High-dose platinum combination therapy in pretreated patients with disseminated melanoma.
BACKGROUND
There are no accepted second-line therapeutic options in patients with disseminated melanoma. We evaluated toxicity and efficacy of a combination therapy with cisplatin and carboplatin.


METHODS
Fifty consecutively treated melanoma patients who were progressive after at least one previous chemotherapy received cisplatin 100 mg/m(2) intravenously and carboplatin 200 mg/m(2) intravenously in a 2-day regimen once every 28 days.


RESULTS
As grade 3 and 4 toxicities, leucopenia (14%), thrombopenia (10%), anaemia (22%), nausea (8%), nephrotoxicity (4%), hypomagnesaemia (80%) and hepatotoxicity (2%) were observed. Among 42 patients evaluable for response, 2 (4.7%) had complete remission, 4 (9.5%) had partial remission and 21 (50%) had stable disease. The median progression-free time was 17 weeks (range 0-156) for all patients and 39 weeks (range 17-156) for patients with objective responses. The median overall survival time for all patients from the start of therapy was 32 weeks (range 2-156). Melanoma inhibitory activity levels of <12 ng/ml before therapy were identified to be associated with a favourable survival.


CONCLUSIONS
Our results indicate that a combination of cisplatin and carboplatin in patients with pretreated disseminated melanoma has an acceptable safety profile, induces objective responses and may prolong survival.
Hofmann
Maja A
MA
Department of Dermatology and Allergy, Skin Cancer Center, Charité - Universitatsmedizin, Berlin, Germany. maja.hofmann@charite.de
Gabriel
Verena
V
Milling
Annett
A
Kiecker
Felix
F
Sterry
Wolfram
W
Trefzer
Uwe
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D016879:Salvage Therapy; D012878:Skin Neoplasms / Q000188:drug therapy*
D016190:Carboplatin; D002945:Cisplatin