title: Second-line chemotherapy of disseminated malignant melanoma with cystemustine at 60 mg/m2: a phase II trial.
abstract: Nitrosoureas possess some anti-tumor activity as a single agent in metastatic melanoma (MM). In a phase II trial, we evaluated the anti-tumor effects of cystemustine chemotherapy, a new nitrosourea, as a second-line treatment. Patients were required to have histologic evidence of disseminated MM and had failed in first-line chemotherapy. Treatment comprised cystemustine given at a dose of 60 mg/m every 2 weeks by a 15-min infusion. From February 1997 to September 1999, 22 patients (median age 66 years) were enrolled and were assessable. Two complete responses, one partial response, three stable diseases and 16 progressions were observed, giving an overall response rate of 13.6%. Median duration of response was 10 months (range 4-63). Median survival of responders and non-responders was 11 and 4 months, respectively. However, hematological toxicity, particularly thrombopenia, was a limiting factor for one-third of patients. We conclude that cystemustine at 60 mg/m is active in patients who progressed after one line of chemotherapy in advanced disease, and offers the possibility of complete responses and long durations of these responses.
authors.affiliation: Unité d'Oncologie Appliquée, Centre Jean Perrin, Centre Hospitalier et Universitaire, Clermont-Ferrand, France. Recherche.CLINIQUE@cjp.fr
authors.forename: Emilie
authors.initials: E
authors.lastname: Thivat
authors.forename: Xavier
authors.initials: X
authors.lastname: Durando
authors.forename: Michel
authors.initials: M
authors.lastname: D'Incan
authors.forename: Hervé
authors.initials: H
authors.lastname: Cure
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Mouret-Reynier
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Madelmont
authors.forename: Pierre
authors.initials: P
authors.lastname: Souteyrand
authors.forename: Philippe
authors.initials: P
authors.lastname: Chollet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000139:chemically induced; D009607:Nitrosourea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; C051263:N'-(2-chloroethyl)-N-(2-(methylsulfonyl)ethyl)-N'-nitrosourea