The authors respond to comments on their previous work analyzing adjuvant interferon for melanoma. They agree meta-analyses are important when individual trials lack power. However, they note that 1) the impact of interferon-α on disease-free survival varied substantially between reported trials, making interpretation difficult, and 2) many prior trials used suboptimal staging compared to current standards, so their results cannot be directly applied today.

1. Annals of Oncology 13: 1319–1323, 2002
Letters to the Editor
Reply to “Adjuvant interferon for substantially among the reported trials; therefore, this does not
permit a straightforward interpretation of the overall result.
melanoma”, by K. Wheatley & Secondly, the results from the great majority of previously
N. Ives published adjuvant trials were obtained in patient populations
that were suboptimally staged compared with the current
We thank Drs Wheatley and Ives for their valuable comments. standard (i.e. stratification for results on ulceration of primary
We entirely agree with their views on the necessity of per- and sentinel node biopsies). Consequently, the result of any
forming well-designed meta-analyses in situations where meta-analysis in which these staging techniques were not
individual trials are not sufficiently powered to detect a small
included cannot be blindly implemented into current practice.
but meaningful benefit of a specific intervention. In this
respect, we are looking forward to the peer-reviewed publica- C. J. A. Punt & A. M. M. Eggermont
tion of their meta-analysis on interferon-α (IFN-α) as adju-
University Medical Center St Radboud, Department of Medical
vant treatment in melanoma.
Oncology, Nijmegen, The Netherlands (E-mail: c.punt@onco.azn.nl)
However, two remarks should be made. First, the impact of
IFN-α on disease-free survival that the authors mention, varies DOI: 10.1093/annonc/mdf297
© 2002 European Society for Medical Oncology