Complex Combination Biochemotherapy Regimen in Advanced Metastatic Melanoma in a Non-intensive Care Unit: Toxicity or Benefit?

• Published in: Japanese journal of clinical oncology 2007-03, Vol.37 (3), p.224-229
• Main Authors: Hofmann, Maja A., Sterry, Wolfram, Trefzer, Uwe
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - administration & dosage; Antineoplastic Agents - toxicity; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Alkylating - toxicity; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Agents, Phytogenic - toxicity; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - toxicity; chemoimmunotherapy; Cisplatin - administration & dosage; Cisplatin - toxicity; Dacarbazine - administration & dosage; Dacarbazine - toxicity; Drug Administration Schedule; Female; Humans; Interferon-alpha - administration & dosage; Interferon-alpha - toxicity; Interleukin-2 - administration & dosage; Interleukin-2 - toxicity; Male; Melanoma - drug therapy; Melanoma - mortality; metastatic melanoma; Middle Aged; Retrospective Studies; Skin Neoplasms - drug therapy; Skin Neoplasms - mortality; survival; toxicity; Treatment Outcome; Vindesine - administration & dosage; Vindesine - toxicity
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hym009

Background There is currently no chemotherapy or chemoimmunotherapy regimen that has shown impact on survival in patients with metastatic melanoma. Different biochemotherapy protocols showed promise with high response rates, but again without significant impact on survival. Methods We report the results of a retrospective analysis of a regimen consisting of dacarbazine, cisplatin, vindesine, interleukin-2 and interferon-α2b in 25 consecutively treated patients with regard to toxicity, efficacy and practicability. The treatment was performed on a regular dermatological ward. Results Grade III and IV toxicities were mainly haematological, with few cases of infection because of neutropenia seen. Best overall responses were CR 2/25, PR 2/25 and SD 9/25. The median progression free interval was 4 months (range 0–19) for all patients and the median survival time was 12 months (range 2–26). From a safety and practical point of view, there was no draw-back on treating patients in a non-intensive care unit. The median survival time is in the range of the one reported for monochemotherapy regimen. While there are some responding patients, the responses are short lived and go in parallel with high toxicity and impaired performance status. Conclusion This complex and highly toxic chemoimmunotherapeutic regimen should not be considered as standard therapy in patients with metastatic malignant melanoma.