Does chemosensitivity-assay-directed therapy have an influence on the prognosis of patients with malignant melanoma stage IV? A retrospective study of 14 patients with malignant melanoma stage IV.
OBJECTIVE
To evaluate the efficacy of chemosensitivity-testing directed chemotherapy in comparison with empirically chosen therapy regimens in patients with malignant melanoma stage IV.


METHODS
Retrospective study including 14 patients with histologically confirmed malignant melanoma and diagnosis of stage IV disease by routine diagnostic procedures. Patients in group A (n = 7) were treated according to their individual chemosensitivity testing results, whereas patients in group B (n = 7) received empirically chosen treatment regimens. Chemosensitivity testing was performed using a nonclonogenic ATP-TCA assay. For statistical analysis the Kaplan-Meier method was used to calculate survival curves. The log-rank test was performed to compare the overall survival according to treatment group, LDH level in serum and AJCC-category. To compare the distribution of sex, LDH level in serum and AJCC-category between the treatment groups, the Fisher exact test was used.


RESULTS
The median overall survival of group A exceeded the median overall survival of group B by 8 versus 3 months, respectively with a median overall survival of 5 months for the whole study population. LDH level in serum at study entry showed a strong correlation with overall survival, with normal LDH levels leading to a statistically significant longer survival (p = 0.006 for the log-rank test, respectively). Moreover, stage AJCC M1a/b yielded to a better prognosis compared with stage AJCC M1c (log-rank test p = 0.066; not statistically significant).


CONCLUSIONS
Chemosensitivity-assay directed therapy might be a useful tool in determining the optimized chemotherapeutic drug or drug combination in the individual patient and might contribute to a better prognosis in patients with metastatic melanoma stage IV.
Doerler
M
M
Department of Dermatology, Ruhr-University Bochum, Germany.
Hyun
J
J
Venten
I
I
Potthoff
A
A
Bartke
U
U
Serova
K
K
Hoextermann
S
S
Altmeyer
P
P
Brockmeyer
Norbert H
NH
D000328:Adult; D000368:Aged; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome