Practical guidelines for the management of biochemotherapy-related toxicity in melanoma.
The combination of cisplatin-based chemotherapy with interleukin 2 (IL-2) and IFN-alpha, referred to as biochemotherapy or chemoimmunotherapy, has shown promising antitumor activity in patients with metastatic melanoma. Phase II studies have reported overall response rates ranging from 40 to 60%, with durable complete remissions in approximately 10% of the patients. Toxicity, however, is often severe and can be life-threatening if the healthcare team is not familiar with toxicity management. In this report, we briefly describe the clinical results of the most effective biochemotherapy regimens and provide a detailed description and management of the most common toxic effects, with emphasis on the concurrent biochemotherapy program initially developed at M. D. Anderson Cancer Center and currently being tested in a slightly modified version in two large-scale Intergroup Phase III trials.
Buzaid
A C
AC
Oncology Center, Hospital Sirio-Libanes, Sao Paulo, SP 01308-050, Brazil. buzaid@attglobal.net
Atkins
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004487:Edema / Q000139:chemically induced; D004890:Erythema / Q000139:chemically induced; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects; D008545:Melanoma / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D012878:Skin Neoplasms / Q000188:drug therapy*
D016898:Interferon-alpha; D007376:Interleukin-2; D002945:Cisplatin