Chemohormone therapy of metastatic melanoma with megestrol acetate plus dacarbazine, carmustine, and cisplatin.
BACKGROUND
Chemotherapy with dacarbazine, carmustine, and cisplatin produces a modest objective response rate in melanoma. Megestrol acetate may ameliorate cachexia, abrogate drug resistance, and increase survival time in melanoma.


METHODS
Nineteen patients with metastatic melanoma (16 evaluable) treated with dacarbazine (220 mg/m2/day for 3 days, intravenously [IV]), cisplatin (25 mg/m2/day for 3 days IV) every 3 weeks, and carmustine (150 mg/m2 IV single dose every 6 weeks) together with megestrol acetate (160 mg/day by mouth continuously) starting 2 days before chemotherapy.


RESULTS
This regimen was well tolerated and resulted in a mean net weight gain of 1.45 kg. A 47% objective response rate was observed in all patients, including visceral sites of response, with a 39+ week median duration of response and median survival time of 16.7+ months in all evaluable patients.


CONCLUSIONS
In this small Phase II study, the authors showed that megestrol acetate may contribute to a high objective response rate and prolonged median survival when used with a chemotherapy regimen of dacarbazine, carmustine, and cisplatin.
Nathanson
L
L
Winthrop-University Hospital, Mineola, New York 11501.
Meelu
M A
MA
Losada
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight; D002100:Cachexia / Q000517:prevention & control; D002330:Carmustine / Q000008:administration & dosage* / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003606:Dacarbazine / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008535:Megestrol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019290:Megestrol Acetate; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors
D003606:Dacarbazine; D008535:Megestrol; D002945:Cisplatin; D019290:Megestrol Acetate; D002330:Carmustine