Chemotherapy for malignant melanoma: combinations and high doses produce more responses without survival benefit.
In a consecutive series of studies, 164 patients with symptomatic and/or visceral metastatic malignant melanoma were treated with single agent vindesine, high dose melphalan with autologous bone marrow transplantation (AMBT), high dose BCNU with ABMT or the BOLD (bleomycin, vincristine, CCNU and DTIC) combination. The high dose treatments and the combination chemotherapy resulted in significantly higher response rates but no prolongation of survival. Factors associated with longer survival included the absence of visceral metastases, the absence of bulky disease and good performance status. For all treatments, life table estimates of survival at 1 and 2 years were only 10% and 4% respectively.
Section of Medicine, Royal Marsden Hospital, Sutton, Surrey, UK.
S
S
Lakhani
P
P
Selby
J M
JM
Bliss
T J
TJ
Perren
M E
ME
Gore
T J
TJ
McElwain
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D003606:Dacarbazine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008130:Lomustine / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D014750:Vincristine / Q000627:therapeutic use; D014751:Vindesine / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001761:Bleomycin; D014750:Vincristine; D008130:Lomustine; D003606:Dacarbazine; D008558:Melphalan; D014751:Vindesine