Summary
First-line treatments of metastatic melanoma are usually decarbazine (DTIC) and/or α-interferon based, with response rates in the range of at most 20–30%. In this study, initiated, in fact, by a temporary DTIC shortage in the country, we have assessed the efficacy and toxicity of a vinblastine — carboplatin regimen for metastatic melanoma. The regimen was subsquently applied in two cohorts of patients: a chemotherapy-naive one and in DTIC failures (because the regimen was claimed non-cross-resistant). The regimen contained 6 mg/m2 vinblastine on d 1 and 450 mg/m2 carboplatin on d 1 for 3 wk. In the chemotherapy-naïve cohort, 50 patients were included, 29 males and 21 females, median age 54 yr (range: 33–68), performance status 0+1 for 26 patients and 2+3 for 24 patients. Forty-eight patients were evaluable for activity. The response was the following: complete response (CR), 1/48 (2%); partial response (PR), 13/48 (27%); stable disease (SD), 20/48 (42%); progressive disease (PD), 14/48 (29%). The overall response rate was 14/48 (29%). The median response duration was 7 mo (range: 3–14); the median time to progression was 4 mo (range: 2–14). Toxicity included granulocytopenia and thrombocytopenia grade IV in 3/50 patients and nausea grade II in 8/50 patients. In the DTIC-failures cohort, 58 patients were included, 38 males and 20 females, median age 51 yr (range: 20–65), performance status 0+1 for 25 patients and 2+3 for 33 patients. All 58 patients were evaluable for activity. The response was the following: CR 3/58 (5%), PR 4/58 (7%), SD 10/58 (17%), PD 41/58 (71%). The overall response rate was 7/58 (12%). The median response duration was 11 mo (range: 3–24); the median time to progression was 4 mo (range: 2–24). Toxicities included granulocytopenia grade IV in 4/58 patients and nausea grade II in 4/58 patients. Thus, despite the fact that the regimen achieved a response rate comparable to DTIC in a first-line setting, the lack of cross-resistance did not prevent it from being of limited activity in DTIC failures, although, even in this group, several long-lasting responses and stabilizations were noted.
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References
Balch, C.M., et al. (1997). Cutaneous melanoma, in Cancer: Principles and Practice of Oncology, 5th ed. (V.T. De Vita, et al. eds.), pp. 1947–1994, Lippincot-Raven, New York.
Chapman, P.B., et al. (1999). Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J. Clin. Oncol. 17(9):2745–2751.
Mastrangelo, M.J., Bellet, R.F. and Berd, D. (1979). Immunology and immunotherapy of human cutaneous malignant melanoma, in Human Malignant Melanoma (W.H. Clarck, Jr., L.I. Goldman, and M.J. Mastrangelo, eds.), p. 355, Grune and Stratton, New York.
Bajetta, E., et al. (1990). Phase II study of interferon alpha 2a and dacarbazine in advanced melanoma. Am. J. Clin. Oncol. 13:405–409.
Al-Sarraf, M., et al. (1982). Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma, a SWOG study. Cancer Treat. Rep. 66:31–35.
Bajetta, E., Rovej, R., Buzzoni, R., Vaglini, M. and Bonadonna, G. (1982). Treatment of advanced malignant melanoma with vinblastine, bleomycin, and cisplatin. Cancer Treat. Rep. 66(6):1299–1302.
Creagan, E.T., et al. (1999). Phase III clinical trial of the combination of cisplatin, dacarbazine, and carmustine with or without tamoxifen in patients with advanced malignant melanoma. J. Clin. Oncol. 17(6):1884–1890.
McDermott, D.F., et al. (2000). A phase I pilot trial of concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin 2, and interferon alpha-2B in patients with metastatic melanoma. Clin. Cancer Res. 6(6):2201–2208.
Evans, L.M., Casper, E.S. and Rosenbluth, R. (1987). Phase II trial of carboplatin in advanced malignant melanoma. Cancer Treat. Rep. 71(2):171–172.
