title: Clinical results using biochemotherapy as a standard of care in advanced melanoma.
abstract: Phase II studies of biochemotherapy in metastatic melanoma patients have reported response rates of 47-63%. Even though these were highly selected patients, we were intrigued by these promising response rates and began using this regimen as standard care in advanced melanoma patients. We report the results of the first 65 patients with AJCC stage IV melanoma (n = 57) or unresectable stage III (n = 8) melanoma treated with concurrent biochemotherapy at Memorial Hospital. Treatment was repeated every 3 weeks and patients were assessed for antitumour effects after every other cycle. The overall response rate among the 63 patients evaluable for response was 29% (three complete responses, 15 partial responses). The median duration of responses was 3.7 months. The response rate among previously treated and previously untreated patients was 6% and 38%, respectively. The estimated median survival for all patients was 8.5 months; the median survival for previously untreated patients was 9.2 months. Tumour response did not correlate with survival. Our experience, which is a retrospective evaluation, does not provide support for the routine use of biochemotherapy as standard treatment. The low response rate among previously treated patients indicates that biochemotherapy is not useful as second-line therapy.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, NY 10021, USA. chapmanp@mskcc.org
authors.forename: P B
authors.initials: PB
authors.lastname: Chapman
authors.forename: K S
authors.initials: KS
authors.lastname: Panageas
authors.forename: L
authors.initials: L
authors.lastname: Williams
authors.forename: J D
authors.initials: JD
authors.lastname: Wolchok
authors.forename: P O
authors.initials: PO
authors.lastname: Livingston
authors.forename: C
authors.initials: C
authors.lastname: Quinn
authors.forename: W-J
authors.initials: WJ
authors.lastname: Hwu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000191:economics; D003362:Cost-Benefit Analysis; D003606:Dacarbazine / Q000008:administration & dosage; D016527:Drug Costs; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000191:economics / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000627:therapeutic use*; D015993:Life Tables; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011994:Recombinant Proteins; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000191:economics; D016019:Survival Analysis; D017211:Treatment Failure; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007376:Interleukin-2; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D014747:Vinblastine; D003606:Dacarbazine; D002945:Cisplatin