title: Biochemotherapy in patients with metastatic anorectal mucosal melanoma.
abstract: BACKGROUND
  Patients with metastatic anorectal melanoma generally have an unfavorable prognosis, but no effective systemic therapy has been reported.
  
  
  METHODS
  The authors retrospectively evaluated the medical records of all patients with metastatic anorectal melanoma treated with biochemotherapy between January 1991 and December 2001 at the University of Texas M. D. Anderson Cancer Center (Houston, TX).
  
  
  RESULTS
  The search yielded 18 patients. Of these patients, 14 had undergone treatment with cisplatin (CDDP), vinblastine (VB), dacarbazine (DTIC), interferon alpha-2b (IFN), and interleukin 2 (IL-2); 2 had undergone treatment with CDDP, VB, DTIC, and IFN; 1 had undergone treatment with CDDP, IFN, and IL-2; and 1 had undergone treatment with CDDP, VB, temozolomide, IFN, and IL-2. All IL-2 treatments were administered intravenously. The median follow-up time was 12.2 months (range, 3.5-43.7 months). Eight patients (44%) had major responses, including two (11%) complete responses (CRs). Three patients were lost to follow-up evaluation after the completion of treatment. The median time to progression among the 15 remaining patients was 6.2 months. Four patients, including 1 with a CR, were alive at their last documented follow-up visits (survival: 14.0, 20.7, 31.3, and 43.7 months, respectively). The median overall survival was 12.2 months. Among 13 patients who received biochemotherapy as first-line systemic therapy, 6 patients (46%) had major responses, including two (15%) CRs. The median time to progression for this group was 6.2 months, and the median overall survival was 12.9 months.
  
  
  CONCLUSIONS
  Biochemotherapy had substantial activity against metastatic anorectal melanoma and should be considered for use in the treatment of metastatic disease from primary anorectal melanoma.
authors.affiliation: Department of Melanoma Medical Oncology, The University of Texas M D Anderson Cancer Center, Houston Texas 77030, USA. kkim@mdanderson.org
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Kim
authors.forename: Angela M
authors.initials: AM
authors.lastname: Sanguino
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hodges
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Papadopoulos
authors.forename: Omar
authors.initials: O
authors.lastname: Eton
authors.forename: Luis H
authors.initials: LH
authors.lastname: Camacho
authors.forename: Lyle D
authors.initials: LD
authors.lastname: Broemeling
authors.forename: Marcella M
authors.initials: MM
authors.lastname: Johnson
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Ballo
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Gershenwald
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Paul F
authors.initials: PF
authors.lastname: Mansfield
authors.forename: Victor G
authors.initials: VG
authors.lastname: Prieto
authors.forename: Agop Y
authors.initials: AY
authors.lastname: Bedikian
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D011994:Recombinant Proteins; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014747:Vinblastine; D002945:Cisplatin