Casper, E.S. and Bajorin, D. (1990). Phase II trial of carboplatin in patients with advanced melanoma. Invest. New Drugs 8(2):187–190.
Mulder, N.H., Sleijfer, D.T., de Vries, E.G., Schraffordt-Koops, H. and Willemse, P.H. (1990). Phase II study of carboplatin and cytosine arabinoside in patients with disseminated malignant melanoma. J. Cancer Res. Clin. Oncol. 116(3):301–302.
Miles, A.B., Hoogstratten, B., Staquet, M. and Winkler, A. (1981). Reporting results of cancer treatment. Cancer 47:207–214.
Cantore, M., et al. (1994). Intra-arterial hepatic carboplatin-based chemotherapy for ocular melanoma metastatic to the liver. Report of a phase II study. Tumori 80(1):37–39.
Chang, A., Hunt, M., Parkinson, D.R., Hochster, H. and Smith T.J. (1993). Phase II trial of carboplatin in patients with metastatic malignant melanoma. Am. J. Clin. Oncol. 16(2):152–155.
Agarwala, S.S., Ferri, W., Gooding, W. and Krikwood, J.M. (1999). A phase III randomized trial of dacarbazine and carboplatin with and without tamoxifen in the treatment of patients with metastatic melanoma. Cancer 85(9):1979–1984.
Mohammed, M.Q., Photiou, A., Shah, P. and Retsas, S. (1995). Activity of platinum drugs against melanoma cell lines: is it modulated in vitro in the presence of tamoxifen? Anticancer Res. 15(4):1319–1326.
Ron, I.G., et al. (1994). A phase II study of combined administration of dacarbazine and carboplatin with home therapy of recombinant interleukin-2 and interferon-alpha 2a in patients with advanced malignant melanoma. Cancer Immunol. Immunother. 38(6):379–384.
Kirchner, H.H., Atzpodien, J. and Poliwoda, H. (1996). Chemo-immunotherapy in advanced malignant melanoma: carboplatin and DTIC or cisplatin, DTIC, BCNU and tamoxifen followed by immunotherapy with interleukin 2 and interferon alpha-2a. Med. Klin. 91(Suppl. 1.3):44–49.
Gause, B.L., et al. (1998). A phase II study of carboplatin, cisplatin, interferon-alpha, and tamoxifen for patients with metastatic melanoma. Cancer Invest. 16(6):374–380.
Bafaloukos, D., et al. (1998). Subcutaneous low doses of interleukin-2 and recombinant interferon alpha with carboplatin and vinblastine in patients with advanced melanoma. Oncology 55(1):48–52.
Propper, D.J., et al. (2000). Phase II study of second-line therapy with DTIC, BCNU, cisplatin and tamoxifen (Dartmouth regimen) chemotherapy in patients with malignant melanoma previously treated with dacarbazine. Br. J. Cancer 82(11):1759–1763.
Eton, O., et al. (2000). A phase II study of “decrescendo” interleukin-2 plus interferon-alpha-2a in patients with progressive metastatic melanoma after chemotherapy. Cancer 88(7):1703–1709.
Bajetta, E., Buzzoni, R. and Vicario, G. (1995). Combined carboplatin and cytosine arabinoside in metastatic melanoma refractory to dacarbazine. Tumori 81(4):238–240.
Swinnen, L.J., Ellis, N.K. and Erickson, L.C. (1991). Inhibition of cis-diammine-1, 1-cyclobutane dicarboxylatoplatinum (II)-induced DNA interstand cross-link removal and potentiation of cis-diammine-1, 1-cyclobutane dicarboxylatoplatinum (II) cytotoxicity by hydroxyurea and 1-beta-d-arabinofuranosylcytosine. Cancer Res. 51(8):1984–1989.
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Jelić, S., Babović, N., Stamatović, L. et al. Vinblastin-carboplatin for metastatic cutaneous melanoma as first-line chemotherapy and in dacarbazine failures. Med Oncol 18, 189–195 (2001). https://doi.org/10.1385/MO:18:3:189
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DOI: https://doi.org/10.1385/MO:18:3:189