IL-2) in metastatic melanoma patients with LMD.
METHODS: We reviewed the outcomes of 43 consecutive metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug Study. All patients had evidence of LMD based on cerebrospinal fluid (CSF) cytology, radiology, and/or surgical pathology. IL-2 at a dose of 1.2 mIU was administered intrathecally via Ommaya reservoir up to 5 times per week in the inpatient setting for 4 weeks; patients with good tolerance and clinical benefit received maintenance IT IL-2 every 1 to 3 months thereafter.
RESULTS: The median age of the patients was 46.7 years (range 18-71); 32 (74%) were male; 31 (72%) had positive CSF cytology, and 39 (91%) had radiographic evidence of LMD. Median overall survival (OS) from initiation of IT IL-2 was 7.8 months (range, 4.7-16.3 months), with 1-, 2-, and 5-year OS rates of 36%, 26%, and 13%. The presence of neurological symptoms (HR 2.1, p=0.03), positive baseline CSF cytology (HR 4.1, p=0.001) and concomitant use of targeted therapy (HR 3.0, p=0.02) were associated with shorter OS on univariate analysis. All patients developed symptoms due to increased intracranial pressure. There were no treatment-related deaths.
CONCLUSION: IT IL-2 treatment is safe and achieves long-term survival in a subset of metastatic melanoma patients with LMD.
","abstract_html":"<p><strong>BACKGROUND:</strong> Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis and a paucity of effective treatment options. We assessed the safety and efficacy of intrathecal interleukin-2 (IT IL-2) in metastatic melanoma patients with LMD.</p> <p><strong>METHODS:</strong> We reviewed the outcomes of 43 consecutive metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug Study. All patients had evidence of LMD based on cerebrospinal fluid (CSF) cytology, radiology, and/or surgical pathology. IL-2 at a dose of 1.2 mIU was administered intrathecally via Ommaya reservoir up to 5 times per week in the inpatient setting for 4 weeks; patients with good tolerance and clinical benefit received maintenance IT IL-2 every 1 to 3 months thereafter.</p> <p><strong>RESULTS:</strong> The median age of the patients was 46.7 years (range 18-71); 32 (74%) were male; 31 (72%) had positive CSF cytology, and 39 (91%) had radiographic evidence of LMD. Median overall survival (OS) from initiation of IT IL-2 was 7.8 months (range, 4.7-16.3 months), with 1-, 2-, and 5-year OS rates of 36%, 26%, and 13%. The presence of neurological symptoms (HR 2.1, p=0.03), positive baseline CSF cytology (HR 4.1, p=0.001) and concomitant use of targeted therapy (HR 3.0, p=0.02) were associated with shorter OS on univariate analysis. All patients developed symptoms due to increased intracranial pressure. There were no treatment-related deaths.</p> <p><strong>CONCLUSION:</strong> IT IL-2 treatment is safe and achieves long-term survival in a subset of metastatic melanoma patients with LMD.</p>","abstract_has_math":false,"creators":["Glitza Oliva, Isabella C"],"institution":null,"degree_name":"Masters of Science (MS)","degree_level":"Thesis (MS)","degree_discipline":null,"degree_department":null,"school":null,"contributors":["Patrick Hwu","Michael A. Davies","Robert Bast"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016-12-01T08:00:00Z","date_published":"2016-12-01T08:00:00Z","updated_at":"2026-07-24T05:48:47Z","subjects":["melanoma","interleukin-2","intrathecal","leptomeningeal disease","Medicine and Health Sciences"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.library.tmc.edu/utgsbs_dissertations/716","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Patrick Hwu","Michael A. Davies","Robert Bast"]},{"key":"dc:creator","label":"Author","values":["Glitza Oliva, Isabella C"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2016-11-26T08:00:00Z"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Thesis (MS)"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Masters of Science (MS)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["melanoma","interleukin-2","intrathecal","leptomeningeal disease","Medicine and Health Sciences"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digitalcommons.library.tmc.edu/utgsbs_dissertations/716"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["BACKGROUND: Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis and a paucity of effective treatment options. We assessed the safety and efficacy of intrathecal interleukin-2 (IT IL-2) in metastatic melanoma patients with LMD.
METHODS: We reviewed the outcomes of 43 consecutive metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug Study. All patients had evidence of LMD based on cerebrospinal fluid (CSF) cytology, radiology, and/or surgical pathology. IL-2 at a dose of 1.2 mIU was administered intrathecally via Ommaya reservoir up to 5 times per week in the inpatient setting for 4 weeks; patients with good tolerance and clinical benefit received maintenance IT IL-2 every 1 to 3 months thereafter.
RESULTS: The median age of the patients was 46.7 years (range 18-71); 32 (74%) were male; 31 (72%) had positive CSF cytology, and 39 (91%) had radiographic evidence of LMD. Median overall survival (OS) from initiation of IT IL-2 was 7.8 months (range, 4.7-16.3 months), with 1-, 2-, and 5-year OS rates of 36%, 26%, and 13%. The presence of neurological symptoms (HR 2.1, p=0.03), positive baseline CSF cytology (HR 4.1, p=0.001) and concomitant use of targeted therapy (HR 3.0, p=0.02) were associated with shorter OS on univariate analysis. All patients developed symptoms due to increased intracranial pressure. There were no treatment-related deaths.
CONCLUSION: IT IL-2 treatment is safe and achieves long-term survival in a subset of metastatic melanoma patients with LMD.
"]},{"key":"dc:title","label":"Title","values":["Long-Term Survival In Metastatic Melanoma Patients With Leptomeningeal Disease Treated With Intrathecal Interleukin-2"]}]}],"canonical_facts":{"dc:contributor":["Patrick Hwu","Michael A. Davies","Robert Bast"],"dc:creator":["Glitza Oliva, Isabella C"],"dc:date.available":["2016-11-26T08:00:00Z"],"dc:description.abstract":["BACKGROUND: Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis and a paucity of effective treatment options. We assessed the safety and efficacy of intrathecal interleukin-2 (IT IL-2) in metastatic melanoma patients with LMD.
METHODS: We reviewed the outcomes of 43 consecutive metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug Study. All patients had evidence of LMD based on cerebrospinal fluid (CSF) cytology, radiology, and/or surgical pathology. IL-2 at a dose of 1.2 mIU was administered intrathecally via Ommaya reservoir up to 5 times per week in the inpatient setting for 4 weeks; patients with good tolerance and clinical benefit received maintenance IT IL-2 every 1 to 3 months thereafter.
RESULTS: The median age of the patients was 46.7 years (range 18-71); 32 (74%) were male; 31 (72%) had positive CSF cytology, and 39 (91%) had radiographic evidence of LMD. Median overall survival (OS) from initiation of IT IL-2 was 7.8 months (range, 4.7-16.3 months), with 1-, 2-, and 5-year OS rates of 36%, 26%, and 13%. The presence of neurological symptoms (HR 2.1, p=0.03), positive baseline CSF cytology (HR 4.1, p=0.001) and concomitant use of targeted therapy (HR 3.0, p=0.02) were associated with shorter OS on univariate analysis. All patients developed symptoms due to increased intracranial pressure. There were no treatment-related deaths.
CONCLUSION: IT IL-2 treatment is safe and achieves long-term survival in a subset of metastatic melanoma patients with LMD.
"],"dc:identifier":["https://digitalcommons.library.tmc.edu/utgsbs_dissertations/716"],"dc:subject":["melanoma","interleukin-2","intrathecal","leptomeningeal disease","Medicine and Health Sciences"],"dc:title":["Long-Term Survival In Metastatic Melanoma Patients With Leptomeningeal Disease Treated With Intrathecal Interleukin-2"],"thesis:degree_level":["Thesis (MS)"],"thesis:degree_name":["Masters of Science (MS)"]},"updated_at":"2026-07-24T05:48:47Z"}