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Cutaneous Melanoma pp 1–20Cite as

Evolving Role of Chemotherapy-Based Treatment of Metastatic Melanoma

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Abstract

For many years the mainstay of treatment for metastatic melanoma, chemotherapy is much less used today. Although a small minority of patients benefit from cytotoxic agents, responses are often only short-lived, and only 1 in 50 to 100 patients survives 5 years with this approach. Multiple drug classes achieve similar results, including nitrosoureas, vinca alkaloids, taxanes, and platinums, but there are no randomized phase III trial data comparing any of these with supportive care. In contrast to other malignancies, attempts to improve outcomes through combining cytotoxic drugs have been unavailing, as have the addition of cytokines or of antiangiogenic therapies. Outside of clinical trials, cytotoxic chemotherapy remains an option for relatively fit patients who have progressed though immunotherapy and are resistant to or ineligible for targeted treatment. Its role, if any, in combination with checkpoint inhibitor immunotherapy remains to be determined.

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Authors and Affiliations

  1. Temple University School of Medicine, St. Luke’s University Hospital, Bethlehem, PA, USA

    Sanjiv S. Agarwala

  2. Department of Oncology, University of Oxford, Oxford, UK

    Mark R. Middleton

  3. Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA

    Michael B. Atkins

Authors
  1. Sanjiv S. Agarwala
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  2. Mark R. Middleton
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  3. Michael B. Atkins
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Correspondence to Mark R. Middleton .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA

    Charles Balch

  2. Division of Surgery, UT MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey Gershenwald

  3. Melanoma Institute of Australia, Wollstonecraft, Australia

    John Thompson

  4. Georgetown Medical Center, Washington, DC, USA

    Michael Atkins

  5. Melanoma and Skin Cancer Program, University of Pittsburgh, Pittsburgh, PA, USA

    John Kirkwood

  6. University of Sydney, Sydney, NSW, Australia

    Richard Kefford

  7. Department of Dermatology, Harvard Medical Center, Boston, MA, USA

    Arthur Sober

  8. Department of Dermatology, Memorial Sloan Kettering, New York, NY, USA

    Allan Halpern

  9. Department of Dermatology, University Hospital, Tübingen, Tübingen, Germany

    Claus Garbe

  10. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown NSW, Australia

    Richard Scolyer

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Agarwala, S.S., Middleton, M.R., Atkins, M.B. (2019). Evolving Role of Chemotherapy-Based Treatment of Metastatic Melanoma. In: Balch, C., et al. Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-46029-1_54-1

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