Clinical evaluation of in vitro chemosensitivity testing: the example of uveal melanoma.
OBJECTIVE
Results from in vitro chemosensitivity testing recommend treosulfan/gemcitabine chemotherapy for the treatment of stage IV uveal melanoma.


METHODS
Twenty patients received treosulfan 3,500 mg/m2 followed by gemcitabine 1,000 mg/m2 on day 1 and day 8 repeated on day 29. In cases of prior chemotherapy only 75% of these dosages were used.


RESULTS
Without any patient achieving an objective response, 25% of patients (95% confidence interval, 8.6-49.1%) had stabilisation of disease. This stabilisation was associated with a prolonged median overall survival of 17 months compared with 7 months for the patients with progressive disease. First-line treatment was not associated with better response or survival although prognostic parameters did not significantly differ from that of other patients.


CONCLUSIONS
The results are disappointing and question the value of individualized chemotherapy based on in vitro assays.
Terheyden
P
P
Julius-Maximilians-University of Würzburg, Department of Dermatology, Josef-Schneider-Strasse 2, Building 13, 97080 Würzburg, Germany.
Bröcker
E B
EB
Becker
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002830:Choroid Neoplasms / Q000188:drug therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000201:enzymology / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D000093542:Gemcitabine
D003841:Deoxycytidine; C018404:treosulfan; D000469:Alkaline Phosphatase; D002066:Busulfan; D000093542:Gemcitabine