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This sequential immunotherapy-chemotherapy regimen is being evaluated for the treatment of metastatic malignant melanoma. It consists of high-dose interleukin-2 (aldesleukin), a recombinant cytokine that stimulates the proliferation and activation of T cells and natural killer cells by binding to the IL-2 receptor, followed by intermittent low-dose temozolomide, an oral alkylating agent. The treatment strategy, pioneered at the Milton S. Hershey Medical Center, is based on the hypothesis that temozolomide can enhance the efficacy of IL-2 by reducing the population of immunosuppressive T-regulatory cells, thereby providing a synergistic effect in patients who have failed prior cytokine therapy.
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