Metastatic melanoma: results of 'classical' second-line treatment with cytotoxic chemotherapies.
BACKGROUND
Metastatic melanoma is one of the most aggressive tumours, with a median survival that does not exceed 12 months. None of the cytotoxic first-line therapies have shown survival benefit in randomised clinical trials.


OBJECTIVE
To describe clinical benefit of second-line cytotoxic chemotherapy in the second line of treatment for metastatic melanoma.


METHODS
In a retrospective study, we analyse the outcome of patients with metastatic melanoma who had received two lines or more of cytotoxic treatments in four French dermato-oncology departments between 1999 and 2009.


RESULTS
We describe the outcomes for 109 patients. Most of these patients received dacarbazine for the first line of chemotherapy and fotemustine for the second line of chemotherapy (67.0 and 64.2%, respectively). A clinical benefit was observed in 24.1% of the patients and overall survival was 4.1 months after the second-line treatment. At least 23.8% of patients suffered from grade 3 or 4 toxicities. The presence of more than two sites of metastasis and an M1c staging according to the AJCC classification represented negative predictive factors of clinical benefit.


CONCLUSIONS
This study shows the modest benefit of a second line of cytotoxic chemotherapy in a nonselected population. If eligible, these patients should be proposed for ongoing clinical trials or for targeted therapies.
Department of Medical Oncology, Centre Régional de Lutte Contre le Cancer Eugène Marquis , Rennes , France.
Christophe
C
Perrin
Marc
M
Pracht
Karen
K
Talour
Henri
H
Adamski
Isabelle
I
Cumin
Marc
M
Porneuf
Marie
M
Talarmin
Habiba
H
Mesbah
Odile
O
Audrain
Aline
A
Moignet
Claudia
C
Lefeuvre-Plesse
Thierry
T
Lesimple
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents