Steven J. O'Day, MD

Despite more than 2 decades of active clinical study, the use of interferon as adjuvant therapy for high-risk melanoma remains controversial. The controversy has centered on dose, schedule, and toxicity of treatment. Agarwala and Kirkwood superbly summarize the clinical studies to date and highlight many of the salient issues relevant to clinicians.

The cachexia of malignancy is considered mediated through excess production of tumor necrosis factor–alpha and other cytokines. Thalidomide (Thalomid), a sedative/hypnotic, has been shown to inhibit tumor necrosis factor–alpha production.