title: Chemotherapy for Melanoma.
abstract: Prior to the recent therapeutic advances, chemotherapy was the mainstay of treatment options for advanced-stage melanoma. A number of studies have investigated various chemotherapy combinations in order to expand on the clinical responses achieved with single-agent dacarbazine, but these have not demonstrated an improvement in overall survival. Similar objective responses were observed with the combination of carboplatin and paclitaxel as were seen with single-agent dacarbazine. The combination of chemotherapy and immunotherapy, known as biochemo-therapy, has shown high clinical responses; however, biochemo-therapy has not been shown to improve overall survival and resulted in increased toxicities. In contrast, palliation and long-term responses have been observed with localized treatment with isolated limb perfusion or infusion in limb-isolated disease. Although new, improved therapeutic options exist for first-line management of advanced-stage melanoma, chemotherapy may still be important in the palliative treatment of refractory, progressive, and relapsed melanoma. We review the various chemotherapy options available for use in the treatment and palliation of advanced-stage melanoma, discuss the important clinical trials supporting the treatment recommendations, and focus on the clinical circumstances in which treatment with chemotherapy is useful.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, 16 Penn Tower, Philadelphia, PA, 19104, USA. Melissa.Wilson@nyumc.org.|Division of Hematology and Medical Oncology, Perlmutter Cancer Center, NYU School of Medicine, 160 E. 34th Street, Rm 915, New York, NY, 10016, USA. Melissa.Wilson@nyumc.org.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Wilson
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Abramson Cancer Center of the University of Pennsylvania, 3400 Civic Center Blvd, 1218 Penn Tower, Philadelphia, PA, 19104, USA. lynn.schuchter@uphs.upenn.edu.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Schuchter
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care; D043823:Taxoids / Q000627:therapeutic use; D000077204:Temozolomide
chemical_list: D043823:Taxoids; D003606:Dacarbazine; D016190:Carboplatin; D000077204:Temozolomide
keywords: Biochemotherapy; Chemotherapy; Dacarbazine; Melanoma; Temozolomide